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Poster Display session 2

3505 - Clinical features of early-stage (I-III) triple-negative breast cancer (TNBC) patients with tumors exhibiting low-overall change in molecular profile after neoadjuvant therapy.

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Breast Cancer

Presenters

Nour Abuhadra

Citation

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

Authors

N. Abuhadra, S. Seth, S. Moulder

Author affiliations

  • Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, 77030 - Houston/US
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Resources

Abstract 3505

Background

Seth et al. (ASCO 19) identified four biologic classes based on longitudinal molecular profiling of TNBC tumors pre- and post- neoadjuvant adriamycin/cyclophosphamide (AC). The four groups were defined based on the enriched and depleted hallmark pathways that were observed. The low-overall change (LOC) group was defined as having no significant change in the pathways in pre- and post-AC biopsies. Of note, this group of patients had lower pathological complete response (pCR) rates. The aim of this study is to describe the clinical features of early-stage (I-III) TNBC patients with tumors exhibiting LOC in their biopsies with neoadjuvant therapy.

Methods

We analyzed the clinical characteristics of 48 patients with early stage (I-III) TNBC enrolled in the ARTEMIS trial (NCT02276443). All patients received neoadjuvant AC; 48% of patients were subsequently treated on a clinical trial and 52% received standard taxane-based chemotherapy. We compared the clinical characteristics of 17 patients in the LOC group with 31 patients in the other three biologic classes. Two-group comparison was performed using Chi-squared test.

Results

Age at diagnosis, histology, Vanderbilt subtype, Ki-67, sTIL levels and vimentin expression were similar between the groups. Median age at diagnosis in the LOC group was 58 (range, 27-74). All patients in this group were stage II-III, with no stage I identified. 59% of patients in the LOC group had stage III disease compared with 26% in the other groups (p = 0.02), Also, 47% of patients in this group had AR ≥ 10% compared to 19% in the other biological groups (p = 0.04).Table:

252P

VariableGroupLow-Overall Change Group (n = 17)%Other Biologic Classes (n = 31)%p
Age at diagnosis≤60105925810.10
>60741619
StageI00619N/A
II74117550.36
III10598260.02
HistologyInvasive ductal158826840.23
Metaplastic00413
Apocrine1600
Other1613
Vanderbilt subtypeBL3188260.24
LAR42426
M/MSL3181135
IM212412
Ki-67 (%)≥ 5084721680.16
< 509531032
Androgen Receptor Expression (%)≥ 108476190.04
< 109532581
Vimentin Expression (%)≥502124130.91
<5015882787
sTILLow (<5)74115480.37
Moderate (≥5-30)9521135
High (>30)0013

Conclusions

Patients with low-overall change in their tumors had later-stage disease and higher AR expression. Previous analysis by Seth et al. has demonstrated a lower pCR rate in this group with standard neoadjuvant chemotherapy. This analysis highlights the potential role of androgen deprivation in this class of tumors.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

The University of Texas MD Anderson Cancer Center Moonshots Program and a CPRIT Multi-Investigator Research Award (MIRA).

Disclosure

S. Moulder: Research grant / Funding (self): Pfizer; Research grant / Funding (self): Genentech; Research grant / Funding (self): Novartis; Research grant / Funding (self): Seattle Genetics; Research grant / Funding (self): EMD Serono; Research grant / Funding (self): Bayer; Research grant / Funding (self): AstraZeneca. All other authors have declared no conflicts of interest.

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