Abstract 12P
Background
As a rare type of breast cancer, the survival benefits of Neoadjuvant therapy (Neo-AT) for triple-negative metaplastic breast cancer (MpBC) was still uncertain. This study aimed to ascertain the long-term survival benefit of Neo-AT in patients with MpBC, construct a nomogram model to predict the survivorship and administrate a risk stratification, anticipating to provide treatment regimen for related population.
Methods
A multi-centers data with 44 patients included and the Surveillance, Epidemiology, and End Results (SEER) database (2000-2020) with 1210 patients were collected, then totally 1163 patients were screened out as original cohort. Kaplan-Meier, propensity-score match analyses, Cox regression model and LASSO (least absolute shrinkage and selection operator) regression and were employed to analyzed the cohort. A nomogram was developed based on the selected variables to predict short- and long- term survival. Dynamic online nomogram was conducted for the convenient application.
Results
In the original cohort included, a total of 155 (13.3%, 155/1210) patients received Neo-AT (Neo-AT group) and only 45 (29.0%, 45/155) cases approached complete response (CR), and 1008 (86.7%) of them underwent adjuvant therapy (AT group). In comparison subjects in the conventional AT, subjects in the Neo-AT group had inferior BCSS (P<0.0001) and OS outcomes (P= 0.00067) during the follow-up time, while through the precise analyses patients acquired CR had a superior survival. This nomogram model was anticipated to offer personalized prediction in BCSS and stratify patients more precisely, aiming to adjust treatment decision-making for those with MpBC. The developed risk stratification based on the nomogram divided patients into two groups, low and high risk death groups. Individuals in the high risk group had 7 times and more risk of mortality in comparison with those in the low risk group.
Conclusions
Triple-negative MpBC patients acquired CR tended to have a more preferable prognosis. This model exhibited a favorable prediction efficacy and confidential potency by low and high death risk groups. More personalized therapy should be rendered to patients with high-risk stratification.
Clinical trial identification
ChiCTR2300077045; 2023-10-27.
Editorial acknowledgement
Legal entity responsible for the study
the First Affiliated Hospital of Xi'an Jiaotong University.
Funding
The First Affiliated Hospital of Xi'an Jiaotong University.
Disclosure
All authors have declared no conflicts of interest.