Differential response to primary chemotherapy and long-term survival in patients with triple-negative breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10519-10519 ◽  
Author(s):  
C. Liedtke ◽  
C. Mazouni ◽  
K. R. Hess ◽  
A. Tordai ◽  
F. André ◽  
...  

10519 Objective. Triple-negative breast cancer is defined as a subtype of invasive breast cancer which lacks estrogen and progesterone receptor expression as well as HER2/neu expression and is highly similar to the basal-like subtype defined by gene expression profiling. Method. 1,143 patients treated at MD Anderson Cancer Center in neoadjuvant trials were included in a retrospective comparative analysis between triple-negative tumors and non-triple-negative tumors for response to neoadjuvant chemotherapy as well as long- term survival. Results. 827/1,143 (72%) patients had received taxanes, either as a single-agent (n=60) or in combination with anthracycline (n=767), whereas the remainder patients received an anthracycline-only chemotherapy. Overall 258/1,143 (23%) tumors were triple- negative. Complete pathological response (pCR) was achieved in 63/257 (25%) patients with triple-negative tumors compared to 99/888 (11%) in patients with non-triple-negative tumors (odds ratio [OR] 1.14, 95%CI: 1.09–1.20, p=.0082). Triple-negative status correlated significantly with high nuclear grade (p<.0001), whereas no significant correlation with any established clinicopathologic parameter was observed. However, 5-year overall survival (5yrOS) was 66% in the triple-negative group compared to 83% in the non-triple-negative control group (OR 2.1, 95%CI: 1.6–2.8, p<.0001). In multivariate analyses, triple-negative status (hazard ratio [HR] 2.0, 95%CI: 1.4–2.8, p<.0001), high nuclear grade, increased tumor size (HR 1.5, 95%CI: 1.3–1.8, p<.0001), positive nodal status (HR 1.4, 95%CI: 1.2–1.7, p=.0002) and high nuclear grade (HR 1.7, 95%CI: 1.1- 2.4, p=.0089) were significantly associated with decreased 5yrOS. When survival was analyzed according to both response rate and triple negative status, achievement of pCR was a stronger predictor of survival compared to triple-negative status. Conclusion. Triple- negative expression status among patients with breast cancer constitutes an independent unfavorable prognostic factor with regards to overall survival unless achieving pCR after neoadjuvant chemotherapy. No significant financial relationships to disclose.

2021 ◽  
pp. 767-781
Author(s):  
Manikandan Dhanushkodi ◽  
Velusamy Sridevi ◽  
Viswanathan Shanta ◽  
Ranganathan Rama ◽  
Rajaraman Swaminathan ◽  
...  

PURPOSE There are sparse data on the outcome of patients with locally advanced breast cancer (LABC). This report is on the prognostic factors and long-term outcome from Cancer Institute, Chennai. METHODS This is an analysis of untreated patients with LABC (stages IIIA-C) who were treated from January 2006 to December 2013. RESULTS Of the 4,577 patients with breast cancer who were treated, 2,137 patients (47%) with LABC were included for analysis. The median follow-up was 75 months (range, 1-170 months), and 2.3% (n = 49) were lost to follow-up at 5 years. The initial treatment was neoadjuvant concurrent chemoradiation (NACR) (77%), neoadjuvant chemotherapy (15%), or others (8%). Patients with triple-negative breast cancer had a pathologic complete response (PCR) of 41%. The 10-year overall survival was for stage IIIA (65.1%), stage IIIB (41.2%), and stage IIIC (26.7%). Recurrence of cancer was observed in 27% of patients (local 13% and distant 87%). Multivariate analysis showed that patients with a tumor size > 10 cm (hazard ratio [HR], 2.19; 95% CI, 1.62 to 2.98; P = .001), hormone receptor negativity (HR, 1.45; 95% CI, 1.22 to 1.72; P = .001), treatment modality (neoadjuvant chemotherapy, HR, 0.56; 95% CI, 0.43 to 0.73; P = .001), lack of PCR (HR, 2.36; 95% CI, 1.85 to 3.02; P = .001), and the presence of lymphovascular invasion (HR, 1.97; 95% CI, 1.60 to 2.44; P = .001) had decreased overall survival. CONCLUSION NACR was feasible in inoperable LABC and gave satisfactory long-term survival. PCR was significantly higher in patients with triple-negative breast cancer. The tumor size > 10 cm was significantly associated with inferior survival. However, this report acknowledges the limitations inherent in experience of management of LABC from a single center.


2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 162-162
Author(s):  
Kazushige Futsuhara ◽  
Kenichi Inoue ◽  
Shigenori E. Nagai ◽  
Tsuyoshi Saito ◽  
Takashi Sakurai ◽  
...  

162 Background: Prospective randomized clinical trials have demonstrated a significant advantage from postoperative adjuvant chemotherapy for patients with breast cancer. However, triple-negative breast cancer is high rate of early recurrence. Therefore, patients who do not achieve pathological complete response (pCR) for neoadjuvant chemotherapy have worse long-term survival than patients who achieve pCR. Treatment after adjuvant chemotherapy and neoadjuvant chemotherapy is not established yet. We notice that TS-1 improve early recurrent rate of breast cancer. TS-1 proved good response for advanced breast cancer and long-term therapy is possible. We planned the study for the purpose of inspecting it about the safety, completion and efficacy of giving TS-1 after standard therapy of triple negative breast cancer for one year. Methods: The patients with stage ±/II/ III triple negative breast cancer received neoadjuvant or adjuvant chemotherapy and surgery and/or radiotherapy. Furthermore, the cases of neoadjuvant chemotherapy did not achieved pCR. After that, dose of TS-1 is 80mg/m² administered orally daily for 2 weeks followed by a 1-week rest period given as 3-week cycles. Results: 63 patients were enrolled, including 44 patients received neoadjuvant chemotherapy and 19 patients received adjuvant chemotherapy. The average age is 50 years (28-68 years). 38 cases (60.3%) brought oral administration for one year to completion. The reasons of discontinuance were 15 cases of toxicity and 10 cases of recurrence. Average relative dose intensity was 80%. The compliance of TS-1 was 70.1% (222.4 days). Overall survival of 3 years was 86.47%, progression-free survival 50.8%. The overall incidence of toxicity was 54 cases (85.7%), and grade 3 toxicity occurred in 21 cases (33.3%). Conclusions: The compliance of TS-1 was approximately equal to the compliance for gastric cancer in spite of receiving treatments of anthracycline and/or taxane. The toxicity was approximately equal to the results for metastatic breast cancer. TS-1 administered orally for one year was feasible for triple negative breast cancer received standard therapy. Clinical trial information: UMIN000001414.


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