Maki Tanioka1, Masaoki Sasaki2, Akihiko Shimomura3, Makoto Fujishima4, Mihoko Doi5, Kazuo Matsuura6, Toshiko Sakuma7, Kenichi Yoshimura8, Toshiaki Saeki6, Masahiro Ohara9, Junji Tsurutani10, Masahiro Watatani11, Toshimi Takano3, Hidetaka Kawabata12, Hirofumi Mukai2, Yoichi Naito2, Koichi Hirokaga13, Shintaro Takao13, Hironobu Minami14. 1. Medical Oncology, Hyogo Cancer Center, Hyogo, Japan; Medical Oncology/Hematology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: tanioka@hp.pref.hyogo.jp. 2. Division of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan. 3. Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan. 4. Division of Breast and Endocrine Surgery, Kinki University School of Medicine, Osaka, Japan. 5. Department of Medical Oncology, Hiroshima Prefectual Hospital, Hiroshima, Japan. 6. Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka, Japan. 7. Pathology Division, Hyogo Cancer Center, Hyogo, Japan. 8. Division of Clinical Trial Design and Management, Translational Research Center, Kyoto University Hosipital, Kyoto, Japan. 9. Breast Surgery, Hiroshima Prefectual Hospital, Hiroshima, Japan. 10. Medical Oncology, Kinki University School of Medicine, Osaka, Japan. 11. Department of Surgery, Nara Hospital, Kinki University Faculty of Medicine, Nara, Japan. 12. Breast and Endocrine Surgery, Toranomon Hospital, Tokyo, Japan. 13. Breast Surgery, Hyogo Cancer Center, Hyogo, Japan. 14. Medical Oncology/Hematology, Kobe University Graduate School of Medicine, Kobe, Japan.
Abstract
OBJECTIVE: For patients with HER2-positive breast cancer, the prognostic impact of pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) is unclear when stratified by hormonal receptor (HR) status; however, the impact of pCR on survival when stratified by hormonal receptor (HR) status is uncertain. PATIENTS AND METHODS: This multicenter retrospective study investigated the predictors of pCR and its prognostic value in Japanese patients 366 HER2-positive breast cancer who received NAC. pCR was defined as no invasive residual tumor in the breast or axilla. RESULTS: Median follow-up was 55 months. Multivariate analysis revealed that HR status (OR, 0.37; p < 0.001) was one of the independent predictors of pCR. Five-year recurrence-free survival was higher in HR-negative patients with pCR (93%) than in those without pCR (68%), and pCR was independently prognostic (hazard ratio, 0.32; p = 0.005). However, 5-year recurrence-free survival was not different between HR-positive patients with pCR (94%) and those without pCR (84%), and pCR was not significantly prognostic (hazard ratio, 0.53; p = 0.39). In addition, 5-year overall survivals were high and similar (97% in pCR, 94% in non-pCR). Among 204 patients treated with neoadjuvant trastuzumab, pCR was not significantly prognostic in the HR-positive group (hazard ratio, 0.63; p = 0.56). CONCLUSION: Our study suggested that the HER2-positive HR-positive patients had a good prognosis despite the lower achievement rate of pCR, whose prognostic impact was smaller than that in the HER2-positive HR-negative patients. The treatment strategy for HER2-positive breast cancer can be stratified by HR status.
OBJECTIVE: For patients with HER2-positive breast cancer, the prognostic impact of pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) is unclear when stratified by hormonal receptor (HR) status; however, the impact of pCR on survival when stratified by hormonal receptor (HR) status is uncertain. PATIENTS AND METHODS: This multicenter retrospective study investigated the predictors of pCR and its prognostic value in Japanese patients 366 HER2-positive breast cancer who received NAC. pCR was defined as no invasive residual tumor in the breast or axilla. RESULTS: Median follow-up was 55 months. Multivariate analysis revealed that HR status (OR, 0.37; p < 0.001) was one of the independent predictors of pCR. Five-year recurrence-free survival was higher in HR-negative patients with pCR (93%) than in those without pCR (68%), and pCR was independently prognostic (hazard ratio, 0.32; p = 0.005). However, 5-year recurrence-free survival was not different between HR-positive patients with pCR (94%) and those without pCR (84%), and pCR was not significantly prognostic (hazard ratio, 0.53; p = 0.39). In addition, 5-year overall survivals were high and similar (97% in pCR, 94% in non-pCR). Among 204 patients treated with neoadjuvant trastuzumab, pCR was not significantly prognostic in the HR-positive group (hazard ratio, 0.63; p = 0.56). CONCLUSION: Our study suggested that the HER2-positive HR-positive patients had a good prognosis despite the lower achievement rate of pCR, whose prognostic impact was smaller than that in the HER2-positive HR-negative patients. The treatment strategy for HER2-positive breast cancer can be stratified by HR status.
Authors: Laura M Spring; Geoffrey Fell; Andrea Arfe; Lorenzo Trippa; Aditya Bardia; Chandni Sharma; Rachel Greenup; Kerry L Reynolds; Barbara L Smith; Brian Alexander; Beverly Moy; Steven J Isakoff; Giovanni Parmigiani Journal: Clin Cancer Res Date: 2020-02-11 Impact factor: 12.531
Authors: Samuel Seoane; Efigenia Arias; Rita Sigueiro; Juan Sendon-Lago; Anxo Martinez-Ordoñez; Esteban Castelao; Noemí Eiró; Tomás Garcia-Caballero; Manuel Macia; Rafael Lopez-Lopez; Miguel Maestro; Francisco Vizoso; Antonio Mouriño; Roman Perez-Fernandez Journal: Oncotarget Date: 2015-06-10
Authors: Tamera J Lillemoe; Mara Rendi; Michaela L Tsai; Monica Knaack; Rina Yarosh; Erin Grimm; Barbara Susnik; Janet Krueger; Susan Olet; Karen K Swenson Journal: Int J Breast Cancer Date: 2021-05-24