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
4546 - Efficacy and toxicity of weekly carboplatin and paclitaxel as induction or palliative treatment in advanced esophageal cancer patients
Presenter: Femke de Man
Session: Poster Display session 2
Resources:
Abstract
5908 - Perioperative chemotherapy with Docetaxel, Oxaliplatin, Fluorouracil and Leucovorin (FLOT) versus Epirubicin, Platinum and Capecitabine or Flourouracil (EOX/ECF) in Resectable Gastric or Gastroesophageal Junction Adenocarcinoma- Safety and response data from India.
Presenter: Tanuj Chawla
Session: Poster Display session 2
Resources:
Abstract
937 - Phase II Study of Preoperative Radiotherapy Combined with S-1 plus Cisplatin in Clinically Resectable Type 4 or Large Type 3 Gastric Cancer: OGSG1205
Presenter: Shunji Endo
Session: Poster Display session 2
Resources:
Abstract
1119 - Observational Study of the Peritoneal Washing Cytology Positive Gastric Cancer without Gross Peritoneal Metastasis Underwent Radical D2 Gastrectomy.
Presenter: Jun Eul Hwang
Session: Poster Display session 2
Resources:
Abstract
3744 - Primary results of multicenter phase II study of neoadjuvant chemotherapy with S-1 and oxaliplatin for locally advanced gastric cancer (Neo G-SOX PII)
Presenter: Akira Miki
Session: Poster Display session 2
Resources:
Abstract
5091 - Multicenter Phase I/II Feasibility Study of Adjuvant Treatment with S-1 in Patients after R0-Resection of Adenocarcinoma of the Stomach and Esophagogastric Junction (GMBH-STO-0114)
Presenter: Kathrin Heinrich
Session: Poster Display session 2
Resources:
Abstract
2891 - A phase I study of Docetaxel/Oxaliplatin/S-1 (DOS) combination neoadjuvant chemotherapy for patients with locally advanced adenocarcinoma of the esophagogastric junction
Presenter: Kei Hosoda
Session: Poster Display session 2
Resources:
Abstract
2994 - Apatinib combined with docetaxel in second-line treatment of advanced gastric cancer: a prospective clinical study (Data updated)
Presenter: Mudan Yang
Session: Poster Display session 2
Resources:
Abstract
3000 - A multicenter phase II study of TAS-114 in combination with S-1 in patients with pre-treated advanced gastric cancer (EPOC1604)
Presenter: Daisuke Takahari
Session: Poster Display session 2
Resources:
Abstract
4653 - Impact of Pembrolizumab (pembro) Versus Paclitaxel on Health-Related Quality of Life (HRQoL) in Patients With Advanced Gastric or Gastroesophageal Junction (GEJ) Cancer That Has Progressed After First-Line Chemotherapy (KEYNOTE-061)
Presenter: Eric Van Cutsem
Session: Poster Display session 2
Resources:
Abstract