Predictors of pathologic response to preoperative chemotherapy and concurrent radiotherapy for locally advanced breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11545-e11545
Author(s):  
R. Venkitaraman ◽  
S. G. Ramanan ◽  
K. R. Rajalekshmy ◽  
T. G. Sagar ◽  
V. Shanta
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Neoadjuvant Chemoradiotherapy ◽  
Complete Response ◽  
Pathologic Response ◽  
Advanced Breast ◽  
Concurrent Radiotherapy

e11545 Background: Combined modality treatment is essential for acheiving optimal results in the management of locally advanced breast cancer (LABC). Neoadjuvant chemoradiotherapy is considered a promising approach for LABC. Pathologic complete response to neoadjuvant treatment for LABC predicts prolonged survival. Aim: To determine the rate of pathologic complete response (pCR) after neoadjuvant chemotherapy and radiotherapy for locally advanced breast cancer and to identify the predictors of pCR. Methods: Female patients with noninflammatory LABC received neo-adjuvant chemotherapy with concurrent radiotherapy, and then underwent mastectomy and axillary clearance. The pathologic response was analysed with respect to the baseline clinical factors and the receptor status on immunohistochemical studies of the initial biopsy specimen. Results: Of the 296 patients included in the study, 286 underwent mastectomy. Ninety-two (31 %) patients achieved a pCR. The significant predictor of a pCR was Oestrogen receptor negative status (p = 0.025), while progesterone receptor negative status (p=0.069 ), HER2 status (p= 0.62), age (p= 0.074), stage (p=0.6), grade (p=0.86), type of chemotherapy (p=0.37) and number of cycles of chemotherapy (p = 0.23) did not predict for pathologic response. Clinical complete response predicted for a pathologic complete response (p=0.0001). Conclusions: Neoadjuvant concurrent chemoradiotherapy results in good pathologic complete response rates in LABC. High pathologic compete response rates are achieved in patients with endocrine receptor negative disease, with neoadjuvant chemoradiotherapy, which might result in improved outcome in this high risk subset of patients. No significant financial relationships to disclose.

Prospective phase II study of neo-adjuvant doxorubicin followed by cisplatin /docetaxel in locally advanced breast cancer—5 years of follow up

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10574-10574
Author(s):  
D. S. Ajarim ◽  
M. Rahal ◽  
A. Al-Sayed ◽  
M. Alshabana ◽  
A. Tulbah ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Conservative Surgery ◽  
Pathologic Response ◽  
Advanced Breast

10574 Background: Neoadjuvant (primary) chemotherapy as part of multimodality treatment is increasingly used as standard of care for patients (pts) with locally advanced breast cancer and firmly established. We conducted a prospective study using doxorubicin 75 mg/m2 q 3 weeks × 3 cycles followed sequentially by docetaxel 75 mg /m2 and cisplatin 75 mg/m2 q 3 weeks × 3cycles. All pts had definitive surgery followed by radiation therapy, ± tamoxifen. Primary end points were pathologic complete response (pCR), secondary endpoints were, safety, rate of conservative surgery and overall survival. Material: Eligible pts included biopsy proven invasive breast cancer, T2-T4 (primary = 4–10 cm) N0-N2, M0. 59 of 60 enrolled pts completed treatment one patient refused surgery after the completion of 6 cycles of chemotherapy were excluded from the analysis, median age:41yrs (24- 60), Premenopausal: 68%, median tumor size: 6.0cm (4 - 10), Stage IIB:32% and IIIA / IIIB: 68%, both ER / PR positive: 53%, Her2/neu (3+) by IHC staining and /or Fish positive: 29%. All patients had negative metastatic workup. Results: 59 pts are evaluable for analysis: clinical complete response was seen in: 44%, clinical partial response in: 56 %. Breast conserving surgery was performed in: 44 %, and MRM in: 56%. Pathological complete response (pCR) in the breast was: 31 %, in axilla were: 37 %. Grade3–4 Toxicities: Febrile Neutropenia: (13%), Nausea vomiting: (12%), Mucositis: (10%), weakness/asthenia/weight loss: 12%. Overall at follow up of 60 months the DFS & OS (67% and 74%).Patients who achieved complete pathologic response in breast and/or axilla the DFS and OS were (91%), 13 patients relapsed 46% were Her2 positive. Conclusion: Sequential combination of doxorubicin followed by docetaxel/cisplatin is a safe, feasible and active combination, that offer the possibility of conservative surgery and associated with high clinical and pathologic response, further investigation of this combinations are warranted. No significant financial relationships to disclose.

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.

Monitorization of primary therapy (PT) by additional imaging methods in locally advanced breast cancer (LABC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10580-10580
Author(s):  
M. Margelí ◽  
B. Cirauqui ◽  
V. Vallejos ◽  
C. Sánchez ◽  
A. Mariscal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Complete Response ◽  
Pathologic Response ◽  
Diagnostic Methods ◽  
Advanced Breast ◽  
Primary Therapy ◽  
Pathological Findings

10580 Introduction: The response of locally advanced breast cancer (LABC) to Primary therapy (PT) may be monitored clinically and by mammography (MG). Magnetic resonance (MR) and 99mTc-sestamibi scintimammography (SMM) are increasingly being used. The aim of this study was to determine whether MG, MR and SMM are accurate indicators of tumour response to PT and whether they are predictors of histological response. Patients and Methods: A prospective observational study was approved at our institution and 52 patients( p) with core biopsy diagnostic of LABC and written consent were enrolled (mean age 52 years, SD 13) All p had clinical, MG, MR, SM assessment pre- and post- PT. Primary chemotherapy based on anthracyclines was administered as follows: 19 p FEC, 17 p AC-Docetaxel, 8 p Gemcitabine- Doxorubicine- Paclitaxel, 1 p FEC- Docetaxel and 1 p Carboplatin- VP16. 6 p were treated with hormone-therapy. RECIST criteria were considered for clinical response assessment and the same criteria was adapted for imaging and pathologic response. Results: After PT 33 tumours were considered not suitable for breast-conserving surgery. Based on histopathological findings, 10 (19%) lesions showed complete pathologic response, 30 (58%) partial response, 12 (23%) stabilization. No progression was detected. Clinical assessment of tumour complete response agreed with pathology in 40 of 52 tumours (78%), and with MG in 39 (78%). Correlation between MG and pathological findings was observed in 42 p (84%). Correlation between MR and pathological findings was observed in 42 p (82%). Correlation between SMM and pathological findings was observed in 31 p (66%). Among patients with complete pathologic remission, 9 of ten patients achieve a complete response by MR and SMM. Conclusion: In conclusion, our results don’t show that MR and SMM add any benefit to the diagnostic arsenal for predicting histopathological complete response to PT. However these new diagnostic methods should be considered in selected cases. No significant financial relationships to disclose.

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