BACKGROUND: The response of primary breast cancer to chemotherapy is usually expressed either as a pathological complete remission (pCR) or as 'no pCR'. A more quantitative measure is called for. PATIENTS AND METHODS: The 'neoadjuvant response index' (NRI) was calculated by adding a breast response score (a number from a five-point scale) to an axillary response score (a number from a three-point scale) and dividing this by the score that would have been obtained in case of a pCR in both breast and axilla. Consequently, the NRI is a number between 0 (representing no response) and 1 (a pCR of both breast and axilla). RESULTS: The NRI was calculated in 267 patients who had received neoadjuvant chemotherapy. The average NRI was 0.48 (median 0.40). Forty-one patients (15%) had an NRI of 0; 55 patients (21%) had an NRI of 1 (pCR). 'Highly endocrine responsive' tumors responded substantially less than 'incompletely endocrine responsive' ones. In triple negatives, an NRI of >0.70 was associated with a better recurrence-free survival than a lower NRI. CONCLUSIONS: The NRI proposed here may be useful to better reflect the efficacy of neoadjuvant systemic regimens than the binary pCR-'no pCR' system.
BACKGROUND: The response of primary breast cancer to chemotherapy is usually expressed either as a pathological complete remission (pCR) or as 'no pCR'. A more quantitative measure is called for. PATIENTS AND METHODS: The 'neoadjuvant response index' (NRI) was calculated by adding a breast response score (a number from a five-point scale) to an axillary response score (a number from a three-point scale) and dividing this by the score that would have been obtained in case of a pCR in both breast and axilla. Consequently, the NRI is a number between 0 (representing no response) and 1 (a pCR of both breast and axilla). RESULTS: The NRI was calculated in 267 patients who had received neoadjuvant chemotherapy. The average NRI was 0.48 (median 0.40). Forty-one patients (15%) had an NRI of 0; 55 patients (21%) had an NRI of 1 (pCR). 'Highly endocrine responsive' tumors responded substantially less than 'incompletely endocrine responsive' ones. In triple negatives, an NRI of >0.70 was associated with a better recurrence-free survival than a lower NRI. CONCLUSIONS: The NRI proposed here may be useful to better reflect the efficacy of neoadjuvant systemic regimens than the binary pCR-'no pCR' system.
Authors: Esther H Lips; Rita A Mukhtar; Christina Yau; Jorma J de Ronde; Chad Livasy; Lisa A Carey; Claudette E Loo; Marie-Jeanne T F D Vrancken-Peeters; Gabe S Sonke; Donald A Berry; Laura J Van't Veer; Laura J Esserman; Jelle Wesseling; Sjoerd Rodenhuis; E Shelley Hwang Journal: Breast Cancer Res Treat Date: 2012-09-08 Impact factor: 4.872
Authors: Marcelo Sobral-Leite; Esther H Lips; Hayra de Andrade Vieira-Monteiro; Letícia Carlos Giacomin; Daniely Regina Freitas-Alves; Sten Cornelissen; Lennart Mulder; Jelle Wesseling; Marjanka K Schmidt; Rosane Vianna-Jorge Journal: PLoS One Date: 2017-12-21 Impact factor: 3.240
Authors: E H Lips; L Mulder; A Oonk; L E van der Kolk; F B L Hogervorst; A L T Imholz; J Wesseling; S Rodenhuis; P M Nederlof Journal: Br J Cancer Date: 2013-04-04 Impact factor: 7.640
Authors: L S Rigter; C E Loo; S C Linn; G S Sonke; E van Werkhoven; E H Lips; H A Warnars; P K Doll; A Bruining; I A Mandjes; M J Vrancken Peeters; J Wesseling; K G Gilhuijs; S Rodenhuis Journal: Br J Cancer Date: 2013-10-22 Impact factor: 7.640