Real-world assessment of the effect of impact of tumor size on pathological complete response rates in triple negative breast cancer after neoadjuvant chemotherapy

Abstract

Background: Triple negative breast cancer (TNBC) is characterized rapid tumor growth, and increased metastatic potential compared to other breast cancer subtypes. However, pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) can predict patients with a better prognosis. Clinical predictors of pCR such as tumor size (TS) are controversial. This study aims to evaluate the influence of TS on achieving pCR, and the associated survival outcomes. Methods: Medical records from 310 TNBC patients treated with NACT between 2010 and 2013 in National Cancer Institute Brazil were screened. The aim study was to examine the impact of TS on pCR. We used descriptive statistics to organize and summarize TS data and all the other variables of interest. Logistic regression has done to assess if any of these variables were associated with pCR. Survival data were extrapolated using Kaplan-Meier analysis and log-rank tests. Results: Thirty-nine (21%) of 187 enrolled patients achieved pCR. Median age was 48 years, 50.27% were postmenopausal, 93.03% T3/T4 and 75.39% axillar clinical node-positive; 92.51% received an anthracycline regimen followed by a taxane. Age >40 years (P=0.04, OR 0.45, 95% CI, 0.20-0.95) and tumor infiltrating lymphocytes (TILs) presence (P<0.01, OR 3.71, 95% CI, 1.60-8.60) were factors significantly associated with increased rates of pCR. Neither the TS (IQR: 4; P=0.22, OR 0.93, 95% CI, 0.83-1.03) nor the other subgroups analysed demonstrated any association with achieving pCR. Median follow-up was 36 months. The 5-year OS and RFS of the study population was 71.20% and 61.10% respectively. Conclusions: Preoperative TS did not significantly impact pCR rate in our cohort of patients receiving NACT for TNBC. Characteristics associated with higher pCR rate included TILs and age >40 years. In addition, pCR, was indicative of better survival outcomes.

The Association between Early-Onset Diagnosis and Clinical Outcomes in Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis

“…Table 1 presents characteristics of included studies [ 19 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. Three studies were based on pooled data from clinical trials [ 32 , 43 , 51 ].…”

“…Hazard ratios less than 1 show favourable outcomes in early-onset age group; hazard ratios greater than 1 show poorer outcomes in early-onset age group. References [ 13 , 22 , 25 , 27 , 29 , 30 , 33 , 40 , 42 , 48 , 49 ]. Abbreviations: CI = confidence interval; HR = hazard ratio.…”

Is it time to retire sentinel lymph node biopsy and use multi-omics prediction models?

“…All of these lines of research would benefit from prospective studies with higher power and more diverse populations in case of genetic differences between ethnic groups. Finally, since genomic data has been useful to predict survival outcomes and to tailor adjuvant treatment in hormonal receptor positive breast cancer, future research should focus on models incorporating clinical data to allow us to personalize curative treatment in TNBC (14).…”

Evaluation of HER&nbsp;2-overexpression Status in Breast Cancer Patients: Results From a Breast Cancer Registry

“…One of the most important biomarkers is HER2 oncogene, which is a part of the message path (Signal Transduction Pathway). This protein is involved in the cell growth and plays a key role in the shift towards malignancy (6,7). Different expression levels of HER2 gene in normal and malignant cells have made HER2 to act as an ideal biomarker for therapeutic purposes (3,8).…”