1
|
Sasa S, Inoue H, Nakagawa M, Toba H, Goto M, Okumura K, Misaki M, Inui T, Yukishige S, Nishisho A, Hino N, Kanematsu M, Bando Y, Uehara H, Tangoku A, Takizawa H. Long-Term Outcomes of S-1 Combined With Low-Dose Docetaxel as Neoadjuvant Chemotherapy (N-1 Study, Phase II Trial) in Patients With Operable Breast Cancer. Clin Breast Cancer 2024; 24:e350-e359.e2. [PMID: 38462397 DOI: 10.1016/j.clbc.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND We previously reported that S-1 and low-dose docetaxel (DOC) (N-1 study, phase II trial) could be a well-tolerated and effective neoadjuvant chemotherapies (NACs) for patients with operable breast cancer. Herein, we analyzed the long-term outcomes and developed clinicopathological and molecular predictors of pathological complete response (pCR). PATIENTS AND METHODS Eighty-three patients received S-1 (40 mg/m2 orally on days 1-14) and DOC (40 mg/m2 intravenously on day 1) every 3 weeks for 4 to 8 cycles. Disease-free survival (DFS) and overall survival (OS) were analyzed for each population with a pCR status. To assess the relationship between pCR and clinicopathological factors such as tumor-infiltrating lymphocytes (TILs, 1+ <10%, 2+ 10%-50%, and 3+ >50%) and nuclear grade (NG), microarray was used to compare the microRNA profiles of the pCR and non-pCR groups using core needle biopsy specimens. RESULTS With a median follow-up duration of 99.0 (range, 9.0-129.0) months, the 5-year DFS and OS rates were 80.7% and 90.9%, respectively. The 5-year OS rate of the pCR group was significantly better than that of the non-pCR group (100% vs. 86.2%, p = .0176). Specifically, in triple-negative patients, the difference was significant (100% vs. 60.0%, p = .0224). Multivariate analysis revealed that high TILs (≥2-3+) and NG 2-3 independently predicted pCR. Microarray data revealed that 3 miRNAs (miR-215-5p, miR-196a-5p, and miR-196b-5p) were significantly upregulated in the pCR group. CONCLUSION Our NAC regimen achieved favorable long-term outcomes and significantly improved OS in the pCR group. High TILs, NG 2-3, and some miRNAs may be predictors of pCR.
Collapse
Affiliation(s)
- Soichiro Sasa
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Hiroaki Inoue
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Misako Nakagawa
- Department of Surgery, Takamatsu Municipal Hospital, Takamatsu, Japan
| | - Hiroaki Toba
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan.
| | - Masakazu Goto
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Kazumasa Okumura
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Mariko Misaki
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Tomohiro Inui
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Sawaka Yukishige
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Aya Nishisho
- Department of Surgery, Tokushima Municipal Hospital, Tokushima, Japan
| | - Naoki Hino
- Department of Surgery, Tokushima Municipal Hospital, Tokushima, Japan
| | - Miyuki Kanematsu
- Department of Surgery, Tokushima Red Cross Hospital, Komatsushima-cho, Komatsushima, Japan
| | - Yoshimi Bando
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
| | - Hisanori Uehara
- Division of Pathology, Tokushima University Hospital, Tokushima, Japan
| | - Akira Tangoku
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| | - Hiromitsu Takizawa
- Department of Thoracic, Endocrine Surgery and Oncology, Institute of Biomedical Science, Tokushima University Graduate School, Tokushima, Japan
| |
Collapse
|