Role of proliferation in response to neoadjuvant chemotherapy in GEICAM/2006-03 and GEICAM/2006-14 breast cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10616-10616
Author(s):  
E. Alba ◽  
Joan Albanell ◽  
Jose Ignacio Chacon Lopez-Muniz ◽  
Lourdes Calvo ◽  
Juan De la Haba- Rodriguez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Neoadjuvant Chemotherapy ◽  
Predictive Factor ◽  
Ductal Carcinoma ◽  
Histological Grade ◽  
Univariate Analysis ◽  
Her2 Status ◽  
Multivariate Logistic Regression ◽  
Long Term Outcome

10616 Background: Ki67 proliferation biomarker determined by immunohistochemistry (IHC) has been studied as a prognostic and predictive factor in Operable Breast Cancer (OBC). Ki67 modifications after neoadjuvant endocrine therapy have been correlated with long term outcome. However, there is no robust data about its predictive role in Neoadjuvant Chemotherapy (NC). In this study, we investigated Ki67 value as predictor of NC efficacy. Methods: 193 patients (pts) from 2 GEICAM phase II randomized trials (2006-03 and 2006-14) were included: 78 (40%) received epirubicine plus cyclophosphamide followed by docetaxel (EC-D), 41 (21%) EC-D plus carboplatin, and out of the 74 HER2+ pts, 37 (19%) received EC-D plus tratuzumab and 37 (19%) EC-D plus lapatinib. Median age was 49 years. From series, 87% were invasive ductal carcinoma, 58% premenopausal, 50% grade III, 23% luminal , 39% basal and 38% HER2+. Ki67 was centrally assessed by IHC (MIB1 clone) and median score was 40% (range 1-100%). Pathological Complete Response (pCR), defined as absence of invasive cells in breast and lymph nodes, was achieved in 56 pts (29%). Univariate and multivariate logistic regression models were used to study the association of each clinical-pathological variable with pCR. ROC curves were used to determine the most accurate ki67 cut-off for predicting NC response. Results: Ki67≥50% was defined as the most accurate threshold to select patients obtaining benefit from NC. In the univariate analysis, histological grade (p=0.01), treatment (P=0.006), ER (p<0.0001), PR (p<0.0001), HER2 (p=0.01), and Ki67≥50% (p=0.0003) were statistically associated with pCR. A multivariate logistic regression showed that only Ki67≥ 50% (p=0.0003; OR=5.4 CI95% 2.1-13.4), ER (p=0.0001; OR=0.2 CI95% 0.1-0.4), and HER2 status (p<0.0001; OR=8.8 CI95% 3.3-23.6) were predictive for pCR (AUC=0.7812). Conclusions: These results suggest that a high proliferation in breast cancer measured by Ki67 marker is an independent predictive factor for pCR in an unclassified HER2 population of OBC patients treated with NC.

Lobular invasive pleomorphic breast cancer (BC) should be isolated from the classic type

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17024-17024 ◽  
Author(s):  
E. Gil Deza ◽  
H. Japaze ◽  
C. García Gerardi ◽  
C. Diaz ◽  
N. Gercovich ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ductal Carcinoma ◽  
Histological Grade ◽  
Lobular Carcinoma ◽  
Stage I ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Entire Cohort ◽  
Worse Prognosis

17024 Background: Lobular invasive BC represents between 5 and 10% of all breast tumors. The MD Anderson Hospital has published a study of 122 pt with lobular invasive carcinoma classic type (LIC) with a better long-term outcome than pt with invasive ductal carcinoma (JCO 23:41, 2005). In most papers, the lobular invasive pleomorphic type (LIP) represents a small number of cases and can be easily confused with the NOS carcinoma. The aim of this study is to compare the onset and prognosis of patients (pt) with LIP vs LIC breast cancer. Methods: A search in the IOHM database of 1169 BC was carried out. All of them had been reviewed by two pathologists and classified according the USA Association of Directors of Anatomic and Surgical Pathology's recommendations. The entire cohort was diagnosed and treated at the IOHM. Only those with lobular invasive BC were included in this paper. Results: Between Oct 97 and Nov 06, 116/1169 pt (10%) were diagnosed with invasive lobular carcinoma. Seventy pt (60%) were LIC, and 46 pt (40%) were LIP. Characteristics of the Population: All pt were females. Both groups were comparable in terms of age (median age for both groups = 60 yo) Staging: LIP presented in more advanced stages: A) LIP group: Stage I: 14 pt; II: 22 pt; III: 8 pt; IV: 2 pt B) LIC group: Stage I: 42 pt ; II:13 pt; III: 15 pt; (p:0,001). The LIP group had a higher histological grade (p:0,0001), and more multifocality (p: 0.023), and vascular invasion (p:0,0001) than the LIC group. There were no differences in hormonal receptors status or the ductal extensive component. The retrospective determination of the Her2/neu status is underway. Treatment: Both groups were treated similarly according to the different stages of the illness. Follow-Up: The average follow up time was 23 months (range 4–102) and the LIP group showed a worse prognosis than the LIC group as measured by a higher rate of metastasis (LIP: 12 pt - LIC: 4 pt) (p:0,002) and a higher mortality rate (LIP: 6 pt - LIC: 0) (p:0,003). Conclusions: 1- The LIP carcinoma is a more aggressive variant and has a worse prognosis than the LIC. 2- The incidence for LIP is higher than expected, as it stands for 40% of the total cases in our study. 3- The results justify the establishment of a clear cut differentiation between the classical and pleomorphic types. No significant financial relationships to disclose.

Multivariable Models Based on Baseline Imaging Features and Clinicopathological Characteristics to Predict Breast Pathologic Response after Neoadjuvant Chemotherapy in Patients with Breast Cancer

Breast Care ◽  
2021 ◽  
Author(s):  
Peixian Chen ◽  
Chuan Wang ◽  
Ruiliang Lu ◽  
Ruilin Pan ◽  
Lewei Zhu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Prediction Models ◽  
Univariate Analysis ◽  
Pathologic Complete Response ◽  
Clinicopathological Characteristics ◽  
Her2 Status ◽  
Imaging Features ◽  
Multivariate Models ◽  
Multivariable Models

Abstract Introduction Currently, the accurate evaluation and prediction of response to neoadjuvant chemotherapy (NAC) remains a great challenge. We developed several multivariate models based on baseline imaging features and clinicopathological characteristics to predict the breast pathologic complete response (pCR). Methods We retrospectively collected clinicopathological and imaging data of patients who received NAC and subsequent surgery for breast cancer at our hospital from 2014 June till 2020 September. We used mammography, ultrasound and magnetic resonance imaging (MRI) to investigate the breast tumors at baseline. Results A total of 308 patients were included and 111 patients achieved pCR. The HER2 status and Ki-67 index were significant factors for pCR on univariate analysis and in all multivariate models. Among the prediction models in this study, the ultrasound-MRI model performed the best, producing an area under curve of 0.801 (95%CI=0.749-0.852), a sensitivity of 0.797 and a specificity of 0.676. Conclusion Among the multivariable models constructed in this study, the ultrasound plus MRI model performed the best in predicting the probability of pCR after NAC. Further validation is required before it is generalized.

scholarly journals Linc00665 Can Predict the Response to Cisplatin-Paclitaxel Neoadjuvant Chemotherapy for Breast Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Huijuan Dai ◽  
Xiaonan Sheng ◽  
Rui Sha ◽  
Jing Peng ◽  
Fan Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Univariate Analysis ◽  
Enrichment Analysis ◽  
Predictive Biomarker ◽  
Gene Set Enrichment Analysis ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Kegg Analysis

ObjectiveLinc00665 is a novel long non-coding RNA that can promote the progression of breast cancer, but its value in predicting the efficacy of neoadjuvant chemotherapy (NAC) for breast cancer has not been reported. We aim to analyze the correlation between Linc00665 expression and pathological complete response (pCR) in breast cancer patients.Materials and MethodsThe present study examined the predictive role of Linc00665 expression in pCR after NAC using both univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curve and area under curve (AUC) were utilized to evaluate the performance of Linc00665 in predicting pCR. The Kyoto Encyclopedia of Gene and Genome (KEGG) analysis and Gene Set Enrichment Analysis (GSEA) were also conducted to determine the biological processes where Linc00665 may participate in.ResultsThe present study study totally enrolled 102 breast cancer patients. The univariate analysis showed that Linc00665 level, human epidermal growth factor receptor 2 (HER2) status and hormone receptor (HR) status were correlated with pCR. The multivariate analysis showed that Linc00665 expression was an independent predictor of pCR (OR = 0.351, 95% CI: 0.125–0.936, P = 0.040), especially in patients with HR-positive/HER2-negative subtype (OR = 0.272, 95% CI: 0.104–0.664, P = 0.005). The KEGG analysis indicated that Linc00665 may be involved in drug metabolism. The GSEA analysis revealed that Linc00665 is correlated to DNA damage repair.ConclusionLinc00665 may be a potential novel predictive biomarker for breast cancer in NAC, especially for HR-positive/HER2-negative patients.

scholarly journals Predicting Pathological Complete Response After Neoadjuvant Chemotherapy in Advanced Breast Cancer by Ultrasound and Clinicopathological Features Using a Nomogram

2021 ◽  
Vol 11 ◽  
Author(s):  
Hao Cui ◽  
Dantong Zhao ◽  
Peng Han ◽  
Xudong Zhang ◽  
Wei Fan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Predictive Value ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Clinicopathological Features ◽  
Multivariate Logistic Regression ◽  
Sensitivity Specificity

Background and AimsPrediction of pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) for breast cancer is critical for surgical planning and evaluation of NAC efficacy. The purpose of this project was to assess the efficiency of a novel nomogram based on ultrasound and clinicopathological features for predicting pCR after NAC.MethodsThis retrospective study included 282 patients with advanced breast cancer treated with NAC from two centers. Patients received breast ultrasound before NAC and after two cycles of NAC; and the ultrasound, clinicopathological features and feature changes after two cycles of NAC were recorded. A multivariate logistic regression model was combined with bootstrapping screened for informative features associated with pCR. Then, we constructed two nomograms: an initial-baseline nomogram and a two-cycle response nomogram. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were analyzed. The C-index was used to evaluate predictive accuracy.ResultsSixty (60/282, 21.28%) patients achieved pCR. Triple-negative breast cancer (TNBC) and HER2-amplified types were more likely to obtain pCR. Size shrinkage, posterior acoustic pattern, and elasticity score were identified as independent factors by multivariate logistic regression. In the validation cohort, the two-cycle response nomogram showed better discrimination than the initial-baseline nomogram, with the C-index reaching 0.79. The sensitivity, specificity, and NPV of the two-cycle response nomogram were 0.77, 0.77, and 0.92, respectively.ConclusionThe two-cycle response nomogram exhibited satisfactory efficiency, which means that the nomogram was a reliable method to predict pCR after NAC. Size shrinkage after two cycles of NAC was an important in dependent factor in predicting pCR.

Đánh giá kết quả điều trị tân bổ trợ ung thư vú tại Bệnh viện Ung bướu Đà Nẵng

2020 ◽  
Author(s):  
Tinh Bui Thanh
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Breast Conserving Surgery ◽  
Lymph Node Biopsy ◽  
Her2 Status ◽  
Breast Cancer Patients

Background: Neoadjuvant chemotherapy for breast cancer was used to downstaging tumours to facilitate breast-conserving surgery. Methods: A descriptive retrospective study of 93 breast cancer patients at Da Nang Oncology Hospital from January 2017 to December 2019. Patients diagnosed with locally advanced breast cancer cT2-4N0- 3M0. Exclude cases of Ductal carcinoma in situ from breast or previously treated. Results: an average age of 48, an average tumor size of 6.0 cm, the majority were Invasive ductal carcinoma (97.8%) and grade 2 ( 85.6%). Hormon receptor positive in 57%, HER-2 positive in 38.7% and 18.3% triple negative Breast cancer. The combination chemotherapy regimen Anthacycline and Taxane accounted for 94.7%, Trastuzumab-based regimen accounted for 25%. There was 8.3% progression of disease during neoadjuvant chemotherapy. About Surgery: Breast- conserving surgery in 20.5%, Breast reconstruction in 6.8%, Mastectomy in 71.6%, Sentinel lymph node biopsy in 4.3%. Her2 status was significantly different between the groups with and without pCR.. Endocrine receptors are negative, Ki67 is high, and Triple negative has a higher rate of pCR but not statistically significant. Conclusion: Neoadjuvant chemotherapy helps to downstaging tumours to facilitate breast-conserving surgery. Her2 status is correlated with the rate of complete pathological response (pCR).

A nomogram to predict the value of mammary adipose index (MAI) for prediction of response to neoadjuvant chemotherapy in breast cancer patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12607-e12607
Author(s):  
Wenxiu Xu ◽  
Jinhai Tang
Keyword(s):  
Breast Cancer ◽  
Logistic Regression ◽  
Adipose Tissue ◽  
Regression Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Calibration Curve ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Histological Response ◽  
Her 2

e12607 Background: Breast cancer (BCa) is the most common malignancy in females on a global scale. Neoadjuvant chemotherapy (NACT) is a promising therapeutic approach for the treatment of locally advanced BCa, which result in primary tumor regression and optimal surgical planning. Cumulative evidence has identified a deleterious crosstalk between cancer cells and the surrounding mammary adipose tissue during tumor progression. Mammary adipose index (MAI) is a novel indicator defined by us, which represents the percentage of adipose tissue in breast. Therefore, this study aims to investigate the correlation between MAI and NACT efficacy of BCa by establishing an intuitive nomogram. Methods: Clinical data of 221 BCa patients who received NACT at the First Affiliated Hospital of Nanjing Medical University from January 1, 2018 to May 31, 2020 were retrospectively collected. Besides, patients were divided into major histological response and non-major histological response group in line with Miller-Payne pathology grading. The level of MAI was collected from magnetic resonance imaging of breast, and was divided into two groups according to the cut-off value. The level of MAI and clinicopathological characteristics were collected to assess the predictive roles of NACT response. Univariate analysis was performed by Chi-square test or Fisher’s exact test. Indicators with P < 0.05 were included in multivariate binary logistic regression analysis. The nomogram was constructed based on results of multivariate logistic analysis. The predictive accuracy and discriminative ability were evaluated by C-index and the calibration curve. Results: Among the 221 patients enrolled, 77 cases (34.84%) were represented by major responses of pathologic histology. In univariate analysis, the level of MAI, tumor size, node status, ER status, PR status HER-2 status and Ki-67 status were correlated with NACT. Multivariate Logistic regression analysis showed that tumor size, HER-2 status and the level of MAI were independent influencing factors for the response to NACT in BCa patients. The patients with a high level of MAI (≥0.6916) were more likely to have a worse NACT response. MAI was an independent predictor for NACT efficacy, and area under the curve of ROC, specificity and sensitivity of the predictive model were 0.805, 0.632 and 0.774 respectively. The nomogram established based on these factors showed its discriminatory ability, and the C-index for prediction was 0.881. The calibration curve indicated that the predictive ability of the nomogram was a good fit to actual observation. The difference was statistically significant (P < 0.05). Conclusions: The nomogram constructed in the present study indicated that the level of MAI could predict the efficacy of NACT in BCa patients, which might provide clinical guidance for the selection of appropriate treatment decisions.

scholarly journals Evaluation of clinical and pathological response factors to neoadjuvant chemotherapy in breast cancer patients

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Rayane Ferreira ◽  
Maximiliano Cassilha Kneubil ◽  
Janaina Brollo ◽  
Luiza Herdy Boechat Luz Tiago ◽  
Karen Bazzo Goulart ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Histological Grade ◽  
Disease Free Survival ◽  
Clinicopathological Features ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Luminal B

Objectives: To evaluate breast cancer (BC) patients treated with neoadjuvant chemotherapy (NACT) and to analyze clinicopathological features correlating with pathological complete response (PCR) and survival outcomes. Methods: Observational, descriptive, and retrospective study. The medical records of BC patients who underwent NACT were reviewed and analyzed using the Statistical Package for the Social Sciences (SPSS), version 20.0. Results: Of the 176 BC patints who underwent NACT, 62 patients (35.2%) achieved PCR. The PCR rate was 22% (n = 2) for luminal A, 15% (n = 9) for luminal B/HER2-negative, 45.5% (n = 15) for luminal B/HER2-positive, 50% (n = 14) for non-luminal/HER2-positive, and 47.8% (n = 22) for triple-negative (p = 0.01). Histological grade, estrogen receptor (ER) expression, progesterone receptor (PR) expression, and HER2 status were significantly associated with PCR (p = 0.022, p = 0.01, p = 0.01, and p = 0.02, respectively). The median follow-up was 35.9 months, the estimated 5-year disease-free survival (DFS) was 96.7% in the PCR group and 83.2% in the non-PCR group (p = 0.05). The estimated 5-year overall survival (OS) was 95.5% in the PCR group and 69.1% in the non-PCR group (p = 0.017). Overall, 11 patients (6.25%) presented with locoregional recurrence (LRR), one (1.6%) in the PCR group and 10 (8.8%) in the non-PCR group (p = 0.10). Conclusion: We observed higher PCR rates in triple-negative and HER2-positive molecular subtypes. DFS and OS were significantly better in patients who achieved PCR, regardless of clinicopathological features. We also observed lower rates of LRR in the population that reached PCR.

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