scholarly journals Pathological responses and survival outcomes in patients with locally advanced breast cancer after neoadjuvant chemotherapy: a single-institute experience

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Kyrillus S. Shohdy ◽  
Doaa S. Almeldin ◽  
Madonna A. Fekry ◽  
Mahmoud A. Ismail ◽  
Nedal A. AboElmaaref ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Objective Response ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Breast ◽  
Survival Outcomes ◽  
Ki 67

Abstract Background Pathological complete response (pCR) is a surrogate for the efficacy of neoadjuvant chemotherapy (NCT) in locally advanced breast cancer (LABC). We analyzed the predictive clinical factors for pathological responses and survival outcomes in a cohort of Egyptian patients. Methods We evaluated the medical records of patients with breast cancer who received NCT in our academic institute. Survival curves were estimated with the Kaplan-Meier method. Cox proportional models were used for multiple regression analysis. Results Our cohort included 368 patients with a median age of 48 years (range 21–70). The median follow-up time was 3 years. The clinical tumor stage (T3–4) represented 58%, with 80% having positive axillary nodes. The luminal subgroup prevailed by 68%. The objective response rate (ORR) reached 78%, and 16% of patients achieved pCR. The clinical node stage and optimal chemotherapy were associated with higher ORR (p = 0.035 and p = 0.001, respectively). Predictors of pCR were clinical T-stage (p = 0.026), high Ki-67 index > 20 (p = 0.05), and receiving optimal chemotherapy (p = 0.014). The estimated 3-year disease free-survival (DFS) was 53%. Receptor status, achieving ORR, and pCR were associated with better DFS with hazard ratios of 0.56, p = 0.008; 0.38, p = 0.04; and 0.28, p = 0.007, respectively. Conclusions Luminal tumors still draw benefit from neoadjuvant chemotherapy in terms of clinical response and breast conservative surgery. Treatment escalation to those who did not achieve pCR requires more investigation, given a higher recurrence rate in real-world experience.

Mamographic density and disease-free survival in [HR+, HER2-] locally advanced breast cancer treated with neoadjuvant chemotherapy.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e11536-e11536 ◽  
Author(s):  
Katerin Ingrid Rojas ◽  
Raymundo Flores ◽  
Claudio J Flores ◽  
Joseph A. Pinto ◽  
Henry Leonidas Gomez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Breast ◽  
Free Survival ◽  
Disease Free

Expression of stathmin in tumor to predict response to neoadjuvant chemotherapy with docetaxel-containing regimens in locally advanced breast cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11566-e11566
Author(s):  
Xuli Meng
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Univariate Analysis ◽  
Objective Response ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Gene Assay ◽  
Response To Neoadjuvant Chemotherapy

e11566 Background: We performed this retrospective study to evaluate the value of clinicopathological factors and a novel molecular marker stathmin in predicting treatment response to neoadjuvant chemotherapy (NCT) with docetaxel-containing regimens in patients with locally advanced breast cancer. Methods: Fifty-four consecutive locally advanced patients receiving docetaxel-containing NCT between January 2006 and July 2010 in Zhejiang Cancer Hospital were included. The expression levels of estrogen receptor (ER), progesterone receptor (PR), epidermal growth factor receptor-2 (HER-2), and p53 were detected by immunohistochemistry, while expression of stathmin mRNA was measured by Quanti-Gene assay. Results: The overall clinical objective response (cOR) rate was 75.9% (41/54) in breast. A total of 34 patients (63.0%) experienced pathological OR (pOR), with pathological complete remission (pCR) rate of 20.4% (11/54) in breast and 16.7% (9/54) in both breast and axilla. In univariate analysis, there were associations of pOR in both breast and axilla with age (P=0.054), ER status (P=0.059), subtypes (P=0.062), p53 (P=0.030), and stathmin expression (three terciles) (P=0.039). Mean expression of stathmin in pOR group was 0.410, compared with that in no response group of 0.556 (P=0.051 by Student’s t-test). Similarly, a lower expression of stathmin might represent a higher pCR rate (P=0.061). Moreover, the LOWESS smoothing plot showed the same trend, i.e., that tumor with a lower level of stathmin expression had a higher probability of response to docetaxel-containing NCT. After multivariate adjustment, both ER and stathmin kept being significant with hazard ratio of 4.58 (95% CI: 1.11-18.94, P=0.036) and 2.94 (95% CI: 1.26-6.86, P=0.012), respectively. Conclusions: ER and stathmin were independent predictive factors for NCT with docetaxel-containing regimens.

Circulating Tumor Cell Subtypes may Predict Responses to Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

2020 ◽  
Author(s):  
Ge Ma ◽  
Jingyi Wang ◽  
Xingmeng Wang ◽  
Hanling Zeng ◽  
Minghui Li ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Circulating Tumor Cell ◽  
Chromosome 8 ◽  
Advanced Breast ◽  
Predictive Capacity ◽  
Ki 67

Abstract Background: Neoadjuvant chemotherapy (NCT) is the standard treatment for patients with locally advanced breast cancer (LABC). However, the predictive value of circulating tumor cells (CTCs) with different molecular subtypes in NCT response has not yet been determined, which was, therefore, the aim of this study. Methods: All patients were staged as LABC and received an EC×4 –T×4 NCT regimen. Blood samples were collected from patients at the time of biopsy, and after the first and eighth NCT courses. Patients were divided into High responders (High-R) and Low responders (Low-R) according to Miller-Payne system and changes in Ki-67 levels after NCT treatment. A novel SE-i•FISH strategy was applied to detect CTCs. Subtypes were successfully analyzed in LABC patients undergoing NCT, for the first time. Results: Total CTCs increased continuously and were higher for Low-R patients; while in the High-R group, total CTCs increased slightly during NCT before returning to baseline levels. Triploid and tetraploid chromosome 8 as well as the proportion of each, increased for Low-R but not High-R patients. The number of small CTCs in the Low-R group increased significantly until the last sample, however, remained constant in the High-R group. The patients with more CTCs had shorter PFS and OS than those with less CTCs after the 8th course of NCT. Conclusions: Total CTCs as well as individual subtypes within peripheral blood following NCT were predictive of patient responses to NCT. More detailed characterization of CTC blood profiles may improve predictive capacity and lead to improved LABC treatments.

scholarly journals Association Between Ki67 After Neoadjuvant Chemotherapy and Disease-Free Survival in Breast Cancer.

2021 ◽  
Vol 4 (2) ◽  
pp. 219-239
Author(s):  
Aan Setiawan ◽  
Mulawan Umar ◽  
Erial Bahar
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patient ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Advanced Breast ◽  
Free Survival ◽  
Disease Free

Background: Post Chemotherapy Ki67 in recent year has been investigated as a predictive and prognostic factor in locally advanced breast cancer patient undergoing neoadjuvant chemotherapy. Objectives: To describe the relationship between post-chemotherapy Ki67 and disease-free survival after neoadjuvant chemotherapy in patients with locally advanced breast cancer at Dr. Hospital. Mohammad Hoesin Palembang. Methods: This study is an analytical observational study with prognostic test design conducted in 30 stage III B breast cancer patient. A retrospective search of a prospectively maintained clinical database was performed to identify patient treated with neoadjuvant chemotherapy at the Mohammad Hoesin Hospital. The expression of Ki67 was assessed using immunohisto-chemistry in post therapy surgical excision specimen. Results: From 30 patients, there was a significant relationship between Post Chemotherapy Ki67 and disease- free survival in patients with locally advanced breast cancer (r = -0,742, p = 0.000). The cut off point value of Ki67 was 27,5% with an area under curve (AUC) of 0,716. The results of the post-chemotherapy Ki67 prognosis test included sensitivity 64%, specificity 60%, Positive Predictive Value 88,9%, Negative Predictive Value 25%, accuracy 63,3%. Conclusion: There is a significant relationship between Post Chemotherapy Ki67 to disease free survival and Post Chemotherapy Ki67 can be used as a prognostic biomarker in breast carcinoma patients undergoing neoadjuvant chemotherapy.

scholarly journals Efficacy of Combination Neoadjuvant Chemotherapy and Regional Inductive Moderate Hyperthermia in the Treatment of Patients With Locally Advanced Breast Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303382096359
Author(s):  
Anton Loboda ◽  
Ivan Smolanka Sr ◽  
Valerii E. Orel ◽  
Liubov Syvak ◽  
Tetiana Golovko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Objective Response ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Control Group ◽  
Axillary Lymph ◽  
Experimental Group

Purpose: To evaluate the efficacy of neoadjuvant chemotherapy in combination with regional inductive moderate hyperthermia for patients with locally advanced breast cancer. Patients and Methods: 200 patients with stage IIB-IIIA breast cancer received neoadjuvant chemotherapy (control group, n = 97) or chemotherapy combined with hyperthermia (experimental group, n = 103). Inductive hyperthermia was set at 27.12 ± 0.16 MHz and the 50 W output power. Results: Thermal and color Doppler ultrasound imaging demonstrated that hyperthermia increased the surface temperature on the breasts to < 4°С while the mean values for systolic blood flow were 3.5 times as high as those prior to treatment. Assessment of tumor size and response found a (31.24 ± 3.85)% reduction in the size of the primary tumor in patients receiving chemotherapy + hyperthermia, while chemotherapy alone showed a (22.95 ± 3.61)% decrease on average (p = 0.034). The rate of objective response increased by 15.9% in the experimental group (р = 0.034) compared with the control group. The patients in the experimental group also had axillary lymph node regression of 14.17% greater than in the control group (p = 0.011). Moreover, the combination treatment allowed to increase the proportion of women eligible for breast-conserving and reconstructive surgery by 13.63% in the experimental group. The viable tumor volume was lower in patients receiving neoadjuvant chemotherapy + hyperthermia (24.4 ± 0.2)% compared with those given chemotherapy alone (30.4 ± 0.25)%. The 10-year overall survival rates were higher (log-rank: p = 0.009) in breast cancer patients who underwent chemotherapy combined with hyperthermia than in patients receiving chemotherapy only. Conclusion: The combination neoadjuvant chemotherapy and the technology of regional inductive moderate hyperthermia improved the efficacy of treatment for patients with locally advanced breast cancer staged IIB-IIIA.

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