R Rouzier1, G Werkoff2, C Uzan3, O Mir4, J Gligorov5, L Selleret6, F Goffinet7, F Goldwasser8, J M Treluyer9, S Uzan10, S Delaloge3. 1. CALG (Cancers Associés à La Grossesse) Network; Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris; University Pierre et Marie Curie, Paris 6, INSERM-UMR S 938 and ER2- Prediction Unit (Pôle GYNORESP). Electronic address: roman.rouzier@tnn.aphp.fr. 2. Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris; University Pierre et Marie Curie, Paris 6, INSERM-UMR S 938 and ER2- Prediction Unit (Pôle GYNORESP). 3. CALG (Cancers Associés à La Grossesse) Network; Department of Surgical Oncology; Breast Cancer Unit, Institut Gustave Roussy, University Paris 11. 4. CALG (Cancers Associés à La Grossesse) Network; Department of Pharmacology; Department of Medical Oncology, Hôpital Cochin -Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris; University Paris Descartes, Paris 5. 5. CALG (Cancers Associés à La Grossesse) Network; Medical Oncology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris. 6. CALG (Cancers Associés à La Grossesse) Network; Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris. 7. CALG (Cancers Associés à La Grossesse) Network; University Paris Descartes, Paris 5; Obstetrics and Gynecology, Hôpital Cochin -Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Paris, France. 8. Department of Medical Oncology, Hôpital Cochin -Saint-Vincent de Paul, Assistance Publique-Hôpitaux de Paris; University Paris Descartes, Paris 5. 9. CALG (Cancers Associés à La Grossesse) Network; Department of Pharmacology; University Paris Descartes, Paris 5. 10. CALG (Cancers Associés à La Grossesse) Network; Department of Obstetrics and Gynecology, Hôpital Tenon, Assistance Publique Hôpitaux de Paris; University Pierre et Marie Curie, Paris 6, INSERM-UMR S 938 and ER2- Prediction Unit (Pôle GYNORESP).
Abstract
BACKGROUND: The aim of this study was to determine the chemosensitivity of pregnancy-associated breast cancer (PABC) in the neoadjuvant setting by comparing the observed pathological complete response (pCR) rate with the rate predicted by a validated nomogram. METHODS: Data from 48 PABC patients who received neoadjuvant chemotherapy (NACT) were collected. To predict the response rate to chemotherapy, we used well-calibrated logistic regression-based nomograms to calculate individual probability of pCR. RESULTS: Observed rates of pCR were concordant with predictions in the whole sample and in the analyzed subgroups. For the whole sample, the area under the receiver-operated curve (AUC) was 0.77 (95% CI 0.66-0.87). The calibration of predicted and observed probabilities was excellent. In the subgroup analyses (NACT initiated during pregnancy or postpartum, NACT with only anthracycline or both anthracycline and taxanes), discriminations assessed by AUC were significantly above 0.5, except for patients treated with anthracycline only. The interpretation was limited by a lack of power. CONCLUSION: Through the use of nomograms, our study demonstrates that PABC is as chemosensitive as non-PABC and suggests that taxanes should be part of the NACT regimen for PABC. Further studies are warranted to increase the power of the presented data.
BACKGROUND: The aim of this study was to determine the chemosensitivity of pregnancy-associated breast cancer (PABC) in the neoadjuvant setting by comparing the observed pathological complete response (pCR) rate with the rate predicted by a validated nomogram. METHODS: Data from 48 PABCpatients who received neoadjuvant chemotherapy (NACT) were collected. To predict the response rate to chemotherapy, we used well-calibrated logistic regression-based nomograms to calculate individual probability of pCR. RESULTS: Observed rates of pCR were concordant with predictions in the whole sample and in the analyzed subgroups. For the whole sample, the area under the receiver-operated curve (AUC) was 0.77 (95% CI 0.66-0.87). The calibration of predicted and observed probabilities was excellent. In the subgroup analyses (NACT initiated during pregnancy or postpartum, NACT with only anthracycline or both anthracycline and taxanes), discriminations assessed by AUC were significantly above 0.5, except for patients treated with anthracycline only. The interpretation was limited by a lack of power. CONCLUSION: Through the use of nomograms, our study demonstrates that PABC is as chemosensitive as non-PABC and suggests that taxanes should be part of the NACT regimen for PABC. Further studies are warranted to increase the power of the presented data.
Authors: Lisa Prior; Richard O'Dwyer; Abdul Rehman Farooq; Megan Greally; Cian Ward; Connor O'Leary; Razia Aslam; Waseem Darwish; Nada Ahmed; Elly Che Othman; Geoffrey Watson; Deirdre Kelly; Jack Gleeson; Lisa Kiely; Anees Hassan; Elaine M Walsh; David O'Reilly; Alfred Jones; Hannah Featherstone; Marvin Lim; Hazel Murray; Bryan T Hennessy; Lillian M Smyth; Gregory Leonard; Liam Grogan; Oscar Breathnach; Paula Calvert; Anne M Horgan; Linda Coate; Emmet J Jordan; Deirdre O'Mahony; Rajnish Gupta; Maccon M Keane; Jennifer Westrup; Karen Duffy; Miriam O'Connor; Patrick G Morris; M John Kennedy; Seamus O'Reilly; John McCaffrey; Catherine M Kelly; Desmond Carney; Giuseppe Gullo; John Crown; Michaela J Higgins; Paul M Walsh; Janice M Walshe Journal: Breast Cancer Res Treat Date: 2021-06-14 Impact factor: 4.872