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Cited by Other Article(s)

González-Woge M, Contreras-Espinosa L, García-Gordillo JA, Aguilar-Villanueva S, Bargallo-Rocha E, Cabrera-Galeana P, Vasquez-Mata T, Cervantes-López X, Vargas-Lías DS, Montiel-Manríquez R, Bautista-Hinojosa L, Rebollar-Vega R, Castro-Hernández C, Álvarez-Gómez RM, De La Rosa-Velázquez IA, Díaz-Chávez J, Jiménez-Trejo F, Arriaga-Canon C, Herrera LA. The Expression Profiles of lncRNAs Are Associated with Neoadjuvant Chemotherapy Resistance in Locally Advanced, Luminal B-Type Breast Cancer. Int J Mol Sci 2024;25:8077. [PMID: 39125649 PMCID: PMC11311431 DOI: 10.3390/ijms25158077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/06/2024] [Accepted: 07/16/2024] [Indexed: 08/12/2024] Open

Affiliation(s)

Miguel González-Woge Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.)
Laura Contreras-Espinosa Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.) Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Unidad de Posgrado, Edificio D, 1° Piso, Circuito de Posgrados, Ciudad Universitaria, Coyoacán, Mexico City C. P. 04510, Mexico;
José Antonio García-Gordillo Departamento de Oncología Médica de Mama, Instituto Nacional de Cancerología, Tlalpan, Mexico City C. P. 14080, Mexico; (J.A.G.-G.); (P.C.-G.)
Sergio Aguilar-Villanueva Departamento de Tumores Mamarios, Instituto Nacional de Cancerología, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (S.A.-V.); (E.B.-R.); (D.S.V.-L.)
Enrique Bargallo-Rocha Departamento de Tumores Mamarios, Instituto Nacional de Cancerología, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (S.A.-V.); (E.B.-R.); (D.S.V.-L.)
Paula Cabrera-Galeana Departamento de Oncología Médica de Mama, Instituto Nacional de Cancerología, Tlalpan, Mexico City C. P. 14080, Mexico; (J.A.G.-G.); (P.C.-G.)
Tania Vasquez-Mata Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.)
Ximena Cervantes-López Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.)
Diana Sofía Vargas-Lías Departamento de Tumores Mamarios, Instituto Nacional de Cancerología, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (S.A.-V.); (E.B.-R.); (D.S.V.-L.)
Rogelio Montiel-Manríquez Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.)
Luis Bautista-Hinojosa Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Unidad de Posgrado, Edificio D, 1° Piso, Circuito de Posgrados, Ciudad Universitaria, Coyoacán, Mexico City C. P. 04510, Mexico;
Rosa Rebollar-Vega Genomics Laboratory, Red de Apoyo a la Investigación, Universidad Nacional Autónoma de México, Tlalpan, Mexico City C. P. 14080, Mexico;
Clementina Castro-Hernández Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.)
Rosa María Álvarez-Gómez Clínica de Cáncer Hereditario, Instituto Nacional de Cancerología, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico;
Inti Alberto De La Rosa-Velázquez Genomics Core Facility, Helmholtz Zentrum Muenchen, Ingolstaedter Landstr 1, 85754 Neuherberg, Germany;
José Díaz-Chávez Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.) Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey C. P. 64710, Mexico
Francisco Jiménez-Trejo Instituto Nacional de Pediatría, Insurgentes Sur No. 3700-C, Coyoacán, Mexico City C. P. 04530, Mexico;
Cristian Arriaga-Canon Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.) Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey C. P. 64710, Mexico
Luis Alonso Herrera Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología-Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Avenida San Fernando No. 22 Col. Sección XVI, Tlalpan, Mexico City C. P. 14080, Mexico; (M.G.-W.); (L.C.-E.); (T.V.-M.); (X.C.-L.); (R.M.-M.); (C.C.-H.); (J.D.-C.) Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey C. P. 64710, Mexico

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Falo C, Azcarate J, Fernandez-Gonzalez S, Perez X, Petit A, Perez H, Vethencourt A, Vazquez S, Laplana M, Ales M, Stradella A, Fullana B, Pla MJ, Gumà A, Ortega R, Varela M, Pérez D, Ponton JL, Cobo S, Benitez A, Campos M, Fernández A, Villanueva R, Obadia V, Recalde S, Soler-Monsó T, Lopez-Ojeda A, Martinez E, Ponce J, Pernas S, Gil-Gil M, Garcia-Tejedor A. Breast Cancer Patient's Outcomes after Neoadjuvant Chemotherapy and Surgery at 5 and 10 Years for Stage II-III Disease. Cancers (Basel) 2024;16:2421. [PMID: 39001483 PMCID: PMC11240707 DOI: 10.3390/cancers16132421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open

Abstract

Introduction: Neoadjuvant chemotherapy in breast cancer offers the possibility to facilitate breast and axillary surgery; it is a test of chemosensibility in vivo with significant prognostic value and may be used to tailor adjuvant treatment according to the response. Material and Methods: A retrospective single-institution cohort of 482 stage II and III breast cancer patients treated with neoadjuvant chemotherapy based on anthracycline and taxans, plus antiHEr2 in Her2-positive cases, was studied. Survival was calculated at 5 and 10 years. Kaplan-Meier curves with a log-rank test were calculated for differences according to age, BRCA status, menopausal status, TNM, pathological and molecular surrogate subtype, 20% TIL cut-off, surgical procedure, response to chemotherapy and the presence of vascular invasion. Results: The pCR rate was 25.3% and was greater in HER2 (51.3%) and TNBC (31.7%) and in BRCA carriers (41.9%). The factors independently related to patient survival were pathology and molecular surrogate subtype, type of surgery, response to NACT and vascular invasion. BRCA status was a protective prognostic factor without reaching statistical significance, with an HR 0.5 (95%CI 0.1-1.4). Mastectomy presented a double risk of distant recurrence compared to breast-conservative surgery (BCS), supporting BCS as a safe option after NACT. After a mean follow-up of 126 (SD 43) months, luminal tumors presented a substantial difference in survival rates calculated at 5 or 10 years (81.2% compared to 74.7%), whereas that for TNBC was 75.3 and 73.5, respectively. The greatest difference was seen according to the response in patients with pCR, who exhibited a 10 years DDFS of 95.5% vs. 72.4% for those patients without pCR, p < 0001. This difference was especially meaningful in TNBC: the 10 years DDFS according to an RCB of 0 to 3 was 100%, 80.6%, 69% and 49.2%, respectively, p < 0001. Patients with a particularly poor prognosis were those with lobular carcinomas, with a 10 years DDFS of 42.9% vs. 79.7% for ductal carcinomas, p = 0.001, and patients with vascular invasion at the surgical specimen, with a 10 years DDFS of 59.2% vs. 83.6% for those patients without vascular invasion, p < 0.001. Remarkably, BRCA carriers presented a longer survival, with an estimated 10 years DDFS of 89.6% vs. 77.2% for non-carriers, p = 0.054. Conclusions: Long-term outcomes after neoadjuvant chemotherapy can help patients and clinicians make well-informed decisions.

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Affiliation(s)

Catalina Falo Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Juan Azcarate Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.A.); (T.S.-M.)
Sergi Fernandez-Gonzalez Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain;
Xavier Perez Information and Data Analysis Department, Institut Català d’Oncologia, Bellvitge Research Institute, 08908 Barcelona, Spain; (X.P.); (J.L.P.)
Ana Petit Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.A.); (T.S.-M.)
Héctor Perez Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Radiotherapy, Institut Català d’Oncologia, 08908 Barcelona, Spain
Andrea Vethencourt Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Silvia Vazquez Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Maria Laplana Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Radiotherapy, Institut Català d’Oncologia, 08908 Barcelona, Spain
Miriam Ales Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.)
Agostina Stradella Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Bartomeu Fullana Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Maria J. Pla Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.A.); (T.S.-M.)
Anna Gumà Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain
Raul Ortega Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain
Mar Varela Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.A.); (T.S.-M.)
Diana Pérez Multidisciplinary Breast Cancer Unit, Department of Reparative Surgery, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (D.P.); (A.L.-O.)
Jose Luis Ponton Information and Data Analysis Department, Institut Català d’Oncologia, Bellvitge Research Institute, 08908 Barcelona, Spain; (X.P.); (J.L.P.)
Sara Cobo Multidisciplinary Breast Cancer Unit, Department of Pharmacy, Hospital Universitari Bellvitge, 08907 Barcelona, Spain;
Ana Benitez Multidisciplinary Breast Cancer Unit, Department of Nuclear Medicine, Hospital Universitari Bellvitge, 08907 Barcelona, Spain;
Miriam Campos Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain;
Adela Fernández Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Rafael Villanueva Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Veronica Obadia Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Sabela Recalde Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Teresa Soler-Monsó Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.A.); (T.S.-M.)
Ana Lopez-Ojeda Multidisciplinary Breast Cancer Unit, Department of Reparative Surgery, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (D.P.); (A.L.-O.)
Evelyn Martinez Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Radiotherapy, Institut Català d’Oncologia, 08908 Barcelona, Spain
Jordi Ponce Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain;
Sonia Pernas Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Miguel Gil-Gil Multidisciplinary Breast Cancer Unit, Department of Medical Oncology, Institut Català d’Oncologia, 08908 Barcelona, Spain; (A.V.); (S.V.); (A.S.); (B.F.); (A.F.); (R.V.); (V.O.); (S.R.); (S.P.); (M.G.-G.) Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.)
Amparo Garcia-Tejedor Instituto de Investigación Biomédica de Bellvitge (IDIBELL), 08908 Barcelona, Spain; (S.F.-G.); (A.P.); (H.P.); (M.L.); (M.J.P.); (A.G.); (R.O.); (M.V.); (E.M.); (J.P.); (A.G.-T.) Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, 08907 Barcelona, Spain; (J.A.); (T.S.-M.)

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Jin SX, Liu BN, Ji HJ, Wu JR, Li BL, Gao XL, Li N, Zheng ZD, Du C. Serum cytokines and creatinine/cystatin C ratio as prognostic biomarkers in advanced cancer patients treated with anti-PD-1/PD-L1 therapy. Support Care Cancer 2024;32:370. [PMID: 38776028 PMCID: PMC11111483 DOI: 10.1007/s00520-024-08525-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024]

Abstract

OBJECTIVE

Immune checkpoint inhibitors (ICIs), specifically targeting the programmed cell death protein-1 or its ligand (PD-1/PD-L1), have been extensively used in the treatment of a spectrum of malignancies, although the predictive biomarkers remain to be elucidated. This study aims to investigate the association between baseline circulating levels of cytokines and the creatinine/cystatin C ratio (CCR) with the treatment outcomes of ICIs in patients with advanced cancer.

METHODS

The pre-treatment circulating levels of 10 cytokines (PD-L1, CTLA4, CXCL10, LAG3, HGF, CCL2, MIG, GRANB, IL-18, and IL-6) were measured via automated capillary-based immunoassay platform in the serum of 65 advanced cancer patients treated with anti-PD-1/PD-L1-based systemic therapy and 10 healthy volunteers. The levels of cytokines and CCR were quantified and categorized into high and low groups based on the median value. The associations of serum cytokines and CCR with response to treatment, survival, and immune-related adverse events were assessed.

RESULTS

Elevated circulating levels of 6 cytokines (PD-L1, CXCL10, HGF, CCL2, MIG, and IL-6) were observed in cancer patients compared with that in healthy volunteers. The correlation coefficients between cytokines, CCR and nutritional risk index were also calculated. In the cancer cohort (N = 65), low circulating HGF (P = 0.023, P = 0.029), low IL-6 (P = 0.002, P < 0.001), and high CCR (P = 0.031, P = 0.008) were associated with significantly improved progression-free survival (PFS) and overall survival (OS). Multi-variable COX analyses adjusted for clinicopathological factors revealed that low HGF, low IL-6, and high CCR were independent favorable prognostic factors for PFS (P = 0.028, P = 0.010, and P = 0.015, respectively) and OS (P = 0.043, P = 0.003, and P = 0.026, respectively). Grade 2 irAEs occurred more frequently in patients with low levels of circulating CCL2 and LAG3.

CONCLUSIONS

Pre-treatment circulating levels of serum IL-6, HGF, and CCR may serve as independent predictive and prognostic biomarkers in advanced cancer patients treated with ICIs-based systemic therapy. These findings might help to identify potential patients who would benefit from these therapies.

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Seller A, Tegeler CM, Mauermann J, Schreiber T, Hagelstein I, Liebel K, Koch A, Heitmann JS, Greiner SM, Hayn C, Dannehl D, Engler T, Hartkopf AD, Hahn M, Brucker SY, Salih HR, Märklin M. Soluble NKG2DLs Are Elevated in Breast Cancer Patients and Associate with Disease Outcome. Int J Mol Sci 2024;25:4126. [PMID: 38612935 PMCID: PMC11012452 DOI: 10.3390/ijms25074126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open

Affiliation(s)

Anna Seller Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany
Christian M. Tegeler Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany Department of Peptide-Based Immunotherapy, Institute of Immunology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
Jonas Mauermann Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany
Tatjana Schreiber Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany
Ilona Hagelstein Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany
Kai Liebel Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany
André Koch Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
Jonas S. Heitmann Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany Department of Peptide-Based Immunotherapy, Institute of Immunology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany
Sarah M. Greiner Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
Clara Hayn Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany
Dominik Dannehl Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
Tobias Engler Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
Andreas D. Hartkopf Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
Markus Hahn Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
Sara Y. Brucker Department of Women’s Health, University Hospital Tübingen, Calwerstraße 7, 72076 Tübingen, Germany
Helmut R. Salih Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany
Melanie Märklin Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany; (A.S.) Cluster of Excellence iFIT (EXC2180) “Image-Guided and Functionally Instructed Tumor Therapies”, University of Tübingen, Röntgenweg 11, 72076 Tübingen, Germany

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Vliek S, Hilbers FS, van Werkhoven E, Mandjes I, Kessels R, Kleiterp S, Lips EH, Mulder L, Kayembe MT, Loo CE, Russell NS, Vrancken Peeters MJTFD, Holtkamp MJ, Schot M, Baars JW, Honkoop AH, Vulink AJE, Imholz ALT, Vrijaldenhoven S, van den Berkmortel FWPJ, Meerum Terwogt JM, Schrama JG, Kuijer P, Kroep JR, van der Padt-Pruijsten A, Wesseling J, Sonke GS, Gilhuijs KGA, Jager A, Nederlof P, Linn SC. High-dose alkylating chemotherapy in BRCA-altered triple-negative breast cancer: the randomized phase III NeoTN trial. NPJ Breast Cancer 2023;9:75. [PMID: 37689749 PMCID: PMC10492793 DOI: 10.1038/s41523-023-00580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/30/2023] [Indexed: 09/11/2023] Open

Affiliation(s)

Sonja Vliek Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
Florentine S Hilbers Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Erik van Werkhoven Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands HOVON Data Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
Ingrid Mandjes Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Rob Kessels Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Sieta Kleiterp Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Esther H Lips Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Lennart Mulder Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Mutamba T Kayembe Department of Biometrics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Claudette E Loo Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Nicola S Russell Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Marie-Jeanne T F D Vrancken Peeters Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands Department of Surgery, Amsterdam University Medical center, Amsterdam, The Netherlands
Marjo J Holtkamp Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Margaret Schot Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Joke W Baars Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Aafke H Honkoop Department of Internal Medicine, Isala Klinieken, Zwolle, The Netherlands
Annelie J E Vulink Division of Medical Oncology, Reinier de Graaf Hospital, Delft, The Netherlands
Alex L T Imholz Department of Internal Medicine, Deventer Ziekenhuis, Deventer, The Netherlands
Suzan Vrijaldenhoven Department of Internal Medicine, Northwest Clinics, Alkmaar, The Netherlands
Franchette W P J van den Berkmortel Department of Oncology, Zuyderland Medisch Centrum, Heerlen-Geleen, The Netherlands
Jetske M Meerum Terwogt Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
Jolanda G Schrama Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
Philomeen Kuijer Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
Judith R Kroep Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
Annemieke van der Padt-Pruijsten Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
Jelle Wesseling Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Gabe S Sonke Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Kenneth G A Gilhuijs Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands
Agnes Jager Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
Petra Nederlof Department of Molecular diagnostics, The Netherlands Cancer Institute, Amsterdam, The Netherlands
Sabine C Linn Department of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.

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Agarwal S, Kapur N, Chaudhary P. Evaluation of Neoadjuvant Response Index (NRI) and Its Correlation with Response Evaluation Criteria in Solid Tumors (RECIST) in Locally Advanced Breast Cancer. Indian J Surg Oncol 2023;14:405-410. [PMID: 37324301 PMCID: PMC10267024 DOI: 10.1007/s13193-022-01697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open

Comprehensive characterization of pre- and post-treatment samples of breast cancer reveal potential mechanisms of chemotherapy resistance. NPJ Breast Cancer 2022;8:60. [PMID: 35523804 PMCID: PMC9076915 DOI: 10.1038/s41523-022-00428-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 04/12/2022] [Indexed: 12/23/2022] Open

Abstract

When locally advanced breast cancer is treated with neoadjuvant chemotherapy, the recurrence risk is significantly higher if no complete pathologic response is achieved. Identification of the underlying resistance mechanisms is essential to select treatments with maximal efficacy and minimal toxicity. Here we employed gene expression profiles derived from 317 HER2-negative treatment-naïve breast cancer biopsies of patients who underwent neoadjuvant chemotherapy, deep whole exome, and RNA-sequencing profiles of 22 matched pre- and post-treatment tumors, and treatment outcome data to identify biomarkers of response and resistance mechanisms. Molecular profiling of treatment-naïve breast cancer samples revealed that expression levels of proliferation, immune response, and extracellular matrix (ECM) organization combined predict response to chemotherapy. Triple negative patients with high proliferation, high immune response and low ECM expression had a significantly better treatment response and survival benefit (HR 0.29, 95% CI 0.10–0.85; p = 0.02), while in ER+ patients the opposite was seen (HR 4.73, 95% CI 1.51–14.8; p = 0.008). The characterization of paired pre-and post-treatment samples revealed that aberrations of known cancer genes were either only present in the pre-treatment sample (CDKN1B) or in the post-treatment sample (TP53, APC, CTNNB1). Proliferation-associated genes were frequently down-regulated in post-treatment ER+ tumors, but not in triple negative tumors. Genes involved in ECM were upregulated in the majority of post-chemotherapy samples. Genomic and transcriptomic differences between pre- and post-chemotherapy samples are common and may reveal potential mechanisms of therapy resistance. Our results show a wide range of distinct, but related mechanisms, with a prominent role for proliferation- and ECM-related genes.

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The Impact of Post-Mastectomy Radiotherapy on Survival Outcomes in Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy. Cancers (Basel) 2021;13:cancers13246205. [PMID: 34944827 PMCID: PMC8699474 DOI: 10.3390/cancers13246205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open

Galati F, Moffa G, Pediconi F. Breast imaging: Beyond the detection. Eur J Radiol 2021;146:110051. [PMID: 34864426 DOI: 10.1016/j.ejrad.2021.110051] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 07/23/2021] [Accepted: 11/15/2021] [Indexed: 12/23/2022]

Development, verification, and comparison of a risk stratification model integrating residual cancer burden to predict individual prognosis in early-stage breast cancer treated with neoadjuvant therapy. ESMO Open 2021;6:100269. [PMID: 34537675 PMCID: PMC8455687 DOI: 10.1016/j.esmoop.2021.100269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 11/20/2022] Open

Abstract

Background

A favorable model for predicting disease-free survival (DFS) and stratifying prognostic risk in breast cancer (BC) treated with neoadjuvant chemotherapy (NAC) is lacking. The aim of the current study was to formulate an excellent model specially for predicting prognosis in these patients.

Patients and methods

Between January 2012 and December 2015, 749 early-stage BC patients who received NAC in Xijing hospital were included. Patients were randomly assigned to a training cohort (n = 563) and an independent cohort (n = 186). A prognostic model was created and subsequently validated. Predictive performance and discrimination were further measured and compared with other models.

Results

Clinical American Joint Committee on Cancer stage, grade, estrogen receptor expression, human epidermal growth factor receptor 2 (HER2) status and treatment, Ki-67 expression, lymphovascular invasion, and residual cancer burden were identified as independent prognostic variables for BC treated with NAC. The C-index of the model consistently outperformed other available models as well as single independent factors with 0.78, 0.80, 0.75, 0.82, and 0.77 in the training cohort, independent cohort, luminal BC, HER2-positive BC, and triple-negative BC, respectively. With the optimal cut-off values (280 and 360) selected by X-tile, patients were categorized as low-risk (total points ≤280), moderate-risk (280 < total points ≤ 360), and high-risk (total points >360) groups presenting significantly different 5-year DFS of 89.9%, 56.9%, and 27.7%, respectively.

Conclusions

In patients with BC, the first model including residual cancer burden index was demonstrated to predict the survival of individuals with favorable performance and discrimination. Furthermore, the risk stratification generated by it could determine the risk level of recurrence in whole early-stage BC cohort and subtype-specific cohorts, help tailor personalized intensive treatment, and select comparable study cohort in clinical trials.

•

Establishing the first risk stratification nomogram for BC treated with NAC and validate its performance in BC cohorts.

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Incorporating residual cancer burden index into predictive nomogram for the first time.

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Predictive model can be utilized to predict DFS for all early-stage BC treated with NAC.

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Performing a continuous rather than categorized model to predict individual survival.

•

The risk stratification can be used to select comparable population in trial design.

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Sha R, Xu Y, Yuan C, Sheng X, Wu Z, Peng J, Wang Y, Lin Y, Zhou L, Xu S, Zhang J, Yin W, Lu J. Predictive and prognostic impact of ferroptosis-related genes ACSL4 and GPX4 on breast cancer treated with neoadjuvant chemotherapy. EBioMedicine 2021;71:103560. [PMID: 34482070 PMCID: PMC8417304 DOI: 10.1016/j.ebiom.2021.103560] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 08/08/2021] [Accepted: 08/15/2021] [Indexed: 01/15/2023] Open

Abstract

BACKGROUND

Recent evidence shows that inducing ferroptosis may improve efficacy of tumor therapy. However, ferroptosis-related genes have been little studied in patients with breast cancer especially in the neoadjuvant setting. ACSL4 and GPX4 have been well established as the positive and negative regulator of ferroptosis, respectively. This study aimed to explore the predictive value of ACSL4 and GPX4 for patients with breast cancer administered neoadjuvant chemotherapy.

METHODS

This study included patients treated with paclitaxel-cisplatin-based neoadjuvant chemotherapy. Immunohistochemistry staining of ACSL4 and GPX4 was carried out on the core needle biopsy specimens. Logistic regression was performed to explore the predictive biomarkers of pathological complete response (pCR). Survival analyses were examined by log-rank test and Cox proportional hazard regression.

FINDINGS

A total of 199 patients were included for the analyses. Both ACSL4 expression and ACSL4/GPX4 combination status could serve as independent predictive factors for pCR. The interaction for pCR was observed between ACSL4 and clinical tumor stage. Besides, ACSL4 expression, GPX4 expression, and their combination status were independent prognostic factors for disease-free survival. Analyses of the Kaplan-Meier Plotter database suggested that higher ACSL4 expression is related to better overall survival, and higher GPX4 expression is related to better distant metastasis-free survival. Pathway analyses revealed that ACSL4 and GPX4 might function in crucial pathways including apoptosis, autophagy, cell adhesion, lipid metabolism, etc. INTERPRETATION: This study revealed the critical value of ACSL4 and GPX4 serving as novel predictive and prognostic biomarkers for patients with breast cancer receiving neoadjuvant chemotherapy. It might be a novel strategy to induce ferroptosis to promote chemosensitivity. Future studies are required to elucidate the potential mechanisms.

FUNDING

This work was supported by Shanghai Natural Science Foundation [grant number 19ZR1431100], Clinical Research Plan of Shanghai Hospital Development Center [grant numbers SHDC2020CR3003A, 16CR3065B, and 12016231], Shanghai "Rising Stars of Medical Talent" Youth Development Program for Youth Medical Talents - Specialist Program [grant number 2018-15], Shanghai "Rising Stars of Medical Talent" Youth Development Program for Outstanding Youth Medical Talents [grant number 2018-16], Shanghai Collaborative Innovation Center for Translational Medicine [grant number TM201908], Multidisciplinary Cross Research Foundation of Shanghai Jiao Tong University [grant numbers YG2017QN49, ZH2018QNA42, and YG2019QNA28], Nurturing Fund of Renji Hospital [grant numbers PYMDT-002, PY2018-IIC-01, PY2018-III-15, and PYIII20-09], Science and Technology Commission of Shanghai Municipality [grant numbers 20DZ2201600 and 15JC1402700], and Shanghai Municipal Key Clinical Specialty.

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Affiliation(s)

Rui Sha Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Yaqian Xu Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Chenwei Yuan Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Xiaonan Sheng Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Ziping Wu Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Jing Peng Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Yaohui Wang Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China.
Yanping Lin Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Liheng Zhou Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Shuguang Xu Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Jie Zhang Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
Wenjin Yin Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China.
Jinsong Lu Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China.

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Garcia-Tejedor A, Fernandez-Gonzalez S, Ortega R, Gil-Gil M, Perez-Montero H, Fernandez-Montolí E, Stradella A, Recalde S, Soler T, Petit A, Bajen MT, Benitez A, Guma A, Campos M, Pla MJ, Martinez E, Laplana M, Pernas S, Perez-Sildekova D, Catala I, Ponce J, Falo C. Can we avoid axillary lymph node dissection in N2 breast cancer patients with chemo-sensitive tumours such as HER2 and TNBC? Breast Cancer Res Treat 2020;185:657-666. [PMID: 33068198 DOI: 10.1007/s10549-020-05970-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/05/2020] [Indexed: 12/16/2022]

Affiliation(s)

Amparo Garcia-Tejedor Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain.
Sergi Fernandez-Gonzalez Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
Raul Ortega Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Miguel Gil-Gil Multidisciplinary Breast Cancer Unit, Department of Oncology, Institut Català d'Oncología, Barcelona, Spain
Hector Perez-Montero Multidisciplinary Breast Cancer Unit, Department of Oncologic Radiotherapy, Institut Català d'Oncología, Barcelona, Spain
Eulalia Fernandez-Montolí Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
Agostina Stradella Multidisciplinary Breast Cancer Unit, Department of Oncology, Institut Català d'Oncología, Barcelona, Spain
Sabela Recalde Multidisciplinary Breast Cancer Unit, Department of Oncology, Institut Català d'Oncología, Barcelona, Spain
Teresa Soler Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Anna Petit Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Maria Teresa Bajen Multidisciplinary Breast Cancer Unit, Department of Nuclear Medicine, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Ana Benitez Multidisciplinary Breast Cancer Unit, Department of Nuclear Medicine, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Anna Guma Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Miriam Campos Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
Maria J Pla Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
Evelyn Martinez Multidisciplinary Breast Cancer Unit, Department of Oncologic Radiotherapy, Institut Català d'Oncología, Barcelona, Spain
Maria Laplana Multidisciplinary Breast Cancer Unit, Department of Oncologic Radiotherapy, Institut Català d'Oncología, Barcelona, Spain
Sonia Pernas Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Diana Perez-Sildekova Multidisciplinary Breast Cancer Unit, Department of Plastic and Restorative Surgery, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Isabel Catala Multidisciplinary Breast Cancer Unit, Department of Pathology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain
Jordi Ponce Multidisciplinary Breast Cancer Unit, Department of Gynecology, Hospital Universitari Bellvitge, Idibell, Universitat de Barcelona, Bellvitge Hospital, Ave. Feixa Llarga, sn., Hospitalet de Llobregat, 08970, Barcelona, Spain
Catalina Falo Multidisciplinary Breast Cancer Unit, Department of Radiology, Hospital Universitari Bellvitge, Idibell, Barcelona, Spain

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Bayarmaa B, Wu Z, Peng J, Wang Y, Xu S, Yan T, Yin W, Lu J, Zhou L. Association of LncRNA MEG3 polymorphisms with efficacy of neoadjuvant chemotherapy in breast cancer. BMC Cancer 2019;19:877. [PMID: 31488093 PMCID: PMC6727505 DOI: 10.1186/s12885-019-6077-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 08/05/2019] [Indexed: 02/08/2023] Open

Abstract

BACKGROUND

Breast cancer is the most common malignancy in women, and neoadjuvant chemotherapy has been recommended to the patients with locally advanced breast cancer as the initial treatments. Long non-coding RNA (lncRNA) MEG3, an identified tumor suppressor, has been implicated in the development of various cancers. However, there is no data to evaluate the effect of MEG3 polymorphisms on neoadjuvant treatment in the breast cancer.

METHODS

Genotyping was performed using Nanodispenser Spectro CHIP chip spotting and Mass ARRAY Compact System. Univariate and multivariate logistic regression analyses were used to analyze the associations between the MEG3 polymorphisms and the pathological complete response (pCR). The disease-free survival (DFS) was estimated by the Kaplan-Meier method, and multivariate Cox proportional hazards models were used to calculate the hazard ratios (HRs) with a 95% confidential interval (CI).

RESULTS

A total of 144 patients with available pretreatment blood species were enrolled in the SHPD002 clinic trial of neoadjuvant chemotherapy for breast cancer. MEG3 rs10132552 were significantly associated with good response (Adjusted OR = 2.79, 95% CI 1.096-7.103, p = 0.031) in dominant model. Median follow-up time was 20 months. In multiple regression analysis, rs10132552 TC + CC (adjusted HR = 0.127, 95% CI 0.22-0.728, p = 0.02) and rs941576 AG + GG (adjusted HR = 0.183, 95% CI 0.041-0.807, p = 0.025) were significantly associated with good DFS. MEG3 rs7158663 (OR = 0.377, 95% CI 0.155-0.917, p = 0.032) were associated with a low risk of hemoglobin decrease in dominant models.

CONCLUSIONS

LncRNA MEG3 polymorphisms were associated with the chemotherapy response and toxicity of paclitaxel and cisplatin. The result indicates that MEG3 polymorphisms can be considered as the predictive and prognostic markers for the breast cancer patients.

TRIAL REGISTRATION

Retrospectively registered (ClinicalTrials. Gov identifier: NCT02221999 ); date of registration: Aug 20th, 2014.

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Steenbruggen TG, van Seijen M, Janssen LM, van Ramshorst MS, van Werkhoven E, Vrancken Peeters MJTDF, Wesseling J, Lips EH, Sonke GS. Prognostic Value of Residual Disease after Neoadjuvant Therapy in HER2-Positive Breast Cancer Evaluated by Residual Cancer Burden, Neoadjuvant Response Index, and Neo-Bioscore. Clin Cancer Res 2019;25:4985-4992. [PMID: 31076546 DOI: 10.1158/1078-0432.ccr-19-0560] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/29/2019] [Accepted: 05/06/2019] [Indexed: 11/16/2022]

Abstract

PURPOSE

In breast cancer, pathologic complete response (pCR) to neoadjuvant systemic therapy (NST) is associated with favorable long-term outcome. Trastuzumab emtansine as additional adjuvant therapy improves recurrence-free survival of patients with HER2-positive breast cancer without pCR, but it is uncertain whether all patients without pCR need additional therapy. We evaluated the prognostic value of residual disease after trastuzumab-based NST in patients with HER2-positive breast cancer using Residual Cancer Burden (RCB), Neoadjuvant Response Index (NRI), and Neo-Bioscore.

EXPERIMENTAL DESIGN

We included patients with stage II or III HER2-positive breast cancer treated with trastuzumab-based NST and surgery at The Netherlands Cancer Institute between 2004 and 2016. RCB, NRI, and Neo-Bioscore were determined. Primary endpoint was 5-year recurrence-free interval (RFI). A 3% difference compared with the pCR group was considered acceptable as noninferiority margin on the 5-year RFI estimate, based on a proportional hazards model, and its lower 95% confidence boundary.

RESULTS

A total of 283 women were included. Median follow-up was 67 months (interquartile range 44-100). A total of 157 patients (56%) with pCR (breast and axilla) had a 5-year RFI of 92% (95% CI, 88-97); patients without pCR had a 5-year RFI of 80% (95% CI, 72-88). Patients with an RCB = 1 (N = 40, 15%), an NRI score between 0.75 and 0.99 (N = 30, 11%), or a Neo-Bioscore of 0 to 1 (without pCR; N = 28, 11%) have a 5-year RFI that falls within a predefined noninferiority margin of 3% compared with patients with pCR.

CONCLUSIONS

The RCB, NRI, and Neo-Bioscore can identify patients with HER2-positive breast cancer with minimal residual disease (i.e., RCB = 1, NRI ≥ 0.75, or Neo-Bioscore = 0-1) after NST who have similar 5-year RFI compared with patients with pCR.

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Mrkonjic M, Berman HK, Done SJ, Youngson B, Mulligan AM. Breast specimen handling and reporting in the post-neoadjuvant setting: challenges and advances. J Clin Pathol 2019;72:120-132. [PMID: 30670564 DOI: 10.1136/jclinpath-2018-205598] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 12/23/2022]

Sobral-Leite M, Lips EH, Vieira-Monteiro HDA, Giacomin LC, Freitas-Alves DR, Cornelissen S, Mulder L, Wesseling J, Schmidt MK, Vianna-Jorge R. Evaluation of the EGFR polymorphism R497K in two cohorts of neoadjuvantly treated breast cancer patients. PLoS One 2017;12:e0189750. [PMID: 29267323 PMCID: PMC5739423 DOI: 10.1371/journal.pone.0189750] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 11/08/2017] [Indexed: 12/27/2022] Open

Biomarkers and Imaging of Breast Cancer. AJR Am J Roentgenol 2017;210:271-278. [PMID: 29166151 DOI: 10.2214/ajr.17.18708] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]

Anderson PG, Kalli S, Sassaroli A, Krishnamurthy N, Makim SS, Graham RA, Fantini S. Optical Mammography in Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy: Individual Clinical Response Index. Acad Radiol 2017;24:1240-1255. [PMID: 28532642 DOI: 10.1016/j.acra.2017.03.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 03/21/2017] [Accepted: 03/22/2017] [Indexed: 12/28/2022]

Weekly paclitaxel and cisplatin as neoadjuvant chemotherapy with locally advanced breast cancer: a prospective, single arm, phase II study. Oncotarget 2017;8:79305-79314. [PMID: 29108309 PMCID: PMC5668042 DOI: 10.18632/oncotarget.17954] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/05/2017] [Indexed: 12/20/2022] Open

Imaging performance in guiding response to neoadjuvant therapy according to breast cancer subtypes: A systematic literature review. Crit Rev Oncol Hematol 2017;112:198-207. [PMID: 28325260 DOI: 10.1016/j.critrevonc.2017.02.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 01/18/2017] [Accepted: 02/14/2017] [Indexed: 11/23/2022] Open

Yang Y, Im SA, Keam B, Lee KH, Kim TY, Suh KJ, Ryu HS, Moon HG, Han SW, Oh DY, Han W, Kim TY, Park IA, Noh DY. Prognostic impact of AJCC response criteria for neoadjuvant chemotherapy in stage II/III breast cancer patients: breast cancer subtype analyses. BMC Cancer 2016;16:515. [PMID: 27444430 PMCID: PMC4955253 DOI: 10.1186/s12885-016-2500-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/04/2016] [Indexed: 12/31/2022] Open

Affiliation(s)

Yaewon Yang Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
Seock-Ah Im Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. .,Cancer Research Institute, Seoul National University, Seoul, Korea.
Bhumsuk Keam Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
Kyung-Hun Lee Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
Tae-Yong Kim Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. .,Cancer Research Institute, Seoul National University, Seoul, Korea.
Koung Jin Suh Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
Han Suk Ryu Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Hyeong-Gon Moon Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Sae-Won Han Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
Do-Youn Oh Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
Wonshik Han Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Tae-You Kim Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
In Ae Park Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Dong-Young Noh Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

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Jebbink M, van Werkhoven E, Mandjes IAM, Wesseling J, Lips EH, Vrancken Peeters MJTDF, Loo CE, Sonke GS, Linn SC, Falo Zamora C, Rodenhuis S. The prognostic value of the neoadjuvant response index in triple-negative breast cancer: validation and comparison with pathological complete response as outcome measure. Breast Cancer Res Treat 2015. [PMID: 26210520 DOI: 10.1007/s10549-015-3510-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]

Pinder SE, Rakha EA, Purdie CA, Bartlett JMS, Francis A, Stein RC, Thompson AM, Shaaban AM. Macroscopic handling and reporting of breast cancer specimens pre- and post-neoadjuvant chemotherapy treatment: review of pathological issues and suggested approaches. Histopathology 2015;67:279-93. [PMID: 25585651 DOI: 10.1111/his.12649] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]

Abdel-Fatah TM, Ball G, Lee AH, Pinder S, MacMilan RD, Cornford E, Moseley PM, Silverman R, Price J, Latham B, Palmer D, Chan A, Ellis IO, Chan SY. Nottingham Clinico-Pathological Response Index (NPRI) after Neoadjuvant Chemotherapy (Neo-ACT) Accurately Predicts Clinical Outcome in Locally Advanced Breast Cancer. Clin Cancer Res 2014;21:1052-62. [DOI: 10.1158/1078-0432.ccr-14-0685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]

Bamal R, Chintamani, Tandon M, Mittal MK, Saxena S. Evaluation and Validation of Neo-Adjuvant Response Index (NRI) and It's Correlation with Various Predictive Biomarkers and RECIST in Locally Advanced Breast Cancer. Indian J Surg Oncol 2014;5:171-7. [PMID: 25419059 PMCID: PMC4235867 DOI: 10.1007/s13193-014-0336-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/11/2014] [Indexed: 11/30/2022] Open

Abstract

BACKGROUND

Response evaluation following neo-adjuvant chemotherapy in breast cancer is usually done without taking in to account the axillary response and the available tools like 'response evaluation criteria in solid tumors' (RECIST) have this limitation. These criteria rely solely on the response observed in the primary tumour. Neoadjuvant response index is one such attempt to have a comprehensive assessment of response both in the primary tumour and the axilla.

METHODS

30 cases of locally advanced breast cancer (LABC) were assessed for response using 'Neo-adjuvant Response Index'. The index always gives score between '0' (no response or progressive disease) and '1' (pathological complete response i.e. no invasive tumor in breast as well as axilla). This index includes axillary response as well and provides a spectrum of response rather than dividing patients into simply responders and non-responders .

RESULTS

Mean reading of index was found to be 0.2925 in this study. Three patients achieved an index of 1. This index correlates significantly with the existing scales for assessing response. Hormone negative tumors were found to be more chemo responsive with higher rates of pathological complete response (pCR) while ER/PR + Her2- tumors showed a very poor response to NACT.

CONCLUSIONS

Based on the observations of the present study it may be submitted that Neoadjuvant Response Index (NRI) is a reliable and simple tool that can serve as a comprehensive and accurate method of assessing response to neo-adjuvant chemotherapy as it takes in to consideration both the tumor and axillary response unlike the existing RECIST, binary system (responders are those with greater than 50 % reduction), RCB method and the available biomarkers. This study being first of it's kind in Indian population, in spite of it's limitations, could prove to be a launching ground for further reasearch and contribute substantially to the evidence base.

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Neoadjuvant chemotherapy adaptation and serial MRI response monitoring in ER-positive HER2-negative breast cancer. Br J Cancer 2013;109:2965-72. [PMID: 24149178 PMCID: PMC3859944 DOI: 10.1038/bjc.2013.661] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 09/17/2013] [Accepted: 10/01/2013] [Indexed: 01/05/2023] Open

Sonke GS, Mandjes IA, Holtkamp MJ, Schot M, van Werkhoven E, Wesseling J, Vrancken Peeters MJ, Rodenhuis S, Linn SC. Paclitaxel, carboplatin, and trastuzumab in a neo-adjuvant regimen for HER2-positive breast cancer. Breast J 2013;19:419-26. [PMID: 23682812 DOI: 10.1111/tbj.12124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]

Lips EH, Mulder L, Oonk A, van der Kolk LE, Hogervorst FBL, Imholz ALT, Wesseling J, Rodenhuis S, Nederlof PM. Triple-negative breast cancer: BRCAness and concordance of clinical features with BRCA1-mutation carriers. Br J Cancer 2013;108:2172-7. [PMID: 23558900 PMCID: PMC3670471 DOI: 10.1038/bjc.2013.144] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open

Keam B, Im SA, Lim Y, Han SW, Moon HG, Oh DY, Cho N, Lee SH, Han W, Moon WK, Kim DW, Kim TY, Park IA, Noh DY. Clinical usefulness of AJCC response criteria for neoadjuvant chemotherapy in breast cancer. Ann Surg Oncol 2013;20:2242-9. [PMID: 23529780 DOI: 10.1245/s10434-012-2756-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Indexed: 12/13/2022]

Koolen BB, Pengel KE, Wesseling J, Vogel WV, Vrancken Peeters MJTFD, Vincent AD, Gilhuijs KGA, Rodenhuis S, Rutgers EJT, Valdés Olmos RA. FDG PET/CT during neoadjuvant chemotherapy may predict response in ER-positive/HER2-negative and triple negative, but not in HER2-positive breast cancer. Breast 2013;22:691-7. [PMID: 23414930 DOI: 10.1016/j.breast.2012.12.020] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 09/18/2012] [Accepted: 12/17/2012] [Indexed: 11/28/2022] Open

Provenzano E, Brown JP, Pinder SE. Pathological controversies in breast cancer: classification of ductal carcinoma in situ, sentinel lymph nodes and low volume metastatic disease and reporting of neoadjuvant chemotherapy specimens. Clin Oncol (R Coll Radiol) 2012. [PMID: 23199579 DOI: 10.1016/j.clon.2012.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]

Ohzawa H, Sakatani T, Niki T, Yasuda Y, Hozumi Y. Pathological responses and survival of patients with human epidermal growth factor receptor 2-positive breast cancer who received neoadjuvant chemotherapy including trastuzumab. Breast Cancer 2012;21:563-70. [PMID: 23108629 DOI: 10.1007/s12282-012-0424-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 10/15/2012] [Indexed: 01/28/2023]

Lobular histology and response to neoadjuvant chemotherapy in invasive breast cancer. Breast Cancer Res Treat 2012;136:35-43. [PMID: 22961065 DOI: 10.1007/s10549-012-2233-z] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 08/24/2012] [Indexed: 10/27/2022]

Abstract

Invasive lobular carcinoma (ILC) has been reported to be less responsive to neoadjuvant chemotherapy (NAC) than invasive ductal carcinoma (IDC). We sought to determine whether ILC histology indeed predicts poor response to NAC by analyzing tumor characteristics such as protein expression, gene expression, and imaging features, and by comparing NAC response rates to those seen in IDC after adjustment for these factors. We combined datasets from two large prospective NAC trials, including in total 676 patients, of which 75 were of lobular histology. Eligible patients had tumors ≥3 cm in diameter or pathologic documentation of positive nodes, and underwent serial biopsies, expression microarray analysis, and MRI imaging. We compared pathologic complete response (pCR) rates and breast conservation surgery (BCS) rates between ILC and IDC, adjusted for clinicopathologic factors. On univariate analysis, ILCs were significantly less likely to have a pCR after NAC than IDCs (11 vs. 25 %, p = 0.01). However, the known differences in tumor characteristics between the two histologic types, including hormone receptor (HR) status, HER2 status, histological grade, and p53 expression, accounted for this difference with the lowest pCR rates among HR+/HER2- tumors in both ILC and IDC (7 and 5 %, respectively). ILC which were HR- and/or HER2+ had a pCR rate of 25 %. Expression subtyping, particularly the NKI 70-gene signature, was correlated with pCR, although the small numbers of ILC in each group precluded significant associations. BCS rate did not differ between IDC and ILC after adjusting for molecular characteristics. We conclude that ILC represents a heterogeneous group of tumors which are less responsive to NAC than IDC. However, this difference is explained by differences in molecular characteristics, particularly HR and HER2, and independent of lobular histology.

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Houssami N, Macaskill P, von Minckwitz G, Marinovich ML, Mamounas E. Meta-analysis of the association of breast cancer subtype and pathologic complete response to neoadjuvant chemotherapy. Eur J Cancer 2012;48:3342-54. [PMID: 22766518 DOI: 10.1016/j.ejca.2012.05.023] [Citation(s) in RCA: 365] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 05/28/2012] [Indexed: 12/28/2022]

Abstract

BACKGROUND

Pathologic complete response (pCR) is a surrogate end-point for prognosis in neoadjuvant chemotherapy (NAC) for breast cancer. We aimed to report summary estimates of the proportion of subjects achieving pCR (pCR%) by tumour subtype, and to determine whether subtype was independently associated with pCR, in a study-level meta-analysis.

METHODS

We systematically identified NAC studies reporting pCR data according to tumour subtype, using predefined eligibility criteria. Descriptive, qualitative and quantitative data were extracted. Random effects logistic meta-regression examined whether pCR% was associated with subtype, defined using three categories for model 1 [hormone receptor positive (HR+/HER2-), HER2 positive (HER2+), triple negative (ER-/PR-/HER2-)] and 4 categories for model 2 [HER2+ further classified as HER2+/HR+ and HER2+/HR-]. Subtype-specific odds ratios (OR) were calculated and were adjusted for covariates associated with pCR in our data.

RESULTS

In model 1, based on 11,695 subjects from 30 eligible studies, overall pooled pCR% was 18.9% (16.6-21.5%), and in model 2 (20 studies, 8095 subjects) pooled pCR% was 18.5% (16.2-21.1%); tumour subtype was associated with pCR% (P<0.0001) in both models. Subtype-specific pCR% (model 2) was: 8.3% (6.7-10.2%) in HR+/HER2- [OR 1/referent], 18.7% (15.0-23.1%) in HER2+/HR+ [OR 2.6], 38.9% (33.2-44.9%) in HER2+/HR- [OR 7.1] and 31.1% (26.5-36.1%) in triple negative [OR 5.0]; pCR% was significantly higher for the HER2+/HR- compared with the triple negative subtype, however pCR% was very similar for these subtypes (and OR=5.0 both subtypes) when studies using HER2-directed therapy with NAC were excluded from the model. Neither sensitivity analysis (excluding unknown subtypes), nor adjustment for associated covariates, substantially altered our findings.

INTERPRETATION

This meta-analysis provides evidence of an independent association between breast cancer subtype and pCR; odds of pCR were highest for the triple negative and HER2+/HR- subtypes, with evidence of an influential effect on achieving pCR in the latter subtype through inclusion of HER2-directed therapy with NAC.

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Pathological Assessment Following Pre-operative Systemic Therapy. CURRENT BREAST CANCER REPORTS 2011. [DOI: 10.1007/s12609-011-0055-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]

Filipovic A, Giamas G, Stebbing J. The potential role of cyclooxygenase-2 (COX-2) during early breast cancer therapy. Ann Oncol 2011;22:1700-2. [PMID: 21551001 DOI: 10.1093/annonc/mdr266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open

Lips EH, Mulder L, de Ronde JJ, Mandjes IAM, Vincent A, Vrancken Peeters MTFD, Nederlof PM, Wesseling J, Rodenhuis S. Neoadjuvant chemotherapy in ER+ HER2- breast cancer: response prediction based on immunohistochemical and molecular characteristics. Breast Cancer Res Treat 2011;131:827-36. [PMID: 21472434 DOI: 10.1007/s10549-011-1488-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 03/25/2011] [Indexed: 11/26/2022]

Abstract

A pathological complete remission (pCR) is rarely achieved by neoadjuvant chemotherapy in estrogen receptor-positive (ER+) HER2-negative (HER2-) tumors. Therefore, its use might be questionable in specific groups of this tumor type. To select which patients benefit and which could be spared neoadjuvant chemotherapy, we tested standard pathology and molecular markers in ER+ HER2- breast tumors. Pretreatment biopsies were available from 211 ER+ HER2- tumors, who had been treated with neoadjuvant chemotherapy (adriamycin/cyclophosphamide). mRNA expression data were available for 132 tumors. We determined progesterone receptor expression (PR), endocrine sensitivity, HER2 expression, histology, proliferation, and molecular subtypes. We correlated these data to chemotherapy response using pCR rates and the previously published neoadjuvant response index (NRI). PR-negative tumors (n = 65, 30.8%) and luminal B type tumors (n = 43, 20.4%) responded significantly better to chemotherapy than other tumors. These associations remained significant in multivariate analysis. However, even in the subgroup of patients with the lowest response rate, comprising tumors that had both a positive-PR expression and the luminal A subtype (n = 58, 44%), the majority of the patients had downstaging because of chemotherapy. For histology (lobular vs. ductal), endocrine sensitivity, and proliferation, no associations with chemotherapy response were observed. Gene expression array analysis resulted in 28 significant genes (FDR < 0.1). PR expression and luminal B status are associated with a better response to neoadjuvant chemotherapy. However, both markers had only weak response predictive power, and it was not possible to identify a subgroup with no or only minimal chemotherapy benefit. Therefore, the decision to refrain from neoadjuvant chemotherapy to ER+ HER2- breast tumors should not be based on predictive markers, but exclusively on estimates of prognosis.

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Loo CE, Straver ME, Rodenhuis S, Muller SH, Wesseling J, Vrancken Peeters MJTFD, Gilhuijs KGA. Magnetic resonance imaging response monitoring of breast cancer during neoadjuvant chemotherapy: relevance of breast cancer subtype. J Clin Oncol 2011;29:660-6. [PMID: 21220595 DOI: 10.1200/jco.2010.31.1258] [Citation(s) in RCA: 214] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open

Abstract

PURPOSE

To evaluate the relevance of breast cancer subtypes for magnetic resonance imaging (MRI) markers for monitoring of therapy response during neoadjuvant chemotherapy (NAC).

PATIENTS AND METHODS

MRI examinations were performed in 188 women before and during NAC. MRI interpretation included lesion morphology at baseline, changes in morphology, size, and contrast uptake kinetics (initial and late enhancement). By using immunohistochemistry, tumors were divided into three subtypes: triple negative, human epidermal growth factor receptor 2 (HER2) positive, and estrogen receptor (ER) positive/HER2 negative. Tumor response was assessed dichotomously (ie, presence or absence of residual tumor in the surgical specimen). Complementary, a continuous scale assessment was used (the breast response index [BRI], representing the relative change in tumor stage). Multivariate regression analysis and receiver operating characteristic analysis were employed to establish significant associations.

RESULTS

Residual tumor at pathology was present in 31 (66%) of 47 triple-negative tumors, 23 (61%) of 38 HER2-positive tumors, and 96 (93%) of 103 ER-positive/HER2-negative tumors. Multivariate analysis of residual disease showed significant associations between breast cancer subtype and MRI (area under the curve [AUC], 0.84; P < .001). BRI also showed significant correlation among breast cancer subtype, MRI, and age (Pearson's r = 0.465; P < .001). In subset analysis, this was only significant for triple-negative tumors (P < .001) and HER2-positive tumors (P < .05). Residual tumor after NAC in the triple-negative and HER2-positive group is significantly associated with the change in largest diameter of late enhancement during NAC (AUC, 0.76; P < .001). No associations were found for ER-positive/HER2-negative tumors.

CONCLUSION

MRI during NAC to monitor response is effective in triple-negative or HER2-positive disease but is inaccurate in ER-positive/HER2-negative breast cancer.

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Bibliography. Current world literature. Curr Opin Obstet Gynecol 2010;23:58-63. [PMID: 21191271 DOI: 10.1097/gco.0b013e3283432017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]

Breast cancer assessment tools and optimizing adjuvant therapy. Nat Rev Clin Oncol 2010;7:725-32. [PMID: 20975745 DOI: 10.1038/nrclinonc.2010.170] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]

Debled M, Mauriac L. Neoadjuvant chemotherapy: are we barking up the right tree? Ann Oncol 2010;21:675-679. [PMID: 20338876 DOI: 10.1093/annonc/mdq062] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open