scholarly journals Impact of Nuclear Oestrogen Receptor Beta Expression in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy

2019 ◽  
Vol 79 (10) ◽  
pp. 1110-1117
Author(s):  
Florian Heitz ◽  
Sherko Kümmel ◽  
Bianca Lederer ◽  
Christine Solbach ◽  
Knut Engels ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Hormone Receptor ◽  
Oestrogen Receptor ◽  
Multivariate Analyses ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Hormone Receptor Positive ◽  
The Impact ◽  
Receptor Beta

Abstract Introduction Oestrogen receptor beta (ER-β) is abundantly expressed in breast cancer (BC), but its impact on neoadjuvant chemotherapy outcome is unknown. Patients and Methods Patients treated in the neoadjuvant GeparTrio trial with available tissue for immunohistochemical analyses were included. Nuclear ER-β expression was correlated with clinico-pathologic characteristics. The impact of its expression on pathological complete response (pCR [ypT0/ypN0]) and survival was determined. Results Samples of 570 patients were available. Low nuclear ER-β expression (IRS < 9) was observed in 48.4% of hormone receptor positive and 58.6% of hormone receptor negative tumours. Low nuclear ER-β expression was associated with higher pCR rates compared to high nuclear ER-β expression (16.1% vs. 4.7%, p = 0.026). Low ER-β expression was no independent predictor of pCR in multivariate analyses. Disease-free and overall survival were not statistically different between patients with high and low nuclear ER-β expression. Triple-negative BCs showed low nuclear ER-β expression in 57.7%, and pCR rates were 27.1% and 0% (p = 0.23) in low and high ER-β expressing tumours, respectively. Conclusion Low ER-β expression is associated with improved pCR rates in univariate analyses. However multivariate analyses and survival analyses do not indicate an impact of ER-β on survival in patients undergoing neoadjuvant chemotherapy. Further examination of ER-β as predictor for endocrine therapy might be of value.

scholarly journals Factors Influencing Decision-Making for or against Adjuvant and Neoadjuvant Chemotherapy in Postmenopausal Hormone Receptor-Positive Breast Cancer Patients in the EvAluate-TM Study

Breast Care ◽  
2016 ◽  
Vol 11 (5) ◽  
pp. 315-322 ◽  
Author(s):  
Paul Gaß ◽  
Peter A. Fasching ◽  
Tanja Fehm ◽  
Johann de Waal ◽  
Mahdi Rezai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Neoadjuvant Chemotherapy ◽  
Neoadjuvant Therapy ◽  
Hormone Receptor ◽  
Patient Population ◽  
Breast Cancer Patients ◽  
Research Issues ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

Background: Decision-making for or against neoadjuvant or adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive breast cancer does not follow any clear guidelines, and some patients may unnecessarily undergo chemotherapy and be exposed to the associated toxicity. The aim of this study was to identify the patient population for whom this issue may bear relevance. Methods: Patients being treated with letrozole in the prospective multicenter noninterventional EvAluate-TM study were recruited. The percentage of patients receiving chemotherapy and factors associated with chemotherapy administration were identified. Results: In all, 3,924 (37.4%) patients received chemotherapy before treatment with letrozole. Of these, 293 (20%) underwent neoadjuvant therapy. Younger age was predictive for both adjuvant and neoadjuvant therapy. Overall, decisions in favor of administering chemotherapy are more likely to be made in patients with a higher body mass index (BMI), and neoadjuvant chemotherapy is administered at a higher rate in women with a lower BMI. Concomitant medication influenced the overall decision-making regarding chemotherapy, irrespective of whether it was given on a neoadjuvant or adjuvant basis. Conclusion: There is an ongoing debate as to whether all of the many patients who receive chemotherapy actually benefit from it. Neoadjuvant chemotherapy is frequently administered in this patient population, and this should encourage further research to resolve current clinical and research issues.

Impact of sequence order of anthracyclines and taxanes in neoadjuvant chemotherapy for breast cancer: Results from a prospective institutional database.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12619-e12619
Author(s):  
Megan Tesch ◽  
Nathalie LeVasseur ◽  
Christine E. Simmons ◽  
Stephen K. L. Chia
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Breast Conserving Surgery ◽  
Breast Cancer Patients ◽  
Duration Of Treatment ◽  
Eligibility Criteria ◽  
The Impact

e12619 Background: There has been growing interest in the optimal sequencing of anthracyclines and taxanes in neoadjuvant chemotherapy (NACT) for breast cancer. However, data comparing efficacy of administering taxanes prior to anthracyclines as opposed to the opposite sequence remains limited and inconsistent. The objective of our study was to assess the impact of sequence order on pathologic and clinical outcomes in a real-world setting. Methods: A prospective institutional database was analyzed to identify all HER2-negative breast cancer patients treated with NACT from 2012 to 2019. Rates of pathologic complete response (pCR), down-staging, and breast-conserving surgery were compared between patients who received anthracyclines followed by taxanes (AC-T) to those who received taxanes followed by anthracyclines (T-AC). Chi-square and independent sample non-parametric tests were used to test for associations between variables and outcomes. Results: Of the 270 patients who met eligibility criteria, 175 (65%) received AC-T and 95 (35%) received T-AC. Median age was 55 (IQR 24-86). Overall, 83% of patients had stage IIB or greater tumors, 40% had grade 3 histology, and 36% had triple-negative disease. Characteristics were balanced between the AC-T and T-AC groups (all p < 0.05). Median duration of treatment with NACT was 102 days (IQR 29-203). Rates of pCR (19% vs 21%, p = 0.750), down-staging (68% vs 61%, p = 0.188), and conversion to breast-conserving surgery (26% vs 20%, p = 0.314) were similar for AC-T vs T-AC, respectively. pCR was higher in triple-negative compared to hormone-positive cases (33% vs 13%, p < 0.001). Conclusions: In this small population-based cohort, sequence order of anthracyclines and taxanes did not demonstrate statistically significant differences in evaluated outcomes from NACT for breast cancer. This supports the current variation in prescribing practice and highlights the need for further studies in this area.

scholarly journals Using Probability for Pathological Complete Response (pCR) as a Decision Support Marker for Neoadjuvant Chemotherapy in HER2 Negative Breast Cancer Patients – a Survey Among Physicians

2018 ◽  
Vol 78 (07) ◽  
pp. 707-714 ◽  
Author(s):  
Paul Gass ◽  
Michael Untch ◽  
Volkmar Müller ◽  
Volker Möbus ◽  
Christoph Thomssen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Work Experience ◽  
Online Survey ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Hormone Receptor Positive ◽  
Patient Groups

Abstract Background In women with early breast cancer, a pathological complete response (pCR) after neoadjuvant chemotherapy is reported to be associated with an improvement of the survival. The aim of this survey among physicians was to investigate whether the probability of achieving pCR in patients with a hormone receptor-positive, HER2-negative disease encourages physicians to recommend neoadjuvant chemotherapy. Methods The study was conducted via an online survey that was sent to 493 physicians, who were either known as members of national guideline committees, heads of breast cancer centers, being high recruiters in clinical trials or leading a private practice. Participants were asked about a specific case that should resemble patients for whom it is unclear, whether they should be treated with chemotherapy. Results 113 (24.5%) physicians participated at the survey, out of which 96.5% had a work experience of more than 10 years and 94.7% were board certified in their specialty. A total of 84.1% would consider pCR for a decision concerning neoadjuvant chemotherapy. With regard to the pCR probability, 2.7 and 10.6% of the participants demanded at least a pCR rate of 5 and 10%, respectively, while 25.7% were satisfied with 20% probability, and another 25.7% with a pCR rate of 30%. Conclusions The vast majority of the long-term experienced physicians would embrace the implementation of a further method such as the prediction of pCR probability in clinical routine to support decision making regarding the necessity of neoadjuvant chemotherapy. The cut-off of around 30% pCR probability seems to be a realizable rate to distinguish patient groups.

The negative prognostic impact of downstaging after neoadjuvant chemotherapy in patients with hormone-receptor positive breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e11524-e11524
Author(s):  
Yuko Takahashi ◽  
Naoki Hayashi ◽  
Naoko Matsuda ◽  
Yuka Kajiura ◽  
Atsushi Yoshida ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Hormone Receptor ◽  
Primary Breast Cancer ◽  
Pathologic Complete Response ◽  
Prognostic Impact ◽  
Hormone Receptor Positive ◽  
The Impact ◽  
Positive Breast Cancer

e11524 Background: While pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) improves patients’ survival, it is not well known whether or not chemosensitivity contributes to improve survival of patients who had non-pCR. The aim of this study was to evaluate the impact of chemosensitivity presented by downstaging after NAC on prognosis in patients with primary breast cancer. Methods: We assessed retrospectively 773 patients with primary breast cancer who underwent surgical resection after NAC between 2001 and 2008 (a median age 49 years, range 26-79 years). 572 patients (74.0%) had hormone-receptor positive tumor and 131 patients (16.9%) had HER2 positive tumor. One hundred forty six patients (18.9%) underwent sentinel node biopsy before NAC. We divided patients into two groups based on chemosensitivity: the downstaging (DS) group and the non-downstaging (non-DS) group. We compared the groups with respect to both disease-free survival (DFS) and overall survival (OS).According to hormone-receptor status and HER2 positivity, pCR was defined as no residual invasive and ypN0. Results: Before NAC, 37 patients had clinical Stage I (4.8%), 613 had cStage II (79.3%), and 123 had cStage III (15.9%). After NAC, 181 had ypStage I (23.4%), 306 had ypStage II (39.6%), and 175 had ypStage III (22.6%). One hundred eleven patients (14.4%) had pCR. Two hundred ninety seven patients (38.4%) had DS and 476 patients (61.6%) had non-DS. Of all patients, patients with DS had significantly longer DFS and OS than non-DS patients (p=0.01, 0.04, respectively). However, among 252 hormone-receptor positive patients with ypStage II, patients with DS (cStage III, n=21) had significantly shorter DFS than patients with non-DS (c Stage±/II, n = 231) (p<0.001). In terms of overall survival, patients with DS had a similar trend compared to patients with non-DS in this population. Conclusions: Our results indicated that hormone-receptor positive breast cancer patients with cStage III before NAC, even after having ypStage II, have worse prognosis than patients with cStage II, therefore, these patients may need additional treatment in the adjuvant setting.

Survival advantage associated with neoadjuvant chemotherapy compared to neoadjuvant hormonal therapy in postmenopausal women with hormone receptor positive breast cancer: A National Cancer Data Base study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12119-e12119
Author(s):  
Alina Basnet ◽  
Dongliang Wang ◽  
Abirami Sivapiragasam
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Hormone Receptor ◽  
National Cancer Data Base ◽  
Breast Cancer Patients ◽  
Cancer Data ◽  
Hormone Receptor Positive ◽  
Positive Breast Cancer

e12119 Background: Neoadjuvant endocrine therapy (NET) and neoadjuvant chemotherapy (NCT) are both considered effective strategies in postmenopausal, hormone receptor positive breast cancer patients. Small prospective studies show comparable response rates and breast conservation rates. Using National Cancer Data Base (NCDB) we report overall survival (OS) differences between these two strategies with subgroup analysis by Estrogen Receptor (ER), Progesterone Receptor (PgR) status. Methods: We extracted data on hormone receptor positive breast cancer patients without metastasis in women aged ≥ 50 from the NCDB registry (2004-2014). We excluded patients who did not receive adjuvant endocrine therapy after NCT and patients who received adjuvant chemotherapy after NET as this could affect OS. We calculated OS using Kaplan Meier analysis with hazard ratio (HR) from cox regression model. Subgroup analysis was performed by ER, PgR status. Results: Out of 2,246,279 patients, 30,348 patients met our inclusion criteria. 7836 received NET and 22512 received NCT. OS rate was 70.8% vs 81.7% at 5 yrs and 42.5% vs 62.1% at 9 yrs for NET and NCT respectively with adjusted hazard ratio (HR) of 1.818; 95% CI (1.657-1.996). OS outcome for ER+/PgR+ group was 72.3% vs 83.5% at 5 yrs and 43.5% vs 64% at 9 yrs for NET and NCT respectively with adjusted HR of 1.807; 95% CI (1.624-2.010). OS for ER+/pgR- group was 62.9% vs 76.8% at 5 yrs and 33.1% vs 54.2% at 9 yrs for NET and NCT respectively with adjusted HR of 1.890; 95% CI (1.549-2.306). Our analysis also revealed that 5591 T1 patients received neoadjuvant therapy among which 2541 received NET and 3050 received NCT. Conclusions: We find a significant survival advantage in patients treated with NCT as opposed to NET. All subgroups showed imporved OS with NCT compared with NET. Limitations that should be considered in this registry based study are: not accounting for Her-2 status, differences in surgical technique, duration and choices of adjuvant chemotherapy and radiotherapy options.

scholarly journals Predictive Value of Immune Genomic Signatures from Breast Cancer Cohorts Containing Data for Both Response to Neoadjuvant Chemotherapy and Prognosis after Surgery

2021 ◽  
Author(s):  
Yidan Zhu ◽  
Takayuki Iwamoto ◽  
Yukiko Kajiwara ◽  
Yuko Takahashi ◽  
Mariko Kochi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Hormone Receptor ◽  
Breast Cancer Subtypes ◽  
Chemotherapy Response ◽  
Breast Cancer Patients ◽  
Predictive Values ◽  
Cancer Subtypes ◽  
Hormone Receptor Positive ◽  
Response To Chemotherapy

Abstract BackgroundPrevious studies of immune-related gene signatures (IGSs) in breast cancer have attempted to predict the response to chemotherapy or prognosis and were performed using different patient cohorts. The purpose of this study was to evaluate the predictive functions of various IGSs using the same patient cohort that included data for response to chemotherapy as well as the prognosis after surgery.MethodsWe applied five previously described IGS models in a public dataset of 508 breast cancer patients treated with neoadjuvant chemotherapy. The prognostic and predictive values of each model were evaluated, and their correlations were compared.ResultsWe observed a high proportion of expression concordance among the IGS models (r: 0.56-1). Higher gene expression scores of IGSs were detected in aggressive breast cancer subtypes (basal and HER2-enriched) (P < 0.001). Four of the five IGSs could predict chemotherapy responses and two could predict 5-year relapse-free survival in cases with hormone receptor-positive (HR+) tumors. However, the models showed no significant differences in their predictive abilities for hormone receptor-negative (HR-) tumors.ConclusionsIGSs are, to some extent, useful for predicting prognosis and chemotherapy response; moreover, they show substantial agreement for specific breast cancer subtypes. However, it is necessary to identify more compelling biomarkers for both prognosis and response to chemotherapy in HR- and HER2+ cases.

Sign in / Sign up

Export Citation Format

Share Document