MRI tumor volume for predicting response to neoadjuvant chemotherapy in locally advanced breast cancer: Findings from ACRIN 6657/CALGB 150007

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 529-529
Author(s):  
N. Hylton ◽  
J. Blume ◽  
C. Gatsonis ◽  
R. Gomez ◽  
W. Bernreuter ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Tumor Size ◽  
Tumor Volume ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Response ◽  
Advanced Breast ◽  
Tumor Diameter

529 Background: American College of Radiology Imaging Network (ACRIN) trial 6657, the imaging component of the I-SPY trial (CALGB 150007/150012), is testing MRI for predicting response to treatment and stratifying risk-of-recurrence in patients with locally-advanced breast cancer. We report preliminary results evaluating MRI for prediction of pathologic response. Methods: Women with ≥3 cm invasive breast cancer receiving neoadjuvant chemotherapy (NACT) with anthracycline-cyclophosphamide (AC) followed by a taxane (T) were enrolled from May 2002 to March 2006. MRI was performed prior to NACT (t1), after 1 cycle AC (t2), between AC and T (t3), and following T prior to surgery (t4). MRI tumor size assessments included longest diameter (MRLD) and tumor volume (MRVol). Clinical size (clinsize) and mammographic longest diameter (MGLD) were also recorded. Linear dimension was measured by the radiologist for MGLD and MRLD; MRVol was calculated by computer using signal enhancement ratio (SER) thresholds. Change in clinical and MRI variables at t2 were compared for ability to predict pathologic complete response (pCR). Results: 237 patients were enrolled at 9 institutions. 216 patients with complete imaging were analyzed. Of tumor size measurements at t4, MRVol showed the strongest correlation with pathsize among clinsize (r = 0.44), MGLD (ns), MRLD (r = 0.28) and MRVol (r = 0.61). Early change in MRVol measured at t2 was the only variable predictive of pCR among clinsize (p = 0.14, 0.15), MRLD (p = 0.40, 0.07), MRVol (p = 0.02, 0.01) and peak SER (p = 0.53, 0.72) in univariate and multivariate logistic regression, respectively. Conclusions: Tumor response measured volumetrically by MRI is a stronger and earlier predictor of pathologic response after NACT than clinical exam or tumor diameter. This work is funded by NIH/ACRIN U01 CA79778; CALGB CA31946, CA33601; NCI SPORE CA58207. [Table: see text]

scholarly journals Perubahan Volume Tumor, Jumlah Trombosit dan Kadar D–dimmer pada Karsinoma Payudara Lanjut Lokal Setelah Kemoterapi Neoadjuvan

2014 ◽  
Vol 43 (1) ◽  
pp. 23-28
Author(s):  
Fredy Rustomi Damanik ◽  
Maman Abdurahman ◽  
Kiki Akhmad Rizki
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Tumor Volume ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Clotting Factors ◽  
Platelet Level ◽  
The Relationship

Background. Locally advanced breast cancer places approximately 40–60% from all the new cases of breast cancer in developing countries. And this kind of breast cancer requires a combined therapy, i.e. chemotherapy, surgery and radiotherapy. Nowadays, the response of chemotherapy is evaluated from the reduction in tumor volume. There is also another parameter. Since half of patients with breast cancer show abnormalities of routine blood clotting factors, D–dimmer which is a fibrin degeneration product from vascular endothelial growth factor (VEGF) is used. There is an increase of plasma D–dimmer level among 86% of breast cancer patients. There is a strong relationship amongst serum VEGF and platelets count in breast cancer patient. Method. To analyze the correlation, we did an evaluation of the tumor volume, platelets count, and plasma D– dimmer among patients with locally advanced breast cancer, before and after cyclophospamide, doxorubicin, 5–fluorouracil (FAC) combined neoadjuvant chemotherapy. This was a prospective study enrolling 36 subjects. The data is obtained from the history, physical examination, laboratory and or radiological exams as it found in medical record. To have a normal distribution of the subjects, a Shapiro–Wilk test was done. Pearson correlation test was applied in evaluation of the relationship of tumor volume, platelet count and plasma D–dimmer level after chemotherapy. Data was analyzed using the SPSS program ver.19. Results. Tumor volume decreases till 153.811 cm3, the platelet level decreased till 4,958.333/mm3 and the plasma D–dimmer level also decreased up to101.389 ng/ml after FAC regimen. A significant relationship was found in platelet counts and tumor volume after chemotherapy with r of 0,391 (p=0,018). The relationship amongst the change in platelet level and plasma D–dimmer level showed a plateau which is quiet high with the value of r=0,473 (p=0,024). Conclusion. There is a positive correlation of the tumor volume, the platelet level, and plasma D–dimmer level after combined FAC neoadjuvant chemotherapy

scholarly journals Predicting Response to Neoadjuvant Chemotherapy in Women with Locally Advanced Breast Cancer in Kenya: Utility of Ki67

2021 ◽  
Vol 18 (1) ◽  
pp. 23-28
Author(s):  
Edwin Mogere ◽  
Joseph Githaiga ◽  
Francis Owilla ◽  
Mary Mungania ◽  
Daniel Ojuka
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Tumor Size ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Advanced Breast ◽  
P Value ◽  
Response To Neoadjuvant Chemotherapy

Background: Ki67 levels have been shown to have good predictive value in breast cancer treatment. There is paucity of data on Ki67 levels in predicting response to neoadjuvant chemotherapy (NACT) in Kenya. This study evaluated the utility of Ki67 in predicting response to NACT. Methods: This was a prospective observational study carried out at Kenyatta National Hospital between December 2017 and January 2019 onpatients with locally advanced breast cancer. We recruited 61 women through consecutive sampling technique. Data collected included patient demographics, pre-treatment tumor size, Ki67 levels and tumor biology. After 3 cycles of first-line chemotherapy, ultrasonography was used to determine response. Data were analyzed by SPSS for proportion of change in tumor size. The response was correlated with tumor biology and pretreatment levels of Ki67 using chisquare at a 95% confidence interval. A p-value <0.05 was considered statistically significant. Results: The response rate after 3 cycles of NACT was 39.4%, sensitivity and specificity of Ki67 levels were 70.8% and 43.2% respectively with a cut-off value of 32.5%. Conclusions: Ki67 was found to predict response in our context at a rate of 39.4% at 20% cutoff after 3 cycles. Keywords: Ki67, Breast cancer, Neoadjuvant chemotherapy

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