Neo-adjuvant doxorubicin and cyclophosphamide followed by paclitaxel in triple-negative breast cancer among BRCA1 mutation carriers and non-carriers
| Autor: | Raphael Catane, Dov Zippel, Shani Paluch-Shimon, Talia Golan, Moshe Shabtai, Moshe Z. Papa, Tami Modiano, Maya Dadiani, Bella Kaufman, Raanan Berger, Ady Yosepovich, Mordechai Gutman, Eitan Friedman, Neil Friedman |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Paclitaxel Cyclophosphamide medicine.medical_treatment Triple Negative Breast Neoplasms Young Adult 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans skin and connective tissue diseases Pathological Neoadjuvant therapy Triple-negative breast cancer Survival analysis Aged Chemotherapy BRCA1 Protein business.industry Middle Aged medicine.disease Survival Analysis Neoadjuvant Therapy Treatment Outcome 030104 developmental biology 030220 oncology & carcinogenesis Mutation Immunology Female business medicine.drug |
| Zdroj: | Breast Cancer Research and Treatment. 157:157-165 |
| ISSN: | 1573-7217 0167-6806 |
| DOI: | 10.1007/s10549-016-3800-5 |
| Popis: | The purpose of this study was to assess pathological complete response and whether it serves a surrogate for survival among patients receiving neo-adjuvant doxorubicin–cyclophosphamide followed by paclitaxel for triple-negative breast cancer with respect to BRCA1 mutation status. From a neo-adjuvant systemic therapy database of 588 breast cancer cases, 80 triple-negative cases who had undergone BRCA genotyping were identified. Logistic regression model was fitted to examine the association between BRCA1 status and pathological complete response. Survival outcomes were evaluated using Kaplan–Meier method, differences between study groups calculated by log-rank test. Thirty-four BRCA1 carriers and 43 non-carriers were identified. The BRCA1 carriers had pathological complete response rate of 68 % compared with 37 % among non-carriers, p = 0.01. Yet this did not translate into superior survival for BRCA1 carriers compared with non-carriers. No difference in relapse-free survival were noted among those with or without pathological complete response in BRCA1 carriers regardless of pathological complete response status (Log-rank p = 0.25), whereas in the non-carrier cohort, relapse-free survival was superior for those achieving pathological complete response (Log-rank p < 0.0001). Response to neo-adjuvant systemic therapy differed in BRCA1-associated triple-negative breast cancer compared with triple-negative non-carriers, with a higher rate of pathological complete response. However, compared with non-carrier triple-negative breast cancer, pathological complete response was not a surrogate for superior relapse-free survival in BRCA1 patients. Future studies using specific chemotherapy regimens may provide further improvements in outcomes. |
| Databáze: | OpenAIRE |
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