Efficacy and safety of cisplatin and paclitaxel (PlaTax regimen) in the neoadjuvant treatment of patients with stage II–III triple-negative breast cancer

Background. Treatment results for the patients with stage II–III triple negative breast cancer (TN BC) have to be improved. Not only the new treatment regimens, but new predictive and prognostic factors should to be developed.Materials and methods. We included 98 patients with stage II–III TN BC in our study. We studied efficacy and safety of PlaTax regimen (cisplatin 75 mg / m2 day 1 + paclitaxel 80 mg / m2 days 1, 8, 15, course every 4 weeks) in this cohort of patients. We assessed pathologic response, survival and factors, which were relevant for predicting response and prognose survival.Results. PlaTax regimen is characterized by high efficacy and tolerable toxicity. Clinical efficacy was 85.8 %, pCR achievement was 60.5 %, tpCR achievement was 58.1 %. The regimen has low haematological toxicity (neutropenia III–IV grades – 4.1 %); the most frequent adverse events were polyneuropathy (18.5 %) and decreased renal function (24.5 %). 3-year progression-free survival was 68.4 %, most of the relapses (92 %) occurred during first 2 years. 3 year overall survival was 77.6 %. The most relevant predictive factor was level of Ki-67 ≥50 % (pCR 38.5 % vs. 68.7 %, p = 0.038). pCR achievement was the most important prognostic factor, resulting in improved 3-year progressionfree survival (44.3 % vs. 89.1 %, p <0.0001), and 3-year overall survival (61.5 % vs. 91.6 %, p = 0.001). Not only the residual disease, but also the size of residual tumor was important from prognostic point of view. Other important prognostic factors were size of the tumor, status of regional lymph nodes, grade. Delay in surgical treatment more than a month lead to decreased 3-year progression-free survival: 87.1 % vs. 62.5 % (p = 0.047).Conclusions. Our data suggest that studied regimen could be an option for patients with stage II–III TN BC. The assessment of the predictive and prognostic factors will help improve the treatment results for patients with stage II–III TN BC.

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Meta-analyses on progression-free survival as a surrogate endpoint for overall survival in triple-negative breast cancer

Breast Cancer Research and Treatment ◽

10.1007/s10549-020-05615-4 ◽

2020 ◽

Vol 181 (1) ◽

pp. 189-198 ◽

Cited By ~ 3

Author(s):

Takehiro Hirai ◽

Asuka Nemoto ◽

Yoshinori Ito ◽

Masaaki Matsuura

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Progression Free Survival ◽

Surrogate Endpoint ◽

Free Survival ◽

Meta Analyses

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Impact of androgen receptor on chemotherapy efficacy in patients with metastatic triple negative breast cancer

HEALTH OF WOMAN ◽

10.15574/hw.2020.150.80 ◽

2020 ◽

pp. 80-84

Author(s):

S.A. Lyalkin ◽

◽

L.A. Syvak ◽

N.O. Verevkina ◽

◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Androgen Receptor ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Progression Free Survival ◽

Second Line ◽

Free Survival ◽

Second Line Chemotherapy ◽

Line Chemotherapy

The objective: was to determine the impact of androgen receptor (AR) expression on the effectiveness of the first and second line chemotherapy in patients with metastatic triple negative breast cancer (mTNBC). Materials and methods. The impact of AR expression on treatment results was evaluated in patients with mTNBC received the first (n=122) and second (n=87) line chemotherapy in open randomized studies. The status of AR was evaluated by immunohistochemistry, AR positive patients were defined as having AR more than 10%. Results. From 116 patients with mTBNC 44 (38%) were AR positive, 72 (62%) – AR negative. Median progression free survival in patients received the first line chemotherapy was 8 months in AR positive and 6 months in AR negative, p=0.27. The incidence of objective tumor response in mTNBC patients received the second line chemotherapy was 71.1% in AR negative and 76.92% in AR positive, p=0.48. Median progression free survival in patients received the second line chemotherapy was 6 months in AR positive and 4 months in AR negative, p=0.0045. Median overall survival in AR positive patients was statistically significantly higher (12 months versus 9 months, р=0.04). Conclusions. Impact of AR expression on progression free and overall survival was proved for mTNBC patients received the second line chemotherapy. Keywords: metastatic triple negative breast cancer, androgen receptor, chemotherapy, progression free survival, overall survival.

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Immediate and long-term results of the first line chemotherapy in patients with metastatic triple negative breast cancer. Final analysis of randomized study

HEALTH OF WOMAN ◽

10.15574/hw.2020.149.75 ◽

2020 ◽

pp. 75-80

Author(s):

S.A. Lyalkin ◽

◽

L.A. Syvak ◽

N.O. Verevkina ◽

◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Randomized Study ◽

Progression Free Survival ◽

First Line ◽

Free Survival ◽

Group 2 ◽

Line Chemotherapy ◽

Group 1

The objective: was to evaluate the efficacy of the first line chemotherapy in patients with metastatic triple negative breast cancer (TNBC). Materials and methods. Open randomized study was performed including 122 patients with metastatic TNBC. The efficacy and safety of the first line chemotherapy of regimens АТ (n=59) – group 1, patients received doxorubicine 60 мг/м2 and paclitaxel 175 мг/м2 and ТР (n=63) – group 2, patients received paclitaxel 175 мг/м2 and carboplatin AUC 5 were evaluated. Results. The median duration of response was 9.5 months (4.5–13.25 months) in patients received AT regimen and 8.5 months (4.7–12.25 months), in TP regimen; no statistically significant differences were observed, р=0.836. The median progression free survival was 7 months (95% CI 5–26 months) in group 1 and 7.5 months (95% CI 6–35 months) in group 2, p=0.85. Both chemotherapy regimens (AT and TP) had mild or moderate toxicity profiles (grade 1 or 2 in most patients). No significant difference in gastrointestinal toxicity was observed. The incidence of grade 3–4 neutropenia was higher in patients of group 2 (TP regimen): 42.8% versus 27% (р<0.05). Conclusions. Both regimens of chemotherapy (AT and TP) are appropriate to use in the first line setting in patients with metastatic TNBC. Key words: metastatic triple negative breast cancer, chemotherapy, progression free survival, chemotherapy toxicity.

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Development of prognostic nomograms using institutional data for patients with triple-negative breast cancer

Future Oncology ◽

10.2217/fon-2021-0677 ◽

2021 ◽

Author(s):

Jie-Yu Zhou ◽

Kang-Kang Lu ◽

Wei-Da Fu ◽

Hao Shi ◽

Jun-Wei Gu ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Predictive Accuracy ◽

Area Under The Curve ◽

Disease Free Survival ◽

Discriminative Ability ◽

Free Survival ◽

Disease Free

Background: Triple-negative breast cancer (TNBC) is an aggressive disease. Nomograms can predict prognosis of patients with TNBC. Methods: A total of 745 eligible TNBC patients were recruited and randomly divided into training and validation groups. Endpoints were disease-free survival and overall survival. Concordance index, area under the curve and calibration curves were used to analyze the predictive accuracy and discriminative ability of nomograms. Results: Based on the training cohort, neutrophil-to-lymphocyte ratio, positive lymph nodes, tumor size and tumor-infiltrating lymphocytes were used to construct a nomogram for disease-free survival. In addition, age was added to the overall survival nomogram. Conclusion: The current study developed and validated well-calibrated nomograms for predicting disease-free survival and overall survival in patients with TNBC.

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Retrospective Study about the Prevalence of (TILs) Tumor Infiltrating Lymphocytes in Non-Metastatic Triple Negative Breast Cancer Patients and its Prognostic Value

QJM ◽

10.1093/qjmed/hcab103.003 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hesham Ahmed ElGhazaly ◽

Manal Mohamed El-Mahdy ◽

Azza Mohamed Adel ◽

Nermeen Mostafa ◽

Aya Magdy Kamal Ali

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Retrospective Study ◽

Triple Negative Breast Cancer ◽

Prognostic Value ◽

Triple Negative ◽

Free Survival ◽

Female Patients ◽

Risk Of Death ◽

Reduced Risk

Abstract Background TNBC comprises a distinct disease entity with a unique microenvironment of TILs, the immunogenic potential of TNBC is derived from its genetic instability and high mutation rate. Tumors from patients with TNBC are more likely than tumors from patients with other subtypes to exhibit chromosomal instability and potential mutations. Objectives The study aims to evaluate the prevalence of CD8+ TILs biomarker by IHC in triple negative breast cancer and its prognostic value. TILs are an important prognostic value for the response of patient to chemotherapy the greater number of TILS is associated with higher probability of response to chemotherapy also decrease recurrence. TILS in triple negative breast cancer suggest a likely option for immunotherapy in this disease. Patients and Methods This is a retrospective study, which was carried on 30 female patients, Clinical data and paraffin wax block of female patients with triple negative breast cancer are to be collected from the breast cancer unit, department of clinical Oncology and Nuclear medicine Ain Shams university and Matarya teaching hospital. Results Several large systematic reviews and meta-analyses have confirmed that high levels of TILs are associated with better disease free survival and overall survival only in triple negative and HER2 positive subtypes, with no significant benefit seen in estrogen receptor positive breast carcinoma. In the Breast International Group (BIG) 02-98 trial shows that for every 10% increase in the intertumoral TILs there was a 17% reduced risk of relapse, and 27% reduced risk of death regardless of chemotherapy type. Also in eastern cooperative oncology group trial (ECOG) 2197, and 1199 showed that for every 10% increase in TILs, a 14% reduction of risk of recurrence, and 19% reduction in risk of death were observed. Conclusion Our study showed that All our patients (100%) were positive for CD8+, with a minimum range of 1% and a maximum range of 60%, most of the patients (20 patients) had CD8% between (10% to 20%). High levels of CD8 + TILs are good prognostic indicators in TNBC. our study showed that there were associations of CD8+ TILs infiltrate status with longer progression free survival and better overall survival in triple-negative breast cancer, but were not statistically significant probably due to our small sample size.

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Immunohistochemical analysis of CD155 expression in triple-negative breast cancer patients

PLoS ONE ◽

10.1371/journal.pone.0253176 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253176

Author(s):

Katsuhiro Yoshikawa ◽

Mitsuaki Ishida ◽

Hirotsugu Yanai ◽

Koji Tsuta ◽

Mitsugu Sekimoto ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Tumor Cells ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Expression Profiles ◽

Histological Grade ◽

Relapse Free Survival ◽

Free Survival ◽

Antitumor Immunotherapy

Introduction CD155 is an immune checkpoint protein. Its overexpression is an indicator of poor prognosis in some types of cancer. However, the significance of CD155 expression in patients with triple-negative breast cancer, and the relationship between CD155 and programmed death-ligand 1 (PD-L1) expression, have not yet been analyzed in detail. Methods Using immunohistochemical staining and tissue microarrays, we analyzed the expression profiles of CD155 and PD-L1 in 61 patients with triple-negative breast cancer. Relapse-free survival and overall survival rates were compared according to CD155 expression. The correlation between CD155 expression and clinicopathological factors, including PD-L1 expression (using SP142 and 73–10 assays), was also examined. Results CD155 expression was noted in 25 patients (41.0%) in this cohort. CD155 expression did not correlate with pathological stage, histological grade, Ki-67 labeling index, or stromal tumor-infiltrating lymphocytes. Only PD-L1 expression in tumor cells by SP142 assay significantly correlated with CD155 expression (p = 0.035); however, PD-L1 expression in tumor cells by 73–10 assay did not show a correlation (p = 0.115). Using the 73–10 assay, 59% of patients showed CD155 and/or PD-L1 expression in tumor cells. Moreover, using the SP142 assay, 63.3% of patients showed CD155 and/or PD-L1 expression in immune cells. CD155 expression did not correlate with either relapse-free survival or overall survival (p = 0.485 and 0.843, respectively). Conclusions CD155 may be a novel target for antitumor immunotherapy. The results of this study indicate that CD155 may expand the pool of candidates with triple-negative breast cancer who could benefit from antitumor immunotherapy.

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