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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Clinicopathological response to neoadjuvant therapies and pathological complete response as a biomarker of survival in human epidermal growth factor receptor-2 enriched breast cancer – A retrospective cohort study
Breast, Volume 59, Year 2021
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Description
Background: Human epidermal growth factor receptor-2 (HER2) is overexpressed in 20–25% of breast cancers. Complete eradication of disease following neoadjuvant therapies and chemotherapy has been referred to as pathological complete response (pCR). Aims: To determine clinicopathological predictors of pCR to neoadjuvant therapies and to evaluate pCR as a surrogate to enhanced survival. Methods: Consecutive female patients with HER2 positive (HER+) breast cancer managed surgically in a single institution between 2005 and 2015 were included. Descriptive statistics and binary logistic regression were used to determine predictors of pCR. Appraisal of pCR as a predictor of survival was performed using Kaplan-Meier curves and Cox regression analysis. Results: 451 patients were included with a mean age of 56.6 ± 13.4 years (range 23–95). Disease-free (DFS) and overall survival (OS) was 82.3% (371/451) and 82.6% (376/451) respectively with a median follow-up of 108.0 months (range 3–184.0). 118 were treated in the neoadjuvant setting (26.2%): tumour size <50 mm (Odds Ratio (OR): 12.156, P = 0.023) and progesterone receptor negativity (OR: 2.762, P = 0.008) independently predicted breast pCR, while ductal carcinoma (OR: 3.203, P = 0.030) and grade 3 disease (OR: 2.788, P = 0.018) predicted axillary pCR. Both breast and axillary pCR predicted enhanced DFS (Hazard Ratio (HR): 0.470 & HR: 0.449) and OS (HR: 0.383 & HR: 0.307). Axillary pCR independently predicted improved OS (HR: 0.326). Conclusion: pCR is sensitive biomarker and surrogate to survival outcomes in HER2+ breast cancer. Patients likely to achieve pCR may be predicted from traditional clinicopathological characteristics and molecular parameters. © 2021
Authors & Co-Authors
Davey, Matthew G.
Ireland, Galway
University of Galway
Ireland, Galway
University Hospital Galway
Wijns, William C.
Ireland, Galway
University Hospital Galway
Soliman, O. I.I.
Ireland, Galway
University Hospital Galway
Miller, Nicola J.
Ireland, Galway
University of Galway
Lowery, Aoife J.
Ireland, Galway
University of Galway
Ireland, Galway
University Hospital Galway
Kerin, Michael J.
Ireland, Galway
University of Galway
Ireland, Galway
University Hospital Galway
Statistics
Citations: 21
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1016/j.breast.2021.06.005
ISSN:
09609776
Research Areas
Cancer
Environmental
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Approach
Quantitative
Participants Gender
Female