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 Stage | CPS+ EG Score | Neo-Bioscore (7 points) | Modified Neo-Bioscore (8 points) |
|---|---|---|---|
| Pretreatment Clinical Stage (CS) | |||
| I | 0 | 0 | 0 |
| IIA | 0 | 0 | 0 |
| IIB | 1 | 1 | 1 |
| IIIA | 1 | 1 | 1 |
| IIIB | 2 | 2 | 2 |
| IIIC | 2 | 2 | 2 |
| Post-treatment Pathologic Stage (PS) | |||
| 0 | 0 | 0 | 0 |
| I | 0 | 0 | 0 |
| IIA | 1 | 1 | 1 |
| IIB | 1 | 1 | 1 |
| IIIA | 1 | 1 | 1 |
| IIIB | 1 | 1 | 1 |
| IIIC | 2 | 2 | 2 |
| Tumor Marker | |||
| ER negative | 1 | 1 | 1 |
| Grade 3 | 1 | 1 | 1 |
| HER2-negative | 1 | 1 | |
| HER2-positive & no Trastuzumab | 2 |
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.
Resources from the same session
1849 - Effect of thioredoxin 1 quantity detection to complement the mammography in breast cancer diagnosis
Presenter: Younju Lee
Session: Poster Display session 2
Resources:
Abstract
2221 - Identification of ultralow risk breast cancer patients (probable overdiagnosis)
Presenter: Salvador Gamez Casado
Session: Poster Display session 2
Resources:
Abstract
5291 - Prevalence of Vitamin D3 deficiency among women with early breast cancer receiving chemotherapy in an oncology dayward.
Presenter: Warner Finstad
Session: Poster Display session 2
Resources:
Abstract
4247 - Changes in ER pathway activity score during neoadjuvant letrozole to assess therapy response and predict disease free survival (DFS) in ER positive breast cancer patients
Presenter: Arran Turnbull
Session: Poster Display session 2
Resources:
Abstract
568 - Second primary malignancies in patients with breast cancer.
Presenter: Carlos Erasun Lecuona
Session: Poster Display session 2
Resources:
Abstract
1428 - Phase II randomized trial of neoadjuvant trastuzumab and pertuzumab (TP) with either palbociclib + letrozole (Pal+L) or paclitaxel (Pac) for elderly patients with estrogen receptor & HER2 positive (ER+/HER2+) Breast Cancer (BC) (International Breast Cancer Study Group IBCSG 55-17, TOUCH)
Presenter: Laura Biganzoli
Session: Poster Display session 2
Resources:
Abstract
1479 - Neoadjuvant HER2-targeted therapy with or without immunotherapy with pembrolizumab (neoHIP): an open label randomized phase 2 trial
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
1481 - A randomized phase 2 study of peri-operative ipilimumab, nivolumab and cryoablation versus standard care in women with residual, early stage/resectable, triple negative breast cancer after standard-of-care neoadjuvant chemotherapy
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
4334 - ALEXANDRA/IMpassion030: A phase 3 study of standard adjuvant chemotherapy with or without atezolizumab in early stage triple negative breast cancer.
Presenter: Michail Ignatiadis
Session: Poster Display session 2
Resources:
Abstract
2107 - Role of Individualized Intervention(s) on Quality of Life (QOL) and Adherence to Adjuvant Endocrine Therapy in Premenopausal Women with Early-Stage Breast Cancer (BC): MyChoice Study
Presenter: Shahid Ahmed
Session: Poster Display session 2
Resources:
Abstract