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Domergue C, Martin E, Lemarié C, Jézéquel P, Frenel JS, Augereau P, Campone M, Patsouris A. Impact of HER2 Status on Pathological Response after Neoadjuvant Chemotherapy in Early Triple-Negative Breast Cancer. Cancers (Basel) 2022; 14:2509. [PMID: 35626113 PMCID: PMC9139240 DOI: 10.3390/cancers14102509] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/10/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Investigates the link between HER2 status and histological response after neoadjuvant chemotherapy in patients with early TNBC. METHODS We retrieved clinical and anatomopathological data retrospectively from 449 patients treated for the first time with standard neoadjuvant chemotherapy for early unilateral BC between 2005 and 2020. The primary endpoint was pathological complete response (pCR, i.e., ypT0 ypN0), according to HER2 status. Secondary endpoints included invasive disease-free survival (I-DFS) and overall survival (OS). RESULTS 437 patients were included, and 121 (27.7%) patients had HER2-low tumours. The pCR rate was not significantly different between the HER2-low group vs. the HER2-0 group (35.7% versus 41.8%, p = 0.284) in either univariate analysis or multivariate analysis adjusted for TNM classification and grade (odds ratio [OR] = 0.70, confidence interval [CI] 95% 0.45-1.08). With a median follow-up of 72.9 months, no significant survival differences were observed between patients with HER2-low tumours vs. patients with HER2-0 tumours in terms of I-DFS (p = 0.487) and OS (p = 0.329). CONCLUSIONS In our cohort, HER2 status was not significantly associated with pCR in a manner consistent with data published recently on TNBC. However, the prognostic impact of HER2-low expression among TNBC patients warrants further evaluation.
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Affiliation(s)
- Camille Domergue
- Medical Oncology Department, ICO Institut de Cancérologie de l’Ouest, 49000 Angers, France; (P.A.); (M.C.); (A.P.)
| | - Elodie Martin
- Clinical Trial Sponsor Unit/Biometry, ICO Institut de Cancérologie de l’Ouest, 44800 Saint-Herblain, France;
| | - Camille Lemarié
- Biopathology Department, ICO Institut de Cancérologie de l’Ouest, 44800 Saint-Herblain, France;
| | - Pascal Jézéquel
- Omics Data Science Unit, ICO Institut de Cancérologie de l’Ouest, 44800 Saint-Herblain, France;
| | - Jean-Sebastien Frenel
- Medical Oncology Department, ICO Institut de Cancérologie de l’Ouest, 44800 Saint-Herblain, France;
| | - Paule Augereau
- Medical Oncology Department, ICO Institut de Cancérologie de l’Ouest, 49000 Angers, France; (P.A.); (M.C.); (A.P.)
| | - Mario Campone
- Medical Oncology Department, ICO Institut de Cancérologie de l’Ouest, 49000 Angers, France; (P.A.); (M.C.); (A.P.)
| | - Anne Patsouris
- Medical Oncology Department, ICO Institut de Cancérologie de l’Ouest, 49000 Angers, France; (P.A.); (M.C.); (A.P.)
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Cirier J, Body G, Jourdan ML, Bedouet L, Fleurier C, Pilloy J, Arbion F, Ouldamer L. [Impact of pathological complete response to neoadjuvant chemotherapy in invasive breast cancer according to molecular subtype]. ACTA ACUST UNITED AC 2017; 45:535-544. [PMID: 28939364 DOI: 10.1016/j.gofs.2017.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/27/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of pathological complete response (pCR) on overall survival (OS) and recurrence-free survival (RFS) according to molecular subtypes in women treated for an invasive breast cancer after neoadjuvant chemotherapy (NAC). METHODS All women (n=225) managed with a neoadjuvant chemotherapy for an invasive breast cancer in our institution between January 2007 and December 2013 were included. The characteristics of patients with pCR (pCR-1), breast pCR and axillary pCR were compared to those without pCR (pCR-0) according to the molecular subtypes: luminal A (n=62), luminal B (n=77), Her-2 (n=31) and triple negative (n=55). RESULTS NAC concerned 225 patients of whom 36 (16%) had pCR. Achievement of pCR led to significantly better overall survival in women with Her-2 tumors (35% versus 100%, P=0.035) and also to significantly better locoregional survival in women treated for triple negative tumors (P=0.026). Predictive factors of pCR were a high pathologic grade: OR=2.39, IC 95% (1.19-4.83), P=0.008; Her-2 molecular subtype (P=0.008); positive estrogenic hormonal receptors (P=0.006), a positive Her-2 receptor: OR=2.58, IC 95% (1.20-5.54), P=0.01. CONCLUSION Achievement of pCR is an intermediate marker of survival in women managed with NAC for breast cancer.
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Affiliation(s)
- J Cirier
- Service de gynécologie, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine de Tours, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France.
| | - G Body
- Service de gynécologie, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine de Tours, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France; Inserm UMR1069, 10, boulevard Tonnellé, 37044 Tours, France
| | - M-L Jourdan
- Inserm UMR1069, 10, boulevard Tonnellé, 37044 Tours, France; Hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - L Bedouet
- Service de gynécologie, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine de Tours, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France
| | - C Fleurier
- Service de gynécologie, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine de Tours, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France
| | - J Pilloy
- Service de gynécologie, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine de Tours, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France
| | - F Arbion
- Service d'anatomie pathologique, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - L Ouldamer
- Service de gynécologie, hôpital Bretonneau, centre hospitalier régional universitaire de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine de Tours, université François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France; Inserm UMR1069, 10, boulevard Tonnellé, 37044 Tours, France
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Pilloy J, Fleurier C, Chas M, Bédouet L, Jourdan ML, Arbion F, Body G, Ouldamer L. [Predictive factors of conservative breast surgery after neoadjuvant chemotherapy for breast cancer]. ACTA ACUST UNITED AC 2017; 45:466-471. [PMID: 28869182 DOI: 10.1016/j.gofs.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/12/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of our study was to evaluate the existence of predictive factors of conservative breast surgery after neoadjuvant chemotherapy (NAC) for breast cancer. METHODS We included all women with invasive breast cancer who received NAC and underwent breast surgery between January 2007 and December 2013 in our institution. Univariable and multivariable analyses were performed to determine the association between clinical and histological factors and conservative breast surgery. RESULTS During the study period, 229 women were included of whom 73 had breast conservative surgery (32%). At univariable analysis, significant predictive factors were age (OR 0.97 [CI 95% 0.95-0.99], P=0.02), radiological size (OR 0.97 [CI 95% 0.96-0.99], P<0.001), multifocality (OR 0.53 [CI 95% 0.27-1.05], P=0.06), breast inflammation (OR 0.15 [CI 95% 0.07-0.32], P<0.001) and the type of hormone receptors (P=0.12). In multivariable analysis, all these factors but age were significant factors and thus considered as independent predictive factors. CONCLUSION This work permitted to identify independent predictive factors of breast conservative surgery after NAC for breast cancer that will be included in a risk scoring system that we aim to evaluate prospectively.
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Affiliation(s)
- J Pilloy
- Département de gynécologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France
| | - C Fleurier
- Département de gynécologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France
| | - M Chas
- Département de gynécologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France
| | - L Bédouet
- Département de gynécologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France
| | - M L Jourdan
- Unité Inserm 1069, 10, boulevard Tonnellé, 37044 Tours, France
| | - F Arbion
- Département de pathologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France
| | - G Body
- Département de gynécologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France; Département de pathologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France
| | - L Ouldamer
- Département de gynécologie, centre hospitalier régional universitaire de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours, France; Faculté de médecine François-Rabelais, 10, boulevard Tonnellé, 37044 Tours, France; Unité Inserm 1069, 10, boulevard Tonnellé, 37044 Tours, France.
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