scholarly journals Survival Outcome and Impact of Chemotherapy in T1 Node-Negative Triple-Negative Breast Cancer: A SEER Database Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jingyi Zhang ◽  
Wenna Wang ◽  
Jiayu Wang ◽  
Yang Luo ◽  
Shanshan Chen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Large Scale ◽  
Triple Negative ◽  
Survival Rates ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Small Tumor ◽  
Significant Difference

Objective. Although triple-negative breast cancer (TNBC) has been considered to be an aggressive disease, the outcome of small-tumor (T1abcN0M0) TNBC and the effect of adjuvant chemotherapy on TNBC survival remain controversial. Methods. We identified 4565 T1abcN0M0 TNBC patients in the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010, to December 31, 2015. After propensity score matching (PSM), 3214 patients were finally analyzed. Survival rates were compared among T1a, T1b, and T1c patients and between patients with and without adjuvant chemotherapy. Results. We classified 424, 1040, and 3101 cases as T1a, T1b, and T1c TNBC, respectively. A total of 2760 (60.5%) patients received adjuvant chemotherapy, accounting for 25.5%, 56.0%, and 66.8% of T1a, T1b, and T1c patients, respectively. Rates of 5-year breast cancer-specific survival (BCSS) for T1a, T1b, and T1c patients receiving chemotherapy were 97.8%, 94.1%, and 94.5%, respectively, compared with 97.2%, 94.0%, and 89.9% in patients without chemotherapy. Patients receiving adjuvant chemotherapy had higher 5-year BCSS (94.5% vs. 89.9%, P  = 0.004) in the T1c subgroup, but no significant difference was detected in T1a or T1b patients due to adjuvant chemotherapy. Conclusion. Small-tumor TNBC showed very good prognosis. Adjuvant chemotherapy improved prognosis in T1c TNBC cases to a greater extent than in T1a and T1b patients. More large-scale clinical trials are needed, and further study should be conducted to determine appropriate adjuvant chemotherapy for T1c TNBC patients.

PD-L1 expression and TOP3A mutation as prognostic factors for adjuvant chemotherapy in triple negative breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 541-541
Author(s):  
Xue Wang ◽  
Peng Yuan ◽  
Feng Du ◽  
Lina Cui ◽  
Fangchao Zheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Genetic Alterations ◽  
Functional Enrichment ◽  
Pathway Enrichment Analysis ◽  
Genetic Characteristics ◽  
Significant Difference

541 Background: Triple negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer that is markedly heterogeneous and lacks specific targets. The aim of this study is to explore potential predictors and therapeutic targets based on clinical and genetic characteristics. Methods: 138 patients with triple-negative breast cancer after surgical treatment were 1:1 randomly assigned to the paclitaxel combined with carboplatin (TCb) group or the epirubicin combined with cyclophosphamide sequential paclitaxel (EC-T) adjuvant chemotherapy group. PD-L1 was retrospectively analyzed by surgically resected specimens, and 733 cancer-related genes were detected by NGS. Pathway enrichment analysis was performed using DAVID for functional enrichment genetic alterations. Cox regression models and Kaplan-Meier were used to evaluate disease-free survival (DFS). Results: In this study, there was no significant difference in DFS between the TCb and EC-T groups. 31 (22.5%) of 138 TNBC patients were positive for PD-L1 expression, including 15 (10.9%) patients positive for PD-L1 in tumor cells (TCs) and 29 (21.0%) patients positive for PD-L1 in tumor-infiltrating immune cells (TICs). Patients with positive PD-L1 expression, either in TCs or TICs, achieved better DFS [HR=0.13 (95% CI: 0.02-0.93), p=0.016], the difference was also shown in the EC-T group [HR=0 (95% CI: 0- inf), p=0.037], but not in the TCb group [HR=0 (95% CI: 0.04-2.1), p=0.189]. In addition, we identified 7 patients with mutations in DNA topoisomerase IIIα(TOP3A), a homologous recombination (HR)-related gene, and patients with mutations in this gene had worse DFS than those without mutations [HR=4]. However, there was no statistically significant association between BRCA mutation and response to either therapeutic regimens. Conclusions: In this TNBC patient population, immunohistochemistry (IHC) and NGS analyses identified potential prognostic markers. PD-L1 positive and TOP3A mutation were significantly associated with early triple-negative breast cancer prognosis.

scholarly journals Impact of estrogen receptor levels on outcome in non-metastatic triple negative breast cancer patients treated with neoadjuvant/adjuvant chemotherapy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Maria Vittoria Dieci ◽  
Gaia Griguolo ◽  
Michele Bottosso ◽  
Vassilena Tsvetkova ◽  
Carlo Alberto Giorgi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Significant Difference ◽  
Neo Adjuvant Chemotherapy

AbstractAlthough 1% is the recommended cut-off to define estrogen receptor (ER) positivity, a 10% cut-off is often used in clinical practice for therapeutic purposes. We here evaluate clinical outcomes according to ER levels in a monoinstitutional cohort of non-metastatic triple-negative breast cancer (BC) patients undergoing (neo)adjuvant chemotherapy. Clinicopathological data of 406 patients with ER < 10% HER2-negative BC treated with (neo)adjuvant chemotherapy between 01/2000 and 04/2019 were collected. Patients were categorized in ER-negative (ER < 1%; N = 364) and ER-low positive (1–9%, N = 42). At a median follow-up of 54 months, 88 patients had relapsed and 64 died. No significant difference was observed in invasive relapse-free survival (iRFS) and overall survival (OS) according to ER expression levels, both at univariate and multivariate analysis (5-years iRFS 74.0% versus 73.1% for ER-negative and ER-low positive BC, respectively, p = 0.6; 5-years OS 82.3% versus 76.7% for ER-negative and ER-low positive BC, respectively, p = 0.8). Among the 165 patients that received neoadjuvant chemotherapy, pathological complete response rate was similar in the two cohorts (38% in ER-negative, 44% in ER-low positive, p = 0.498). In conclusion, primary BC with ER1–9% shows similar clinical behavior to ER 1% BC. Our results suggest the use of a 10% cut-off, rather than <1%, to define triple-negative BC.

scholarly journals Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis of 36480 cases. 

2020 ◽  
Author(s):  
Lin-Yu Xia ◽  
Qing-Lin Hu ◽  
Jing Zhang ◽  
Wei-Yun Xu ◽  
Xiao-Shi Li
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Residual Disease ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Current Evidence ◽  
Survival Outcomes ◽  
Significant Difference

Abstract Background: The survival outcomes of neoadjuvant chemotherapy (NACT) versus adjuvant chemotherapy (ACT) for patients with triple-negative breast cancer (TNBC) remain unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of NACT versus ACT in TNBC. Methods: A systematic search was performed on the PubMed and Embase databases to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC. Results: A total of nine studies involving 36480 patients met the selection criteria. Among them,10728 (29.41%) received NACT, and 25752 (70.59%) received ACT. The pathological complete response (pCR) rate was 35% (95% CI = 0.23-0.48). Compared with ACT, the overall survival (OS) of NACT was poor (HR = 1.59; 95%CI = 1.25-2.02; P=0.0001), and there was no significant difference in disease-free survival (DFS) between the two treatments (HR = 0.85; 95%CI = 0.54-1.34; P=0.49). NACT with pCR significantly improved the OS (HR = 0.53; 95%CI = 0.29-0.98; P=0.04) and DFS (HR = 0.52; 95%CI = 0.29-0.94; P=0.03), while the OS (HR = 1.18; 95%CI = 1.09-1.28; P<0.0001) and DFS (HR = 2.36; 95%CI = 1.42-3.89; P=0.0008) of patients with residual disease (RD) following NACT were worse compared to those receiving ACT. Conclusion: These findings suggest that, for TNBC, NACT with pCR is superior to ACT in improving OS and DFS. and it turns to be opposite when patients receiving NACT with RD.

scholarly journals Does Race Affect Outcomes in Triple Negative Breast Cancer?

2010 ◽  
Vol 4 ◽  
pp. 117822341000400 ◽  
Author(s):  
Jasgit C. Sachdev ◽  
Saira Ahmed ◽  
Muhammad M. Mirza ◽  
Aamer Farooq ◽  
Lori Kronish ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Menopausal Status ◽  
Cancer Center ◽  
Early Event ◽  
Breast Cancer Specific Survival ◽  
Cancer Specific Survival ◽  
Significant Difference ◽  
The Impact

Background There is discordance among studies assessing the impact of race on outcome of patients with Triple Negative Breast Cancer (TNBC). We assessed survival outcomes for African American (AA) versus Caucasian (CA) women with TNBC treated at an urban cancer center in Memphis, TN with a predominant AA patient population. Methods Patients with Stage I-III TNBC were identified from our breast database. Event free survival (EFS) and Breast cancer specific survival (BCSS) were the primary outcome measures. Cox proportional hazards models were fitted for EFS and BCSS. Results Of the 124 patients, 71% were AA. No significant association between race and stage ( P = 0.21) or menopausal status ( P = 0.15) was observed. Median age at diagnosis was significantly lower for AA versus CA women (49.5 vs. 55 years, P = 0.024). 92% of the patients received standard neo/adjuvant chemotherapy, with no significant difference in duration and type of chemotherapy between the races. With a median follow up of 23 months, 28% of AA vs. 19% of CA women had an event ( P = 0.37). 3 year EFS and BCSS trended favorably towards CA race (77% vs. 64%, log rank P = 0.20 and 92% vs. 76%, P = 0.13 respectively) with a similar trend noted on multiple variable modeling (EFS: HR 0.62, P = 0.29; BCSS: HR 0.36, P = 0.18). AA women ≥50 years at diagnosis had a significantly worse BCSS than the CA women in that age group ( P = 0.012). Conclusion Older AA women with TNBC have a significantly worse breast cancer specific survival than their CA counterparts. Overall, there is a trend towards lower survival for AA women compared to Caucasians despite uniformity of tumor phenotype and treatment. The high early event rate, irrespective of race, underscores the need for effective therapies for women with TNBC.

scholarly journals Contralateral Prophylactic Mastectomy Improves Survival Only Marginally in Patients with Unilateral Triple-Negative Breast Cancer: A Cohort Study Based on SEER Database

2021 ◽  
Author(s):  
Pengcheng Yang ◽  
Yuxin Chu ◽  
Qian Li ◽  
Tianyu Lei ◽  
Jia Song ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Prophylactic Mastectomy ◽  
Radical Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Seer Database ◽  
Total Mastectomy ◽  
Kaplan Meier ◽  
Significant Difference

Abstract Background: The effect of contralateral prophylactic mastectomy (CPM) on the survival rate of triple-negative breast cancer (TNBC) patients is still controversial. The purpose of this study was to confirm whether unilateral TNBC patients benefit from CPM.Methods: 10006 patients with unilateral TNBC in the Surveillance, Epidemiology and End Results (SEER) database were enrolled in this study, propensity score matching (PSM) was applied to balance patient assignments. After PSM,3039 pairs of patients were divided into a CPM group and no-CPM group, respectively. All the patients have undergone total mastectomy or radical mastectomy. Cox proportional hazards regression models were used to evaluate overall survival (OS) and breast cancer-specific survival (BCSS) of the two groups. Subgroup analysis was introduced to exclude the effect of confounding factors. To identify potential variables for prognosis, Kaplan–Meier survival analysis and Cox regression analysis were used and were presented by Kaplan–Meier curve and forest plot separately.Results: With a median follow‐up time of 34.5months (IQR 1–83 months), the estimated 5-year BCSS rates for patients in the CPM group and the no-CPM group were 81.96% and 78.71%, the 5-year OS rates were 80.10% and 75.05%, respectively. CPM improved the BCSS (hazard ratio [HR]= 0.79; 95% confidence interval [CI]=0.69-0.90, p=0.001) and OS (HR= 0.74; 95% CI=0.66-0.84, p<0.001) of unilateral TNBC patients. Univariate subgroup analyses revealed that there was no significant difference in survival time for patients in stage N3 who underwent CPM or not (p>0.05).Conclusions: CPM only limitedly improved BCSS and OS in patients with unilateral TNBC undergoing total mastectomy or radical mastectomy and was not recommended for stage N3 patients.

scholarly journals Survival outcomes of neoadjuvant versus adjuvant chemotherapy in triple-negative breast cancer: a meta-analysis in 36480 cases.

2020 ◽  
Author(s):  
Lin-Yu Xia ◽  
Qing-Lin Hu ◽  
Jing Zhang ◽  
Wei-Yun Xu ◽  
Xiao-Shi Li
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Residual Disease ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Current Evidence ◽  
Survival Outcomes ◽  
Significant Difference

Abstract Background The survival outcomes of neoadjuvant chemotherapy(NACT) versus adjuvant chemotherapy(ACT) in triple-negative breast cancer (TNBC) remains unclear. Therefore, in this study, a meta-analysis was conducted to analyze current evidence on the survival outcomes of neoadjuvant versus ACT in TNBC. Methods A systematic search of PubMed and Embase databases were done to identify relevant articles investigating the survival outcomes of NACT versus ACT in TNBC. Results A total of nine studies involving 36480 patients met the selection criteria.Of them,10728(29.41%) received NACT, and 25752(70.59%) received ACT.The pathological complete response (pCR) rate is 35% (95% CI = 0.23-0.48). Compared with ACT, the overall survival(OS) of NACT was poor(HR = 1.59; 95%CI = 1.25-2.02; P=0.0001), and there was no significant difference in disease-free survival(DFS) between them(HR = 0.85; 95%CI = 0.54-1.34; P=0.49). NACT with pCR can significantly improve the OS(HR = 0.53; 95%CI = 0.29-0.98; P=0.04) and DFS(HR = 0.52; 95%CI = 0.29-0.94; P=0.03), while the OS(HR = 1.18; 95%CI = 1.09-1.28; P<0.0001) and DFS(HR = 2.36; 95%CI = 1.42-3.89; P=0.0008) of patients with residual disease(RD) following NACT were worse compared with ACT. Conclusion The findings suggest that, for TNBC, Patients receiving NACT with pCR can significantly improve OS and DFS compared with ACT and it turns to be opposite when patients receiving NACT with RD.

scholarly journals Age-Related Biology of Early-Stage Operable Breast Cancer and Its Impact on Clinical Outcome

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1417
Author(s):  
Binafsha M. Syed ◽  
Andrew R. Green ◽  
Emad A. Rakha ◽  
David A.L. Morgan ◽  
Ian O. Ellis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Stage ◽  
Histological Grade ◽  
Survival Rates ◽  
Growth Factor Receptor ◽  
Progesterone Receptors ◽  
Biological Characteristics ◽  
Cancer Specific Survival ◽  
Age Related ◽  
Significant Difference

As age advances, breast cancer (BC) tends to change its biological characteristics. This study aimed to explore the natural progression of such changes. The study included 2383 women with clinically T0-2N0-1M0 BC, managed by primary surgery and optimal adjuvant therapy in a dedicated BC facility. Tissue micro-arrays were constructed from their surgical specimens and indirect immunohistochemistry was used for analysis of a large panel (n = 16) of relevant biomarkers. There were significant changes in the pattern of expression of biomarkers related to luminal (oestrogen receptor (ER), progesterone receptors (PgR), human epidermal growth factor receptor (HER-2), E-cadherin, MUC1, bcl2 CK7/8, CK18 and bcl2) and basal (CK5/6, CK14, p53 and Ki67) phenotypes, lymph node stage, histological grade and pathological size when decade-wise comparison was made (p < 0.05). The ages of 40 years and 70 years appeared to be the milestones marking a change of the pattern. There were significantly higher metastasis free and breast cancer specific survival rates among older women with ER positive tumours while there was no significant difference in the ER negative group according to age. Biological characteristics of BC show a pattern of change with advancing age, where 40 years and 70 years appear as important milestones. The pattern suggests <40 years as the phase with aggressive phenotypes, >70 years as the less aggressive phase and 40–70 years being the transitional phase.

scholarly journals The Survival Outcomes of T1aN0M0 Triple-Negative Breast Cancer With Adjuvant Chemotherapy

2020 ◽  
Vol 10 ◽  
Author(s):  
Wen-Fen Fu ◽  
Qing-Xia Chen ◽  
Xiao-Xiao Wang ◽  
Jie Zhang ◽  
Chuan-Gui Song
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Survival Outcomes

scholarly journals Targeting the Id1-Kif11 Axis in Triple-Negative Breast Cancer Using Combination Therapy

Biomolecules ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 1295
Author(s):  
Archana P. Thankamony ◽  
Reshma Murali ◽  
Nitheesh Karthikeyan ◽  
Binitha Anu Varghese ◽  
Wee S. Teo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cell Cycle ◽  
Triple Negative Breast Cancer ◽  
Large Scale ◽  
Triple Negative ◽  
Genomic Analysis ◽  
Aurora Kinase ◽  
Cell Cycle Regulators ◽  
Tumor Models ◽  
Tnbc Subtype

The basic helix-loop-helix (bHLH) transcription factors inhibitor of differentiation 1 (Id1) and inhibitor of differentiation 3 (Id3) (referred to as Id) have an important role in maintaining the cancer stem cell (CSC) phenotype in the triple-negative breast cancer (TNBC) subtype. In this study, we aimed to understand the molecular mechanism underlying Id control of CSC phenotype and exploit it for therapeutic purposes. We used two different TNBC tumor models marked by either Id depletion or Id1 expression in order to identify Id targets using a combinatorial analysis of RNA sequencing and microarray data. Phenotypically, Id protein depletion leads to cell cycle arrest in the G0/G1 phase, which we demonstrate is reversible. In order to understand the molecular underpinning of Id proteins on the cell cycle phenotype, we carried out a large-scale small interfering RNA (siRNA) screen of 61 putative targets identified by using genomic analysis of two Id TNBC tumor models. Kinesin Family Member 11 (Kif11) and Aurora Kinase A (Aurka), which are critical cell cycle regulators, were further validated as Id targets. Interestingly, unlike in Id depletion conditions, Kif11 and Aurka knockdown leads to a G2/M arrest, suggesting a novel Id cell cycle mechanism, which we will explore in further studies. Therapeutic targeting of Kif11 to block the Id1–Kif11 axis was carried out using small molecular inhibitor ispinesib. We finally leveraged our findings to target the Id/Kif11 pathway using the small molecule inhibitor ispinesib in the Id+ CSC results combined with chemotherapy for better response in TNBC subtypes. This work opens up exciting new possibilities of targeting Id targets such as Kif11 in the TNBC subtype, which is currently refractory to chemotherapy. Targeting the Id1–Kif11 molecular pathway in the Id1+ CSCs in combination with chemotherapy and small molecular inhibitor results in more effective debulking of TNBC.

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