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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

2815 - Pathologic response as a strong predictor of survival irrespective of phenotype in early Breast Cancer

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Ariadna Gasol Cudos

Citation

Annals of Oncology (2018) 29 (suppl_8): viii58-viii86. 10.1093/annonc/mdy270

Authors

A. Gasol Cudos1, S. Morales Murillo1, J. Veas Rodriguez2, F. Vilardell Vilellas2, D.R. Sanchez Guzman2, E. Iglesias Martinez1

Author affiliations

  • 1 Breast Cancer Unit, Hospital Arnau de Vilanova, 25198 - Lleida/ES
  • 2 Oncology, Hospital Arnau de Vilanova, 25198 - Lleida/ES
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Resources

Abstract 2815

Background

Pathologic complete response after neoadjuvant chemotherapy is considered as a surrogate of survival by most authors, although there are special phenotypes, such HER2 positive, where their potential as apredictor of survival is stronger.

Methods

Overall survival was analyzed according to pathologic response in a cohort of early breast cancer patients (all subtypes) treated with standard neoadjuvant chemotherapy. Between March 2000 to October 2016, 459 breast cancer patients were treated with neoadjuvant chemotherapy with anthracicline and taxane regimens.

Results

Median age was 52 (range 28-87), 173 tumors (38%) were classifyed as HER2 positive, 148 (32%) triple negative and 138 (30%) as luminal breast cancer. Median initial size was 34 mm (10-100) and 237 patients (51%) had initial node involvement. We achieved a total of 152/459 complete pathologic response with a 43% rate in HER2 positive, 44% in triple negative and 9% in luminal breast cancer patientes. Ten years disease free survival in the whole serie was 83%, with a 72% for patients without complete pathologic response versus 90% for complete pathologic response (long rang <0,00001). A strong correlation between pathologic response and survival wass found in all subtypes (long rang p:0,033; 0,028 and 0,027 in HER2 positive, luminal and triple negative respectively). A table with survival results according the RCB response by Symmans method in the whole series and different phenotypes is attached.Table: 264P

PhenotypeRCB type 0RCB1 type IRCB type IIRCB type III
OverallMedian DFS:167 HR: 1Median DFS:156 HR: 2,6Median DFS:130 HR: 4,5Median DFS:85 HR: 9,6
HER 2 positiveMedian DFS: 126 HR: 1Median DFS: 90 HR: 1,6Median DFS:100 HR: 2,5Median DFS:96 HR: 4,4
LuminalMedian DFS: 176 HR: 1Median DFS: 160 HR: 2,8Median DFS:115 HR: 4,8Median DFS: NA HR: NA
Triple negativeMedian DFS:188 HR: 1Median DFS: 141 HR: 8,8Median DFS: 117 HR: 16,7Median DFS:122 HR: 28.4

Conclusions

Pathologic response is a strong predictor of overall survival in all breast cancer phenotypes althoug in the triple negative has the highest magnitude with a HR of 28,4 in patients with worse pathologic response (RCB type III). Neoadjuvant chemotherapy should be considered in the majority of patients who are candidates to chemotherapy, specially in triple negative and HER2 positive; however, in luminal phenotype a better selection for neoadyuvant chemotherapy is needed.

Clinical trial identification

Legal entity responsible for the study

Hospital Universitari Arnau de Vilanova.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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