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Tytuł pozycji:

Clinicopathological response to neoadjuvant therapies and pathological complete response as a biomarker of survival in human epidermal growth factor receptor-2 enriched breast cancer - A retrospective cohort study.

Tytuł:
Clinicopathological response to neoadjuvant therapies and pathological complete response as a biomarker of survival in human epidermal growth factor receptor-2 enriched breast cancer - A retrospective cohort study.
Autorzy:
Davey MG; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Kerin E; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
O'Flaherty C; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
Maher E; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
Richard V; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
McAnena P; Department of Surgery, Galway University Hospitals, Galway, Ireland.
McLaughlin RP; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Sweeney KJ; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Barry MK; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Malone CM; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Wyns W; Department of Cardiology, Galway University Hospitals, Galway, Ireland.
Soliman O; Department of Cardiology, Galway University Hospitals, Galway, Ireland.
Miller N; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland.
Keane MM; Department of Medical Oncology, Galway University Hospitals, Galway, Ireland.
Lowery AJ; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Kerin MJ; The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Źródło:
Breast (Edinburgh, Scotland) [Breast] 2021 Oct; Vol. 59, pp. 67-75. Date of Electronic Publication: 2021 Jun 18.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: 2002- : Amsterdam : Elsevier
Original Publication: Edinburgh ; New York : Churchill Livingstone, c1992-
MeSH Terms:
Breast Neoplasms*/drug therapy
Carcinoma, Ductal, Breast*/drug therapy
Receptor, ErbB-2*
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; Disease-Free Survival ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Prognosis ; Retrospective Studies ; Young Adult
Contributed Indexing:
Keywords: Breast cancer; HER2 gene; Pathological complete response; Personalised medicine; Precision medicine
Substance Nomenclature:
EC 2.7.10.1 (ERBB2 protein, human)
EC 2.7.10.1 (Receptor, ErbB-2)
Entry Date(s):
Date Created: 20210625 Date Completed: 20211015 Latest Revision: 20220531
Update Code:
20240105
PubMed Central ID:
PMC8234352
DOI:
10.1016/j.breast.2021.06.005
PMID:
34171619
Czasopismo naukowe
Background: Human epidermal growth factor receptor-2 (HER2) is overexpressed in 20-25% of breast cancers. Complete eradication of disease following neoadjuvant therapies and chemotherapy has been referred to as pathological complete response (pCR).
Aims: To determine clinicopathological predictors of pCR to neoadjuvant therapies and to evaluate pCR as a surrogate to enhanced survival.
Methods: Consecutive female patients with HER2 positive (HER+) breast cancer managed surgically in a single institution between 2005 and 2015 were included. Descriptive statistics and binary logistic regression were used to determine predictors of pCR. Appraisal of pCR as a predictor of survival was performed using Kaplan-Meier curves and Cox regression analysis.
Results: 451 patients were included with a mean age of 56.6 ± 13.4 years (range 23-95). Disease-free (DFS) and overall survival (OS) was 82.3% (371/451) and 82.6% (376/451) respectively with a median follow-up of 108.0 months (range 3-184.0). 118 were treated in the neoadjuvant setting (26.2%): tumour size <50 mm (Odds Ratio (OR): 12.156, P = 0.023) and progesterone receptor negativity (OR: 2.762, P = 0.008) independently predicted breast pCR, while ductal carcinoma (OR: 3.203, P = 0.030) and grade 3 disease (OR: 2.788, P = 0.018) predicted axillary pCR. Both breast and axillary pCR predicted enhanced DFS (Hazard Ratio (HR): 0.470 & HR: 0.449) and OS (HR: 0.383 & HR: 0.307). Axillary pCR independently predicted improved OS (HR: 0.326).
Conclusion: pCR is sensitive biomarker and surrogate to survival outcomes in HER2+ breast cancer. Patients likely to achieve pCR may be predicted from traditional clinicopathological characteristics and molecular parameters.
(Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

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