Clinical and pathological predictors of recurrence in breast cancer patients achieving pathological complete response to neoadjuvant chemotherapy

Publication date: Available online 2 August 2019Source: European Journal of Surgical OncologyAuthor(s): Mariko Asaoka, Kazutaka Narui, Nobuyasu Suganuma, Takashi Chishima, Akimitsu Yamada, Sadatoshi Sugae, Saori Kawai, Natsuki Uenaka, Saeko Teraoka, Kana Miyahara, Takahiko Kawate, Eichi Sato, Toshitaka Nagao, Yuka Matsubara, Shipra Gandhi, Kazuaki Takabe, Takashi IshikawaAbstractIntroductionDespite the excellent prognosis associated with pathological complete response (pCR) to neoadjuvant chemotherapy (NAC), some patients still develop recurrence. Here, we investigated the outcomes of breast cancer patients with pCR, as well as the clinical and pathological predictors of cancer recurrence in these patients.Materials and methodsOf the 1599 breast cancer patients treated with NAC, we evaluated 394 patients who achieved pCR between January 2007 and December 2016. pCR was defined as no evidence of invasive cancer in breast. Residual in situ ductal and axillary lymph node diseases were not considered. We analyzed the outcomes using the Kaplan–Meier method. We assessed the association of clinical and pathological predictors with cancer recurrence using the cox proportional hazards regression model.ResultsThe median follow-up time was 63 months. The 5-year disease-free survival rate was 92.3%. Cancer recurrence was observed in 28 patients (7.1%): local recurrence 8 patients (2.0%), visceral metastasis 10 patients (2.5%), and brain metastasis 10 patients (2.5%). Brain metastase...
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research

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Abstract PURPOSE: High levels of tumor-infiltrating lymphocytes (TILs) before neoadjuvant chemotherapy (NAC) are associated with higher pathological complete response (pCR) rates, and better survival in TNBC and HER2-positive breast cancers (BCs). We investigated the value of TIL levels by evaluating lymphocyte infiltration before and after NAC. PATIENTS AND METHODS: We assessed stromal TIL levels in 716 pre- and post-treatment matched paired specimens, according to the guidelines of the international TIL working group. RESULTS: Pre-NAC TIL levels were higher in tumors for which pCR was achieved than in ...
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
ConclusionDespite guideline recommendations, a high rate of preoperative staging imaging is completed for patients with clinical stage 1 or 2 breast cancer who receive NAC, with few positive results.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 22 June 2019Source: Journal of Geriatric OncologyAuthor(s): Etienne Brain, Philippe Caillet, Nienke de Glas, Laura Biganzoli, Karis Cheng, Lissandra Dal Lago, Hans WildiersAbstractHER2-positive (HER2+) breast cancer (BC) affects older women nearly as frequently as younger ones. Many older patients have cardiovascular comorbidity and risk greater toxicity from therapy. Treatment therefore requires careful consideration, especially since trials include few patients over 65 and so provide limited guidance. A multidisciplinary task force of the International Society of Geriatric Oncology cond...
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: This meta-analysis demonstrated that CD44 overexpression might be an unfavorable prognostic factor for CRC patients and could be used to predict poor differentiation, lymph node metastasis and distant metastasis. Introduction Although therapies for colorectal cancer (CRC) has improved in recent years, colorectal cancer is still the third most common cause of cancer related death worldwide (1). Metastasis are observed in 25% of patients at initial diagnosis and approximately 50% of patients will develop metastasis (2). Presently, the outcome prediction and the therapy schedule determination of CRC patie...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusion: Adjuvant trastuzumab was associated with higher CNS failure rate in Korean patients with HER2-enriched breast cancer. Close monitoring and reasonable approaches such as CNS penetrating HER2 blockades combined with the current standard therapy could contribute to improving intracranial tumor control and quality of life in patients with CNS metastasis from HER2-enriched breast cancer. PMID: 30941239 [PubMed]
Source: Journal of Breast Cancer - Category: Cancer & Oncology Tags: J Breast Cancer Source Type: research
This study aimed to develop mathematical tools to predict the likelihood of recurrence after neoadjuvant chemotherapy (NAC) plus trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer.MethodsData of 776 patients from a multicenter retrospective cohort study were collected. All patients had HER2-positive breast cancer and received NAC plus trastuzumab between 2001 and 2010. Two mathematical tools using a machine learning method were developed to predict the likelihood of disease-free survival (DFS) (DFS model) and brain metastasis (BM) (BM model) within 5  years after surger...
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
Conclusion: Trastuzumab does not decrease the detection rate of CTCs in HER2 non-amplified, non-metastatic breast cancer. PMID: 29893791 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Oncol Source Type: research
NCI's Center for Cancer Research (CCR) Grand Rounds Dr. Matthew Ellis ’ s clinical and basic research focuses on breast cancer. He has developed neoadjuvant endocrine therapy as an alternative to chemotherapy for promoting breast-conserving therapy in postmenopausal women with ER+ HER2- stage 2 and 3 disease. He developed and validated the Ki67 proliferation marker-based Preoperative Endocrine Prognostic Index which is now undergoing a large validation study (the ALTERNATE study). These clinical studies have provided the clinical context and tumor specimens for seminal investigations into the ER+ breast cancer somati...
Source: Videocast - All Events - Category: General Medicine Tags: Upcoming Events Source Type: video
Background)The addition of trastuzumab to standard neoadjuvant chemotherapy (NAC) doubles the pathological complete response (pCR) rate in patients with HER2-positive primary breast cancer. Patients who achieved pCR after NAC with trastuzumab showed a better prognosis compared to those without pCR. However, it is still difficult to predict the likelihood of recurrence after surgery at an individual patient-level. The aim of this study was to develop a mathematical model to predict disease-free survival (DFS) events such as recurrence for patients treated with NAC and trastuzumab. Because brain metastasis (BM) often occurs ...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
Conclusions: Neoadjuvant triple targeting of ER, HER2 and Rb in HER2+/ER+ breast cancer treatment caused a significant and rapid decrease of Ki67 that was of larger magnitude after 2 weeks than at surgery irrespective of the recorded objective clinical response. The good tolerability, the rapid effect on Ki67, the consistent clinical response, and the rate of pCR with this chemotherapy-free approach support further clinical testing and additional molecular characterization.Supported in part by an unrestricted grant from Pfizer Italia S.r.l. and from Roche S.p.a. ItaliaCitation Format: Hamilton E, Borges V, Conlin A, Walker...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
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