99O_PR - Prediction of relapse in patients with locally advanced breast cancer after neoadjuvant treatment

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Breast cancer
Topics Anticancer agents
Breast Cancer, Locally Advanced
Presenter Olexiy Aseyev
Citation Annals of Oncology (2016) 27 (suppl_9): ix30-ix34. 10.1093/annonc/mdw576
Authors O. Aseyev, L. Simmonds, M. Gertler, S. Verma
  • Medical Oncology, The Ottawa Hospital Regional Cancer Centre, K1h 6L8 - Ottawa/CA

Abstract

Background

Despite advances in cancer treatment, over 25% of patients (pts) with locally advanced breast cancer (LABC) relapse during first 5 years after treatment. The primary objective was to construct a prediction tool for risk of relapse in patients with LABC after neoadjuvant therapy.

Methods

This was single center, retrospective study of 546 patients with LABC who received neoadjuvant chemotherapy at the Ottawa Hospital Cancer Center between 2005 and 2015. Median follow-up was 49 months. The following data collected: demographics, tumor size, nodal and receptor status, grade, HER-2, stage of disease, cancer treatment and clinical outcomes. Primary endpoints were local and/or distant disease recurrence rate during first 5 years and time to relapse during the first 5 years. A prediction tool was devised based on the Cox regression model.

Results

The recurrence rate during first 5 years of follow up was 17.3% (local relapse – 3.2%, distant relapse – 13.2%, local + distant relapse – 0.9%).Over 60 variables were included in primary analysis. Cox regression proportional hazards model analysis resulted in only 5 factors with significant influence on risk of relapse during first 5 years of follow up. Risk factors and their risk prediction value are: 1) residual disease (yes- 4; no-0), (HR = 4.25; p-value=0.000), 2) lymph nodes status (positive-3; negative-0), (HR = 2.27; p-value=0.006), 3) Inflammatory histology (yes-2; no-0), (HR = 1.90; p-value=0.003) 4) estrogen receptors status (positive-2; negative-0), (HR = 2.07; p-value=0.001), 5) Adjuvant radiotherapy (yes-0; no-1), (HR = 1.76; p-value=0.036). Internal validation of proposed model was performed. ROC analysis of the proposed model revealed a sensitivity of 75%. According to this simple RP score, patients can be classified into to three groups (RP score – 0-5; 6-7; 8-12). Risk of relapse was 7 times higher in patients with RP Score 8-12 vs patients with score 0-5 (p-value

Conclusions

Our prognostic tool based on 5 risk factors can be used to predict risk of relapse after neoadjuvant treatment with a sensitivity of 75%. Patients with high risk may require additional treatment and/or more active follow-up strategies and this simple model may be used to design unique studies in LABC based on RP score.

Clinical trial indentification

Legal entity responsible for the study

The University of Ottawa

Funding

The Ottawa Hospital Cancer Centre

Disclosure

All authors have declared no conflicts of interest.