Prognostic factors for early relapse in non-metastatic triple negative breast cancer — real world data

Abstract

Background: Triple negative breast cancer (TNBC) has the worst prognosis amongst all subtypes. Studies have shown that the achievement of pathologic complete response in the breast and axilla correlates with improved survival.The aim of this study was to identify clinical or pathological features of real-life TNBC patients with a higher risk of early relapse.Materials and methods: Single-centre retrospective analysis of 127 women with TNBC, stage II-III, submitted to neoadjuvant treatment and surgery between January 2016 and 2020. Multivariate Cox regression analysis for disease free survival (DFS) at 2 years was performed and statistically significant variables were computed into a prognostic model for early relapse.Results: After 29 months of median follow-up, 105 patients (82.7%) were alive and, in total, 38 patients (29.9%) experienced recurrence. The 2-year DFS was 73% (95% CI: 21.3-22.7). In multivariate analysis, being submitted to neoadjuvant radiotherapy [HR 2.8 (95% CI: 1.2-6.4), p = 0.017] and not achieving pathologic complete response [HR 0.3 (95% CI: 0.1-1.7), p = 0.011] were associated with higher risk of recurrence. In our prognostic model, the presence of at least one of these variables defined a subgroup of patients with a worse 2-year DFS than those without these features (59% vs. 90%, p < 0.001, respectively). Conclusions:In this real-life non-metastatic TNBC cohort, neoadjuvant radiotherapy (performed due to insufficient clinical response to neoadjuvant chemotherapy or significant toxicity) impacted as an independent prognostic factor for relapse along with the absence of pathologic complete response identifying a subgroup of higher risk patients for early relapse that might merit a closer follow-up.

A Holistic Approach to Hard-to-Treat Cancers: The Future of Immunotherapy for Glioblastoma, Triple Negative Breast Cancer, and Advanced Prostate Cancer

“…According to the Surveillance, Epidemiology, and End Result Program (SEER) database, TNBC bears an overall 5-year survival rate of 77% which drops down to 12% when the disease is at the metastatic stage [ 88 ]. In non-metastatic TNBC, between 30 and 40% of cases will result in relapse often leading to metastasis [ 89 , 90 ].…”

The Rac inhibitor HV-107 as a potential therapeutic for metastatic breast cancer

“…Due to the complex heterogeneity of TNBC, targeted therapies are limited (Marmé and Schneeweiss 2015 ; McArthur 2022 ). Despite initial responses to chemotherapy, resistance frequently and rapidly occurs, and metastatic tumors arise (Soares et al 2021 ; Health 2018 ). TNBC has the highest rate of distant metastasis among all breast cancer subtypes and is associated with the shortest overall survival, with metastatic breast cancer lacking effective targeted treatment.…”

Prognostic Factors in Patients with Triple Negative Breast Cancer Undergoing Adjuvant Radiotherapy: A 10-Year Single Center Experience

“…2 Triple negative breast cancer (TNBC) consists of subgroups in which estrogen receptor (ER) and progesterone receptor (PR) stain less than <1% and HER-2 is negative. 3 TNBC accounts for approximately 10-15% of all breast cancers. 4,5 The risk of TNBC increases with young menarche, young first birth, non-breastfeeding, and abdominal obesity.…”