Analysis of the pathological response to primary chemotherapy in patients with locally advanced breast cancer (LABC) grouped according to ER, PR and HER2 status

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 626-626 ◽  
Author(s):  
L. A. Fernandez-Morales ◽  
E. Dalmau ◽  
S. Martinez ◽  
A. Arcusa ◽  
C. Pericay ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptors ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Complete Response ◽  
Primary Chemotherapy ◽  
Response To Treatment ◽  
Her2 Status ◽  
P Value ◽  
Chi Squared

626 Background: The determination of ER and PR has a considerable importance when evaluating the prognosis and the response to treatment in breast cancer (BC). Assessment of HER2 status is also a standard for the management of BC. Hormone receptors (HR), HER2, and increasingly, genomic profiles distinguish at least four major classes of BC: HER2+; HER2-HR+, which can be divided into two classes, favorable and unfavorable; and basal-like that express neither HER2 nor HR. In the clinical practice is possible to divided BC according to ER, PR and HER2: ER-PR-HER2+, ER-PR-HER2-, ER+PR+HER2-, ER+RP+HER2+; and less frequently ER+PR-HER2-, ER+PR-HER2+, ER-PR+HER2+ and ER-PR+HER2-. In the neoadjuvant setting the pathological complete response (pCR) to primary chemotherapy (PC) is associated to negativity for ER and PR receptors, and in patients (pts) with HER2 + BC, the addition of trastuzumab to PC increasing the rate of pCR. The aims of this study were to determine the pCR of PC with anthracyclines (A) and taxanes (T) in pts with LABC grouped according to ER, PR and HER2 status. Methods: Pts with LABC treated with PC including A and T were grouped according to ER, PR and HER2 status, and the pCR rate were analyzed using the chi-squared test and correlations with a p value of ≤0,05 were considered statistically significant. Results: A total of 103 pts were treated. There were 14.6% of ER-PR-HER2+ BC, 23.3% ER-PR-HER2-, 35.0%ER+PR+HER2-, 8.7% ER+PR+HER2+, 11.7% ER+PR-HER2-, 2.9% ER+PR-HER2+, 1.9% ER-PR+HER2+, and 1.9% ER-PR+HER2-. For the analysis of pCR only 100 pts were included. There were18 pts who achieved a pCR. Of these pts, 9/18 (50.0%) were RE-RP-HER2-, 5/18 (27.8%) ER-PR-HER2+, 3/18 (16.7%) ER+PR+HER2+, and 1/18 (5.6%) ER+PR+HER2- (p≤0.01). The table 1 show the pCR rate for each subgroup of BC. Conclusions: In patients with LABC to group BC according to ER, PR and HER2 status can help to predict pCR to PC. [Table: see text] No significant financial relationships to disclose.

Impact of body composition on toxicity and pathological complete response in locally advanced breast cancer (BC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 593-593
Author(s):  
Laura Sofia Munoz-Arcos ◽  
Jessica Mayer ◽  
Orli Haken ◽  
Jessica Goldman ◽  
Joseph A. Sparano ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pathological Complete Response ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Tumor Grade ◽  
Complete Response ◽  
Stage Ii ◽  
Her2 Status ◽  
Severe Toxicity ◽  
Logistic Regression Models

593 Background: Obesity, defined as body mass index (BMI) > 30 kg/m2, has been associated with inferior outcomes in localized breast cancer (BC), including lower pathological complete response (pCR) to neoadjuvant chemotherapy (NAC). High BMI is usually associated with excess adipose tissue (AT), but also reflects skeletal muscle (SM) mass. Low SM mass (sarcopenia) has also been associated with inferior outcomes and more chemotherapy-associated toxicity. We aimed to evaluate the association of BMI, AT and SM tissue with pCR and toxicity after NAC for stage II-III breast cancer (BC). Methods: 191 patients with stage II-III BC received NAC, had information regarding baseline BMI, toxicity and pCR to NAC at surgery, and, had abdominal computerized tomography (CT) prior to NAC. Total AT (TAT), visceral AT (VAT), subcutaneous AT (SAT), SM area (SMA) and SM density (SMD) were measured by CT at the L3 level using the TOMOVISION software. SM index (SMI) was calculated (SMA/height) to assess for sarcopenia (SMI < 40). Association linking BMI, SAT, VAT, SMA and SMD to pCR and severe toxicity (ST ≥ grade 3) was evaluated using logistic regression models. Results: Patients were predominantly black (51%) with a median age of 54 years (interquartile range = 45-63). pCR was achieved in 31% (60/191) of patients. Of those, 47% (n = 28/60), 40% (n = 24/60) and 13% (n = 8/60) corresponded to HER2(+), triple negative, and hormone receptor-HR(+)/HER2(-) tumors, respectively. ST occurred in 38% (n = 73/191) of patients. Obesity and sarcopenia were present in 52% (n = 100/191) and 14% (n = 27/191) of patients, respectively. There was a statistically significant association between VAT and pCR (median VAT 95.3 cm2 vs. 121.8 cm2 in the pCR vs. no-pCR groups, respectively, p = 0.03). This association remained after adjusting for age, race, tumor grade, stage, BMI, SMD, HR and HER2 status (p = 0.04). There was a statistically significant association between SMA and ST (mean SMA 123 cm2 vs. 130 cm2 in the ST vs. no-ST groups, respectively, p = 0.03). This association disappeared after adjusting for age, race, BMI, VAT, SAT, and SMD (p = 0.21). Conclusions: This study provides evidence that in patients with stage II-III BC receiving NAC, excess VAT is associated with significantly lower pCR rates, and low SMA is associated with ST. Additional research is needed to elucidate the pathophysiologic mechanisms contributing to these associations.

Assessment of pathological complete response (pCR) to neoadjuvant dose-dense chemotherapy in HER2+ patients with locally advanced breast cancer (LABC) treated with trastuzumab (T) compared with HER2+ and HER2- patients treated without T

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11057-11057
Author(s):  
A. Sanchez-Muñoz ◽  
A. M. García-Tapiador ◽  
R. Dueñas-García ◽  
A. Jaén-Morago ◽  
E. Martínez-Ortega ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Complete Response ◽  
Breast Conserving Surgery ◽  
Her2 Status ◽  
Institutional Practice ◽  
Trastuzumab Therapy ◽  
Dose Dense

11057 Purpose: To identify Her2+expression as predictive factor for pCR to T in pts with LABC treated with neoadjuvant chemotherapy. Methods: A total of 127 newly diagnosed stage II-III, including inflammatory tumors, breast cancer pts were reviewed. Median age was 47,7 (r 26,4 - 73,6). Median tumor size was 5 cm (1–10). 57 (44,8%) were T2, 33 (26%) T3 and 37 (29,2%) T4 (25 of them inflammatory). 59 (46,5%) pts were clinically lymph node positive before treatment. 50 pts (39,4%) were hormonal receptor negative, and 38 (30,4%) Her2+. The pts received one of the 2 chemotherapy regimens every 2 weeks with prophylactic growth factors support: A) epirubicin 90 mg/m2-cyclophophamide 600 mg/m2 d1 for 3 cycles, followed by a second sequence with paclitaxel (P) 150 mg/m2- gemcitabine (G) 2500 mg/m2 d1 ± T 2mg/kg/wk according to status Her2 (n= 73); B) adriamicin 40mg/m2 d1 plus P 150mg/m2-G 2000 mg/m2 d2 for 6 cycles (n=54). Subsequently pats underwent surgery and radiotherapy and/or adjuvant hormonal therapy according to institutional practice. Results: 43 (33,9 %) pts achieved a pCR (absence of invasive tumor in the breast). The pts were classified in two groups to analyze the influence of the treatment with T on pCR: (1) Her2+ pats treated with T (20 pts): pCR 50%; (2) The rest of the pts, treated only with chemotherapy (107 pts: 18 Her2+ and 89 Her2- ): pCR 32% (p=0.068). Breast-conserving surgery was performed in 77 pts (60,6%). Conclusions: Both dose dense chemotherapy regimens were highly effective in terms of pCR. Although there were not a significative correlation of Her2+ status and trastuzumab therapy with pCR, probably due to the small number of pts, a favorable tendency was seen in the group of Her2+ tumors treated with T. At the meeting, analysis of the correlation of pCR with progression free survival will be presented. No significant financial relationships to disclose.

scholarly journals Assessment and Prediction of Response to Neoadjuvant Chemotherapy in Breast Cancer: A Comparison of Imaging Modalities and Future Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3521
Author(s):  
Valeria Romeo ◽  
Giuseppe Accardo ◽  
Teresa Perillo ◽  
Luca Basso ◽  
Nunzia Garbino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Response ◽  
Imaging Techniques ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Complete Response ◽  
Mri Imaging ◽  
Future Perspectives ◽  
Advanced Imaging

Neoadjuvant chemotherapy (NAC) is becoming the standard of care for locally advanced breast cancer, aiming to reduce tumor size before surgery. Unfortunately, less than 30% of patients generally achieve a pathological complete response and approximately 5% of patients show disease progression while receiving NAC. Accurate assessment of the response to NAC is crucial for subsequent surgical planning. Furthermore, early prediction of tumor response could avoid patients being overtreated with useless chemotherapy sections, which are not free from side effects and psychological implications. In this review, we first analyze and compare the accuracy of conventional and advanced imaging techniques as well as discuss the application of artificial intelligence tools in the assessment of tumor response after NAC. Thereafter, the role of advanced imaging techniques, such as MRI, nuclear medicine, and new hybrid PET/MRI imaging in the prediction of the response to NAC is described in the second part of the review. Finally, future perspectives in NAC response prediction, represented by AI applications, are discussed.

scholarly journals The Prognostic Impact of Body Composition for Locally Advanced Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 608
Author(s):  
Toshiaki Iwase ◽  
Aaroh Parikh ◽  
Seyedeh S. Dibaj ◽  
Yu Shen ◽  
Tushaar Vishal Shrimanker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Adipose Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Advanced Breast

Our previous study indicated that a high amount of visceral adipose tissue was associated with poor survival outcomes in patients with early breast cancer who received neoadjuvant chemotherapy. However, inconsistency was observed in the prognostic role of body composition in breast cancer treatment outcomes. In the present study, we aimed to validate our previous research by performing a comprehensive body composition analysis in patients with a standardized clinical background. We included 198 patients with stage III breast cancer who underwent neoadjuvant chemotherapy between January 2007 and June 2015. The impact of body composition on pathologic complete response and survival outcomes was determined. Body composition measurements had no significant effect on pathologic complete response. Survival analysis showed a low ratio of total visceral adipose tissue to subcutaneous adipose tissue (V/S ratio ≤ 34) was associated with shorter overall survival. A changepoint method determined that a V/S ratio cutoff of 34 maximized the difference in overall survival. Our study indicated the prognostic effect of body composition measurements in patients with locally advanced breast cancer compared to those with early breast cancer. Further investigation will be needed to clarify the biological mechanism underlying the association of V/S ratio with prognosis in locally advanced breast cancer.

scholarly journals Influence of ABCB1 C3435T gene polymorphisms on tumor response to neoadjuvant chemotherapy in locally advanced breast cancer patients from Northeastern Brazil.

2019 ◽  
Author(s):  
Diego de Aragão Bezerra ◽  
Jose Juvenal Linhares ◽  
Emmanuelle Coelho Noronha ◽  
Kaio César Simiano Tavares ◽  
André Saraiva Leão Marcelo Antunes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced Breast Cancer ◽  
Single Gene ◽  
Locally Advanced ◽  
Northeastern Brazil ◽  
P Value ◽  
Female Population ◽  
C3435t Polymorphism ◽  
Response To Neoadjuvant Chemotherapy

Abstract Background: Breast cancer (BC) is the most common tumor and the leading cause of cancer-related death among the female population worldwide. To evaluate the association between the ABCB1 C3435T single gene nucleotide polymorphisms (SNPs) with the response to neoadjuvant chemotherapy in women with breast cancer. Methods: This study included 32 female patients who received neoadjuvant chemotherapy. The polymorphisms were genotyped through real-time allele-specific polymerase chain reaction (PCR). The statistical analysis was performed using the Fisher's exact test or Pearson's chi-square test in the Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: The genotypes found for the C3435T polymorphism were in Hardy-Weinberg equilibrium and their genotypic distributions were CC= 10 (31.1%), CT= 14 (43.8%), and TT= 08 (25.0%) with χ2: 0.86 and p-value > 0.05. Allele frequencies were C = 0.54 and T = 0.46. There were no significant statistical differences between genotypes considering the response to neoadjuvant chemotherapy and immunohistochemistry; the presence of the T allele was associated with worsen axillary status response to neoadjuvant chemotherapy. Conclusion: No definite association between the presence of C3435T polymorphism and the response to neoadjuvant chemotherapy was observed. Further studies in Brazil involving larger samples will contribute to validating the results of this study. Keywords: Breast cancer; Neoadjuvant Chemotherapy; Polymorphisms; Gene ABCB1

scholarly journals Concordance Between ER, PR, HER2 neu Receptors Before and After Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Heba F. Taha ◽  
Ola M. Elfarargy ◽  
Reham A. Salem ◽  
Doaa Mandour ◽  
Amira A. Salem ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Hormone Receptor ◽  
Growth Hormone Receptor ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Before And After ◽  
Tumor Phenotype

Abstract Background Introducing neoadjuvant chemotherapy (NCT) in a breast cancer patient may be associated with changes in estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth hormone receptor 2 (HER2) status. Method In our prospective cohort study, we evaluated the impact of change in estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth hormone receptor 2 (HER2) on the prognosis of breast cancer patients treated with neoadjuvant chemotherapy (NCT). We investigated 110 patients with locally advanced breast cancer for ER, PR and HER2 status of their lesions before and after NCT. Result For hormone receptor status (HR) (which include ER, PR) of the residual tumor of the patients after receiving NCT, 12 (10.9%) of them changed from HR (+) to HR (−) and 15 (13.6%) changed from HR (−) to HR (+). For HER2 status after NCT, 8 (7.3%) patients changed from HER2 (+) to HER2 (−) and 9 (8.2%) patients changed from HER2 (−) to HER2 (+). Triple negative (TN) tumor phenotype changes occurred in 17 (15.5%) patients. Patients for whom the HR status changed from positive to negative had poor prognosis for both disease-free survival (DFS) and overall survival (OS) in univariate survival analysis. Conclusion Changes in ER, PR, HER2 status and tumor phenotype in breast cancer patients after NCT had a negative prognostic impact and were associated with a poor prognosis.

Sign in / Sign up

Export Citation Format

Share Document