Neoadjuvant Chemotherapy of Triple-Negative Breast Cancer: Evaluation of Early Clinical Response, Pathological Complete Response Rates, and Addition of Platinum Salts Benefit Based on Real-World Evidence

Autor:	Iveta Selingerová, Tomas Kazda, Ivana Kolouskova, Katarína Petráková, Miloš Holánek, Oldrich Coufal, Ondrej Bilek, Radka Obermannova, Lenka Foretova, Pavel Fabian, Marek Svoboda, Alexandr Poprach, Mária Zvaríková
Rok vydání:	2021
Předmět:	0301 basic medicine Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment lcsh:RC254-282 Article 03 medical and health sciences 0302 clinical medicine Breast cancer platinum salts Statistical significance Internal medicine medicine brca mutation Lymph node Triple-negative breast cancer Neoadjuvant therapy Chemotherapy early clinical response business.industry BRCA mutation Retrospective cohort study medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens 3. Good health 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis triple-negative breast cancer pathological complete response business neoadjuvant chemotherapy
Zdroj:	Cancers Cancers, Vol 13, Iss 1586, p 1586 (2021) Volume 13 Issue 7
ISSN:	2072-6694
Popis:	Pathological complete response (pCR) achievement is undoubtedly the essential goal of neoadjuvant therapy for breast cancer, directly affecting survival endpoints. This retrospective study of 237 triple-negative breast cancer (TNBC) patients with a median follow-up of 36 months evaluated the role of adding platinum salts into standard neoadjuvant chemotherapy (NACT). After the initial four standard NACT cycles, early clinical response (ECR) was assessed and used to identify tumors and patients generally sensitive to NACT. BRCA1/2 mutation, smaller unifocal tumors, and Ki-67 ≥ 65% were independent predictors of ECR. The total pCR rate was 41%, the achievement of pCR was strongly associated with ECR (OR = 15.1, p < 0.001). According to multivariable analysis, the significant benefit of platinum NACT was observed in early responders ≥45 years, Ki-67 ≥ 65% and persisted lymph node involvement regardless of BRCA1/2 status. Early responders with pCR had a longer time to death (HR = 0.28, p < 0.001) and relapse (HR = 0.26, p < 0.001). The pCR was achieved in only 7% of non-responders. However, platinum salts favored non-responders’ survival outcomes without statistical significance. Toxicity was significantly often observed in patients with platinum NACT (p = 0.003) but not for grade 3/4 (p = 0.155). These results based on real-world evidence point to the usability of ECR in NACT management, especially focusing on the benefit of platinum salts.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f681da16225b79ebd53b7d805fa65519 https://pubmed.ncbi.nlm.nih.gov/33808149 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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