Predictive factors for relapse in triple-negative breast cancer patients without pathological complete response after neoadjuvant chemotherapy

Abstract

IntroductionTriple-negative breast cancer (TNBC) patients who do not obtain pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) present higher rate of relapse and worse overall survival. Risk factors for relapse in this subset of patients are poorly characterized. This study aimed to identify the predictive factors for relapse in TNBC patients without pCR after NACT.MethodsWomen with TNBC treated with NACT from January 2008 to May 2020 at the Modena Cancer Center were included in the analysis. In patients without pCR, univariate and multivariable Cox analyses were used to determine factors predictive of relapse.ResultsWe identified 142 patients with a median follow-up of 55 months. After NACT, 62 patients obtained pCR (43.9%). Young age at diagnosis (<50 years) and high Ki-67 (20%) were signi!cantly associated with pCR. Lack of pCR after NACT resulted in worse 5-year event-free survival (EFS) and overall survival (OS). Factors independently predicting EFS in patients without pCR were the presence of multifocal disease [hazard ratio (HR), 3.77; 95% CI, 1.45–9.61; p=0.005] and residual cancer burden (RCB) III (HR, 3.04; 95% CI, 1.09–9.9; p=0.04). Neither germline BRCA status nor HER2-low expression were associated with relapse.DiscussionThese data can be used to stratify patients and potentially guide treatment decision-making, identifying appropriate candidates for treatment intensi!cation especially in neo-/adjuvant setting.

Increased blood draws for ultrasensitive ctDNA and CTCs detection in early breast cancer patients

“…These findings suggest that the utilization of our methodology for MRD detection is likely to enhance the anticipation of clinical recurrence compared to previous studies in early BC 16 , 17 , 39 . However, clinical surveillance is necessary to draw definitive conclusions about the clinical significance of our findings 16 , 17 , 40 , 41 .…”

Increased Blood Draws for Ultrasensitive ctDNA and CTCs Detection in Early Breast Cancer Patients

“…These findings suggest that the utilization of our methodology for MRD detection is likely to enhance the anticipation of clinical recurrence compared to previous studies in early BC 16,17,39 . However, clinical surveillance is necessary to draw definitive conclusions about the clinical significance of our findings 16,17,40,41 .…”

Impact of HER2-low Breast Cancer on Survival in Denmark: A Nationwide Investigation (2007-2019)

“…These advancements have led to a renewed interest in the subgroup of patients with HER2-low BC including their outcome. Up to now, con icting results have been reported on the prognostic signi cance of HER2-low BC compared to HER2 0 with reports of both no effect (5, 8,(17)(18)(19)(20)(21)(22)(9)(10)(11)(12)(13)(14)(15)(16) and better survival (23-28).…”

“…Additional trials with the compounds within the HER2-low category are ongoing (5, 6). The HER2-low category is de ned by a HER2 score of 1 + or 2+ (previously included in the HER2 negative category) without detectable gene ampli cation and accounts for 40-60% of BC cases (with some studies reporting frequencies up to 70%), representing a large group of patients with potential bene t from new forms of HER2-targeted therapy in the metastatic or locally advanced setting (4,7,(16)(17)(18)(19)(20)(21)(22)(8)(9)(10)(11)(12)(13)(14)(15). These advancements have led to a renewed interest in the subgroup of patients with HER2-low BC including their outcome.…”

“…These advancements have led to a renewed interest in the subgroup of patients with HER2-low BC including their outcome. Up to now, con icting results have been reported on the prognostic signi cance of HER2-low BC compared to HER2 0 with reports of both no effect (5, 8,(17)(18)(19)(20)(21)(22)(9)(10)(11)(12)(13)(14)(15)(16) and better survival (23-28).In this retrospective population-based study we aimed to investigate the clinical outcomes of HER2-low BC compared to HER2 0 in all Danish patients diagnosed from 2007 to 2019, who were treated with curative intent.…”