Hakyoung Kim1, Won Park1, Seung Jae Huh1, Doo Ho Choi1, Jae Myoung Noh1, Young-Hyuck Im2, Jin Seok Ahn2, Yeon Hee Park2, Seok Jin Nam3, Seok Won Kim3, Jeong Eon Lee3, Eun Yoon Cho4. 1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 3. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 4. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
AIM: We evaluated the tumor response and clinical outcomes according to molecular subtypes in stage II-III breast cancer patients who received neo-adjuvant chemotherapy (NAC) followed by surgery and radiotherapy. METHODS: We retrospectively analyzed 329 patients with clinical stage II-III breast cancer who received NAC followed by surgery and radiotherapy. Luminal A and B, HER2-enriched and triple-negative subgroups were identified. RESULTS: The overall pathologic complete response (pCR) rate after NAC was 20.1% and the HER2-enriched subgroup had the highest pCR rate (43.6%), whereas luminal A showed the lowest rate of pCR (4.6%). The median follow-up duration was 55 months (range, 5-98 months). The 5-year overall survival (OS) and disease-free survival (DFS) rates were 88.9% and 72.9%, respectively. In subgroup analysis, according to the pathologic response (pCR vs non-pCR), the triple-negative subtype exhibited a significant difference in 5-year OS rate (100.0% vs 71.6%, P = 0.005) and 5-year DFS rate (93.1% vs 55.1%, P < 0.001). A distinct survival difference according to molecular subtype was found, particularly in the non-pCR group (5-year OS and DFS, P < 0.001, respectively). CONCLUSIONS: The non-pCR group showed significantly decreased 5-year OS and DFS rates compared to the pCR group, especially in triple negative and HER2-enriched breast cancer patients. A significant difference in survival rates and molecular subtypes was found in patients who failed to attain pCR.
AIM: We evaluated the tumor response and clinical outcomes according to molecular subtypes in stage II-III breast cancerpatients who received neo-adjuvant chemotherapy (NAC) followed by surgery and radiotherapy. METHODS: We retrospectively analyzed 329 patients with clinical stage II-III breast cancer who received NAC followed by surgery and radiotherapy. Luminal A and B, HER2-enriched and triple-negative subgroups were identified. RESULTS: The overall pathologic complete response (pCR) rate after NAC was 20.1% and the HER2-enriched subgroup had the highest pCR rate (43.6%), whereas luminal A showed the lowest rate of pCR (4.6%). The median follow-up duration was 55 months (range, 5-98 months). The 5-year overall survival (OS) and disease-free survival (DFS) rates were 88.9% and 72.9%, respectively. In subgroup analysis, according to the pathologic response (pCR vs non-pCR), the triple-negative subtype exhibited a significant difference in 5-year OS rate (100.0% vs 71.6%, P = 0.005) and 5-year DFS rate (93.1% vs 55.1%, P < 0.001). A distinct survival difference according to molecular subtype was found, particularly in the non-pCR group (5-year OS and DFS, P < 0.001, respectively). CONCLUSIONS: The non-pCR group showed significantly decreased 5-year OS and DFS rates compared to the pCR group, especially in triple negative and HER2-enriched breast cancerpatients. A significant difference in survival rates and molecular subtypes was found in patients who failed to attain pCR.
Authors: Anna K Casasent; Mathilde M Almekinders; Charlotta Mulder; Proteeti Bhattacharjee; Deborah Collyar; Alastair M Thompson; Jos Jonkers; Esther H Lips; Jacco van Rheenen; E Shelley Hwang; Serena Nik-Zainal; Nicholas E Navin; Jelle Wesseling Journal: Nat Rev Cancer Date: 2022-10-19 Impact factor: 69.800
Authors: T J Stankowski-Drengler; J R Schumacher; B Hanlon; D Livingston-Rosanoff; K Van de Walle; C C Greenberg; L G Wilke; H B Neuman Journal: Ann Surg Oncol Date: 2020-01-03 Impact factor: 5.344