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
4142 - Association of derived neutrophil-to-lymphocyte ratio (dNLR) with pathological complete response (pCR) after neoadjuvant chemotherapy (CT)
Presenter: Alberto Ocaña
Session: Poster Display session 2
Resources:
Abstract
1733 - Competing nomogram for late-period breast cancer-specific death in patients with early-stage hormone receptor-positive breast cancer
Presenter: Jianfei Fu
Session: Poster Display session 2
Resources:
Abstract
1978 - A Nomogram to Predict Pathologic Complete Response of Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer Based on Simple Blood Indicators
Presenter: Fanrong Zhang
Session: Poster Display session 2
Resources:
Abstract
3062 - Identification of GSTP1 transferred by extracellular vesicles responsible for adriamycin-resistance in breast cancer cells
Presenter: Sujin Yang
Session: Poster Display session 2
Resources:
Abstract
5274 - Expression of X-linked Inhibitor of Apoptosis Protein (XIAP) and its Association with Clinicopathological Parameters in Invasive Breast Cancers
Presenter: Gayathri Devi
Session: Poster Display session 2
Resources:
Abstract
1324 - The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients
Presenter: Soo Youn Bae
Session: Poster Display session 2
Resources:
Abstract
4877 - Correlation of clinical and pathological features with the tumour microenvironment in DCIS. An institutional experience
Presenter: Ann Eapen
Session: Poster Display session 2
Resources:
Abstract
2471 - Correlation between radiologic complete response (rCR) in contrast-enhanced magnetic resonance imaging (CE-MRI) after neoadjuvant chemotherapy for early breast cancer and pathologic complete response and their impact in recurrence-free survival
Presenter: Ariadna Gasol Cudos
Session: Poster Display session 2
Resources:
Abstract
2632 - Ring-like uptake appearance on dedicated breast positron emission tomography before chemotherapy predicts outcome of neoadjuvant chemotherapy in breast cancer
Presenter: Norio Masumoto
Session: Poster Display session 2
Resources:
Abstract
3911 - Defining a SUV decrease cut-off in PET/CT response monitoring after one cycle of preoperative breast cancer chemotherapy
Presenter: Marcin Kubeczko
Session: Poster Display session 2
Resources:
Abstract