Meta-analysis confirms achieving pathological complete response after neoadjuvant chemotherapy predicts favourable prognosis for breast cancer patients

Kong, Xiangnan; Moran, Meena S.; Zhang, Ning; Haffty, Bruce G.; Yang, Qifeng

doi:10.1016/j.ejca.2011.06.014

Cited by 227 publications

(162 citation statements)

References 27 publications

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“…Increasingly, patients with operable disease are also considered for neoadjuvant treatment to monitor the "in vivo" effect of therapy. However, without effective rescue strategies for nonresponders, the clinical utility of this approach is limited, and achieving a pathologic complete response (pCR) is not associated with a better prognosis in patients with luminal A or luminal B/HER2-positive disease [4,5].…”

Section: Introductionmentioning

confidence: 99%

In the Era of Genomics, Should Tumor Size Be Reconsidered as a Criterion for Neoadjuvant Chemotherapy?

et al. 2015

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Background. The Oncotype DX recurrence score (RS) assay has been validated for prediction of 10-year risk of distant recurrence and likelihood of benefit from chemotherapy in patients with estrogen receptor (ER)-positive, HER2-negative early breastcancer. Patients with high RS tumors have substantial benefit, and patients with low RS tumors have minimal if any benefit from chemotherapy. Tumor size is used as a key parameter when selecting patients for neoadjuvant chemotherapy. The aim of this study was to assess the distribution of RS in patients selected for neoadjuvant chemotherapy primarily according to tumor size. Patients and Methods. Patients with ER-positive and HER2-negative tumors that were node-negative or had no more than 1 positive node from three trials were included in this study. Oncotype DX was performed at Genomic Health, Inc., blinded

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Section: Introductionmentioning

confidence: 99%

In the Era of Genomics, Should Tumor Size Be Reconsidered as a Criterion for Neoadjuvant Chemotherapy?

et al. 2015

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“…Literature suggests that patients achieving pCR after NAC have improved survival outcomes [9]. In our study serial MRI correctly predicted pCR in nearly 52% ( We found serial MRI a useful tool to identify non-responding tumours early and aid in tailoring of NAC.…”

Section: Discussionmentioning

confidence: 58%

“…Furthermore, NAC provides opportunities to assess invivo chemosensitivity by monitoring tumour response. Patients who achieve complete pathological response(pCR) have improved prognostic outcomes including both overall and disease-free survival [9]. The purpose of changing NAC when limited early response is observed is to improve tumour response using a second-line NAC.…”

Section: Introductionmentioning

confidence: 99%

Serial MRI scans help in assessing early response to neoadjuvant chemotherapy and tailoring breast cancer treatment

Fatayer

Sharma

Manuel

et al. 2016

European Journal of Surgical Oncology (EJSO)

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“…We used three criteria: (1) the ability of the AIF to minimize the number of computational fit fails, (2) the ability of the AIF to produce physiologically valid parameters and (3) detection of pathological response (a predictor for disease-free and overall survival 20 ), to NAC chemotherapy in a well-defined population of advanced breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Arterial input functions in dynamic contrast-enhanced magnetic resonance imaging: which model performs best when assessing breast cancer response?

Woolf

Taylor

Makris

et al. 2016

BJR

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Objective: To evaluate the performance of six models of population arterial input function (AIF) in the setting of primary breast cancer and neoadjuvant chemotherapy (NAC). The ability to fit patient dynamic contrastenhanced MRI (DCE-MRI) data, provide physiological plausible data and detect pathological response was assessed. Methods: Quantitative DCE-MRI parameters were calculated for 27 patients at baseline and after 2 cycles of NAC for 6 AIFs. Pathological complete response detection was compared with change in these parameters from a reproduction cohort of 12 patients using the Bland-Altman approach and receiver-operating characteristic analysis. Results: There were fewer fit failures pre-NAC for all models, with the modified Fritz-Hansen having the fewest pre-NAC (3.6%) and post-NAC (18.8%), contrasting with the femoral artery AIF (19.4% and 43.3%, respectively).Median transfer constant values were greatest for the Weinmann function and also showed greatest reductions with treatment (268%). Reproducibility (r) was the lowest for the Weinmann function (r 5 249.7%), with other AIFs ranging from r 5 227.8 to 239.2%. Conclusion: Using the best performing AIF is essential to maximize the utility of quantitative DCE-MRI parameters in predicting response to NAC treatment. Applying our criteria, the modified Fritz-Hansen and cosine bolus approximated Parker AIF models performed best. The Fritz-Hansen and biexponential approximated Parker AIFs performed less well, and the Weinmann and femoral artery AIFs are not recommended. Advances in knowledge: We demonstrate that using the most appropriate AIF can aid successful prediction of response to NAC in breast cancer.

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Meta-analysis confirms achieving pathological complete response after neoadjuvant chemotherapy predicts favourable prognosis for breast cancer patients

Cited by 227 publications

References 27 publications

In the Era of Genomics, Should Tumor Size Be Reconsidered as a Criterion for Neoadjuvant Chemotherapy?

In the Era of Genomics, Should Tumor Size Be Reconsidered as a Criterion for Neoadjuvant Chemotherapy?

Serial MRI scans help in assessing early response to neoadjuvant chemotherapy and tailoring breast cancer treatment

Arterial input functions in dynamic contrast-enhanced magnetic resonance imaging: which model performs best when assessing breast cancer response?

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