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Poster Display session 2

1058 - Assessment of CPS+EG, Neo-Bioscore and modified Neo-Bioscore in breast cancer patients treated with preoperative systemic therapy: a multicenter cohort study

Date

29 Sep 2019

Session

Poster Display session 2

Presenters

LING XU

Citation

Annals of Oncology (2019) 30 (suppl_5): v55-v98. 10.1093/annonc/mdz240

Authors

L. XU1, Y. Liu1, Z. Fan2, Z. Jiang3, Y. Liu4, R. Ling5, J. Zhang6, Z. Yu7, F. Jin8, C. Wang9, S. Cui10, S. Wang11, D. Mao12, Q. Xiang13, Z. Zhang13, B. Zhou1, Z. Liu14, C. Ma14, X. Duan1, Y. Cui13

Author affiliations

  • 1 Breast Disease Center, Peking University First Hospital, 100034 - Beijing/CN
  • 2 Department Of Breast Surgery, The First Hospital of Jilin University, 130021 - Changchun/CN
  • 3 Department Of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, 100071 - Beijing/CN
  • 4 Hebei Breast Cancer Center, The 4th Hospital of Hebei Medical University, 050011 - Shijiazhuang/CN
  • 5 Department Of Thyroid, Breast And Vascular Surgery, Xijing Hospital, Air Force (Military) Medical University, 710032 - Xi'an/CN
  • 6 Breast Disease Department, The Second Affiliated Hospital of Harbin Medical University, 150001 - Harbin/CN
  • 7 Department Of Breast Surgery, The Second Hospital of Shandong University, 250033 - Jinan/CN
  • 8 Department Of Breast Surgery, The First Hospital of China Medical University, 110001 - Shenyang/CN
  • 9 Department Of Breast Surgery, Affiliated Union Hospital of Fujian Medical University, 350001 - Fuzhou/CN
  • 10 Department Of Breast Surgery, Affiliated Tumor Hospital of Zhengzhou University, 450008 - Zhengzhou/CN
  • 11 Breast Center, Peking University People’s Hospital, 100044 - Beijing/CN
  • 12 Department Of Breast Surgery, The Affiliated Hospital of Guizhou Medical University, 550004 - Guiyang/CN
  • 13 Department Of Pharmacy, Peking University First Hospital, 100034 - Beijing/CN
  • 14 Institute Of Mental Health, Peking University, 100191 - Beijing/CN
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Resources

Abstract 1058

Background

An accurate prognostic assessment of breast cancer patients after preoperative systemic therapy (PST) is critical for physicians to adjust the systemic treatments. While both CPS+EG and Neo-Bioscore provide a satisfactory prediction, they, however, have limitations due to the lack of targeted therapies in current clinical practice.

Methods

A retrospective multicenter cohort study was conducted from 12 participating hosipitals’ databases from 2006 to 2015. Five-year disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS) were calculated using the Kaplan-Meier Method. Area under the curve (AUC) of the three staging systems was compared. The detailed staging systems are summarized in Table. Wald test and maximum likelihood estimates in Cox proportional hazards model was used for multivariate analysis.

Results

A total of 1077 patients were enrolled. The CPS+EG, Neo-Bioscore, and modified Neo-Bioscore could all stratify the DFS, DSS and OS (all P < 0.001). While in the same stratum of Neo-Bioscore score 2 and 3, the HER2-positive patients without trastuzumab therapy had much poorer DSS (P = 0.013 and P values <0.01, respectively) as compared to HER2-positive patients with trastuzumab therapy and HER2-negative patients. Only the modified Neo-Bioscore had a significantly higher stratification of 5-year DSS than PS (AUC 0.79 vs. 0.65, P = 0.03).Table:

249P Point assignment for the CPS+EG, neo-bioscore, and modified neo-bioscore staging systems

Cancer StageCPS+ EG ScoreNeo-Bioscore (7 points)Modified Neo-Bioscore (8 points)
Pretreatment Clinical Stage (CS)
I000
IIA000
IIB111
IIIA111
IIIB222
IIIC222
Post-treatment Pathologic Stage (PS)
0000
I000
IIA111
IIB111
IIIA111
IIIB111
IIIC222
Tumor Marker
ER negative111
Grade 3111
HER2-negative11
HER2-positive & no Trastuzumab2

Abbreviations: CPS+EG, clinical-pathologic staging system incorporating estrogen receptor–negative disease and nuclear grade 3 tumor pathology; ER, estrogen receptor; PR, progesterone receptor; HER2, human epidermal growth factor receptor 2.

Conclusions

The modified Neo-Bioscore could circumvent the limitation of CPS+EG or Neo-Bioscore. The access of appropriate treatment should be incorporated into the existing staging systems for more refined prognosis prediction.

Clinical trial identification

The trial protocol number: NCT03437837 Release date: February 19, 2018.

Editorial acknowledgement

Legal entity responsible for the study

Xuening Duan AND Yimin Cui.

Funding

National Key Research and Development Program of China.

Disclosure

All authors have declared no conflicts of interest.

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