Does fertility preservation affect the start of the oncological treatment and the response to neoadjuvant chemotherapy in breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12613-e12613
Author(s):  
Sonia Baulies ◽  
Maxim Izquierdo ◽  
Marta Devesa ◽  
Ignacio Rodriguez ◽  
Fransec Tresserra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Fertility Preservation ◽  
Triple Negative ◽  
Pathological Complete Response ◽  
Group Versus ◽  
Complete Response ◽  
Control Group ◽  
Oncological Treatment ◽  
Luminal Tumor

e12613 Background: Study in breast cancer patients to assess whether fertility preservation (FP) can affect the onset of the oncological treatment and the pathological response in those patients who underwent neoadjuvant chemotherapy (NAC). Methods: Patients with breast cancer who underwent fertility preservation and NAC are matched 1:2.45 to non-FP controls by age and date al diagnosis and are studied: -Timing between the diagnosis of breast cancer and the onset of oncological treatment was performed. The following variables were chosen: 1.- Confirmation (pathologic result), 2.- FP visit, 3.- Onset FP, 4.- Final FP, 5. – Onset oncological treatment. The periods analyzed (median in days) were: 1.- Period of FP visit (AP result-FP visit), 2.- Period of FP (FP beginning –FP ending), 3.- Period of onset of oncological treatment (FP ending-onset of oncological treatment), 4.- Overall period (AP result-onset of oncological treatment). -Studying the pathological complete response (Miller Payne scale) among patients with FP compare to non-FP control group was also performed. Results: 20 patients with FP and NAC are studied between 2010-2019 and were compared to 49 non-FP patients. The median age at diagnosis was 36 years (28-39). The oncological characteristics of the patients are shown in Table 1. The time analysis in FP group was: 1.- Period of FP visit was 4 days (1-26), 2.- the period of FP (start of the stimulation treatment until the recovery of the oocytes) 12 days (7-20), 3.- the Period of onset of oncological treatment 7 days (1-27). The overall period took 26 days (18-51) compared to 17.5 days (1-60) in non-FP group (NS). Pathological complete response (Miller Payne 5): The pathological complete response was 80% (16/20) in FP group versus 40.8% (20/49) in non-FP group. Analyzed by tumor subtype in FP group, a MP5 was achieved in 72.7% luminal tumor (8/11), 75% positive-HER2 (3/4), 100% triple negative (5/5) versus 19% luminal tumor (4/21), 41.6% (5/12) positive-HER2 and 68.7% triple negative (11/16) in non-FP group. Conclusions: FP does not delay the onset of oncological treatment and our data do not suggest an adverse impact of FP on pathological complete response to NAC. [Table: see text]

A meta-analysis of platinum-based neoadjuvant chemotherapy versus standard neoadjuvant chemotherapy for triple-negative breast cancer

2019 ◽  
Vol 15 (23) ◽  
pp. 2779-2790 ◽  
Author(s):  
Dong Wang ◽  
Jiafu Feng ◽  
Bei Xu
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Randomized Clinical Trials ◽  
Triple Negative ◽  
Pathological Complete Response ◽  
Meta Analysis ◽  
Complete Response ◽  
Breast Cancers ◽  
Dna Damaging Agents ◽  
Platinum Agents

Aim: Platinum agents are DNA damaging agents with promising activity in breast cancers, especially in triple-negative subgroup. This meta-analysis was conducted to compare the treatments of platinum-based neoadjuvant chemotherapy (NAC) and standard NAC for triple-negative breast cancers (TNBCs). Materials & methods: Diverse electronic databases were searched to identify the randomized clinical trials that directly compared the treatments of platinum-based NAC versus NAC in TNBC patients. Toxicity of platinum-based regimens was further evaluated. Results: Addition of platinum agents significantly improved the pathological complete response rates in TNBC patients compared with the standard NAC. Unfortunately, platinum-based regimens were more likely to develop higher incidence of hematologic toxicities. Conclusion: Platinum-based NAC regimens could achieve significant pathological complete response improvement with well-tolerated toxicity in TNBC patients.

Are BRCA1 mutations a predictive factor for anthracycline-based neoadjuvant chemotherapy response in triple-negative breast cancers?

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 580-580 ◽  
Author(s):  
T. Petit ◽  
M. Wilt ◽  
J. Rodier ◽  
D. Muller ◽  
J. Ghnassia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Her2 Overexpression ◽  
Breast Cancers ◽  
Platinum Compounds ◽  
Response To Chemotherapy ◽  
Chemotherapy Efficacy

580 Background: BRCA1 being involved in DNA repair and apoptosis, its mutations may influence response to chemotherapy. In vitro studies demonstrated that loss of BRCA1 function increased sensitivity to platinum compounds and induced resistance to anthracyclines. BRCA1-related breast cancers tend to be ductal carcinomas with high tumor grade, absence of hormonal receptors and no HER2 overexpression, so called triple-negative. We retrospectively analyzed anthracycline-based neoadjuvant chemotherapy efficacy in triple- negative tumors according to BRCA1 status. Methods: 393 breast cancer pts were treated with FEC100 neoadjuvant chemotherapy (FU 500 mg/m2, epirubicine 100 mg/m2, cyclophosphamide 500 mg/m2) between 1/2000 and 12/2006. Out of them, 14% had a triple-negative phenotype (55 pts). Patients with young age at diagnosis or family history of breast cancer were offered genetic testing for BRCA1 and BRCA2 mutations. Twelve of these patients had a BRCA1 deleterious mutation with a triple-negative tumor. Characteristics of these 12 pts at diagnosis were: median age = 38, tumor stage = 7 T2N0, 2 T2N1, 2 T3N0, 1 T3N1. Results: Pathological complete response was defined as absence of invasive tumor in breast and axillary nodes. After 6 cycles of FEC100, 42% of patients with triple-negative tumors (23/55) had a pathological complete response, compared to 17% (2/12) with a BRCA1 mutation. Only one of the 12 BRCA1 patients had an axillary node involvement. Conclusions: In our series, BRCA1 deleterious mutations decreased anthracycline-based chemotherapy efficacy in triple- negative breast cancers. Platinum compounds should be evaluated in these BRCA1-related tumors. No significant financial relationships to disclose.

scholarly journals Neoadjuvant Chemotherapy of Triple-Negative Breast Cancer: Evaluation of Early Clinical Response, Pathological Complete Response Rates, and Addition of Platinum Salts Benefit Based on Real-World Evidence

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1586
Author(s):  
Milos Holanek ◽  
Iveta Selingerova ◽  
Ondrej Bilek ◽  
Tomas Kazda ◽  
Pavel Fabian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Real World ◽  
Triple Negative ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Ki 67 ◽  
Platinum Salts ◽  
Real World Evidence

Pathological complete response (pCR) achievement is undoubtedly the essential goal of neoadjuvant therapy for breast cancer, directly affecting survival endpoints. This retrospective study of 237 triple-negative breast cancer (TNBC) patients with a median follow-up of 36 months evaluated the role of adding platinum salts into standard neoadjuvant chemotherapy (NACT). After the initial four standard NACT cycles, early clinical response (ECR) was assessed and used to identify tumors and patients generally sensitive to NACT. BRCA1/2 mutation, smaller unifocal tumors, and Ki-67 ≥ 65% were independent predictors of ECR. The total pCR rate was 41%, the achievement of pCR was strongly associated with ECR (OR = 15.1, p < 0.001). According to multivariable analysis, the significant benefit of platinum NACT was observed in early responders ≥45 years, Ki-67 ≥ 65% and persisted lymph node involvement regardless of BRCA1/2 status. Early responders with pCR had a longer time to death (HR = 0.28, p < 0.001) and relapse (HR = 0.26, p < 0.001). The pCR was achieved in only 7% of non-responders. However, platinum salts favored non-responders’ survival outcomes without statistical significance. Toxicity was significantly often observed in patients with platinum NACT (p = 0.003) but not for grade 3/4 (p = 0.155). These results based on real-world evidence point to the usability of ECR in NACT management, especially focusing on the benefit of platinum salts.

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