Discordance between molecular subtyping from pre- and post-neoadjuvant chemotherapy (NACT) biopsy specimens in a Brazilian breast cancer cohort

Autor: Marcelle Goldner Cesca, Vladmir Cláudio Cordeiro de Lima, Solange Moraes Sanches, Fernanda A. Oliveira, Sinara Figueiredo Silva, Fernando Augusto Batista Campos, Rafaela Pirolli, Monique Celeste Tavares, Camilla Albina Zanco Fogassa, Poliana de Andrade, Mariana Pinheiro Xerfan, Luciana de Moura Leite, Bruna Raphaeli Silva Mattos
Rok vydání: 2020
Předmět:
Zdroj: Web of Science
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2020.38.15_suppl.e12649
Popis: e12649 Background: Discordance between immunohistochemistry (IHC) and molecular subtyping from pre and post neoadjuvant chemotherapy (NACT) biopsy specimens in breast cancer (BC) patients (pts) varies in the literature. This information could have prognostic and treatment implications. To evaluate the clinicopathologic characteristics and prognostic factors in pts with localized breast cancer treated with NACT who had IHC repeated in the post treatment biopsies. Methods: We retrospectively reviewed all BC pts treated with NACT at our service (2007 – 2018). Descriptive statistics were used to describe the population. Survival curves were estimated by Kaplan-Maier method, prognostic factors adjusted by Cox regression model. Results: 607 consecutive pts were treated with NACT at our service. From those, 178 (29.3%) had a pathological complete response, 420 (69.2%) had residual disease and 9 (1.5%) had an unknown status. For 95 pts, the IHC was repeated in the pathological specimen, with a change in the molecular subtype in 26 (27.3%) cases. 10 luminal pts lost the hormonal receptor expression and changed to triple negative, 6 luminal B became luminal A, 3 luminal A became luminal B, 6 pts lost the her2 amplification and 1 pt gained a her2 amplification. This 95 pts cohort had a median desease free survival (DFS) of 71 months (m) and an overall survival (OS) of 137m. Pts who had a change in their molecular subtype after NACT had a DFS of 52 m vs 71m (p .26) and OS 86m, not significantly different from those who maintained the same status (p .23). Conclusions: A little more than one quarter of the pts that had repeated post NACT IHC had a change in the molecular subtype, especially with loss of hormonal receptors of luminal tumors, that became triple negative. That did not translated into significantly worse survivals.
Databáze: OpenAIRE
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