Assessing the Correlation of Rate of Pathological Complete Response and Outcome in Post Neoadjuvant Chemotherapy Setting and Molecular Subtypes of Breast Cancer.

Autor:	Omair A; Pathology, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.; Pathology, King Abdullah International Medical Research Center (KAIMRC), Riyadh, SAU., Alkushi A; Pathology, King Abdulaziz Medical City, Riyadh, SAU.; Pathology, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.; Pathology, King Abdullah International Medical Research Center (KAIMRC), Riyadh, SAU., Alamri G; Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.; Medicine, King Abdullah International Medical Research Center (KAIMRC), Riyadh, SAU., Almojel T; Pathology, King Saud University, Riyadh, SAU., Alsadun S; Surgery, King Abdulaziz Medical City, Riyadh, SAU., Masuadi E; Research Unit/Biostatistics, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.; Research Unit/Biostatistics, King Abdullah International Medical Research Center (KAIMRC), Riyadh, SAU., Arabi H; Pathology, King Abdulaziz Medical City, Riyadh, SAU., Mohamed AE; Oncology, King Abdulaziz Medical City, Riyadh, SAU., Abulkhair OA; Oncology, Dr. Sulaiman Al Habib Hospital, Riyadh, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Apr 11; Vol. 15 (4), pp. e37449. Date of Electronic Publication: 2023 Apr 11 (Print Publication: 2023).
DOI:	10.7759/cureus.37449
Abstrakt:	Background Neoadjuvant chemotherapy (NAC) is being widely used in treating breast cancer (BC). This study aimed to analyze the correlation between clinicopathological features, immunohistochemistry (IHC)-based molecular subtypes, and the pathological response to NAC and its relationship with disease-free survival (DFS) and overall survival (OS). Materials and methods A retrospective analysis of 211 breast cancer patients who received NAC between 2008 and 2018 was performed. Tumors were classified by IHC into luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched, and triple-negative subtypes. The chi-square test was used to assess the association between pathological response and clinicopathological parameters. Cox regression analysis was used to assess factors related to DFS and OS. Results Post NAC, 19.4% of patients achieved a pathologic complete response (pCR). Estrogen receptor (ER), progesterone receptor (PR), HER2 (p<0.001, 0.005, and 0.02), Ki67 (p=0.03), molecular subtypes (p<0.001), T stage (p=0.04), and N stage (p=0.01) were significantly associated with pathological response. The rate of pCR was highest among HER2-enriched and triple-negative tumors (45.2% and 28%, respectively) with OR=0.13 and p<0.001 for the HER2-enriched subtype. Patients with pCR were 61% less likely to develop metastasis (adjusted hazard ratio [aHR]=0.39, p=0.06, 95% CI=0.14-1.06) and were significantly associated with better OS (aHR=0.07, p=0.02, 95% CI=0.01-0.61). Patients who were ≤40 years old (aHR=2.1, p=0.01), with T4 (aHR=3.4, p=0.02), grade 3 (aHR=2.5, p=0.01), and node-positive disease (HR=2.24, p=0.02) were at an increased risk of developing metastasis. High Ki67 was found to be significantly associated with better DFS (p=0.006). Conclusion HER2-enriched and triple-negative BC were associated with a higher rate of pCR. Patients with pCR had significantly better DFS and OS. Younger age, advanced stage, higher grade, and lymph node involvement were risk factors for metastasis. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Omair et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu