Abstract 2471
Background
Patients with early breast cancer (EBC) achieving pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) have a favorable prognosis. Breast surgery and more chemotherapy treatment might be avoided in patients in whom the presence of residual tumor can be ruled out with high confidence. We investigated the diagnostic accuracy of contrast enhanced MRI (CE-MRI) in predicting pCR and long-term outcome after NACT.
Methods
Patients with EBC, who had undergone CE-MRI before and after NACT, were retrospectively analyzed (n = 421), and regarding to the absence (radiologic complete remission; rCR) or presence (no-rCR) of residual contrast enhancement.
Results
Overall rCR and pCR rates were 35% (147/421) and 36% (154/421), respectively. We found a total of 70% (101/144) of rCR corresponded to a pCR (meaning the positive predictive value - PPV). In contrast, in 80% (219/272) of patients, residual tumor observed on MRI was pathologically confirmed (meaning the negative predictive value - NPV). Sensitivity to detect a pCR was 65% (101/154), while specificity to detect residual tumor and accuracy were 83% (219/262); and 76% (320/421), respectively. The PPV was significantly lower in luminal compared to HER2 positive and triple negative tumors (10/34 = 29 % vs. 50/62 = 81% and 41/48 = 85% respectively). The concordance between rCR and pCR was moderate (Cohen’s kappa − 0.5) but with low level in luminal tumors (Coheńs Kappa – 0.3). In multivariate analysis both assessments were significantly associated with disease free survival (rCR : HR:0,344 P = 0.001; pCR : HR : 0,154 P = 0.000), but not in luminal tumors (rCR : HR:0,813 P = 0.692; pCR : HR : 0,326 P = 0.275).
Conclusions
The accuracy of preoperative CE-MRI to predict pCR after NACT for EBC is moderate but in luminal tumors did not accurately predict pCR. However, rCR was strongly associated with favorable RFS, especially in HER2 positive and triple negative breast cancer tumors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2670 - Molecular subtypes of metastatic(met) gastric cancer(GC) (MoTriGastric): new biomarkers closer to the clinics
Presenter: Maria Alsina Maqueda
Session: Poster Display session 2
Resources:
Abstract
3797 - Exploring candidate signal transduction pathways for targeted therapy in esophageal cancer
Presenter: Aafke Creemers
Session: Poster Display session 2
Resources:
Abstract
5485 - Clinical implication of CLDN18, RhoGAP, and E-cadherin in gastric signet ring cell carcinoma
Presenter: Hyunho Kim
Session: Poster Display session 2
Resources:
Abstract
1970 - Identification of a spectrum of germline mutations for hereditary diffuse gastric cancer in the Russian population by next-generation sequencing.
Presenter: IRINA EFIMOVA
Session: Poster Display session 2
Resources:
Abstract
4989 - The molecular profiling and prognostic value of Chinese gastric signet ring cell carcinoma patients
Presenter: Jia Wei
Session: Poster Display session 2
Resources:
Abstract
7145 - A phase 2 basket study of MCLA-128, a bispecific antibody targeting the HER3 pathway, in NRG1 fusion-positive advanced solid tumors
Presenter: Alison Schram
Session: Poster Display session 2
Resources:
Abstract
1406 - Simultaneous Resection of Pancreatic Cancer and Liver Oligometastases After Induction Chemotherapy in Stage IV Patients:an Open-Label Prospective Randomized Multicenter phase 3 trial(CSPAC-1)
Presenter: Miaoyan Wei
Session: Poster Display session 2
Resources:
Abstract
1530 - Multicenter randomized phase II trial of 5-Fluorouracil/leucovorin (5-FU/LV) with or without liposomal irinotecan (nal-IRI) in metastatic biliary tract cancer (BTC) as second-line therapy after progression on gemcitabine plus cisplatin (GemCis): NIFTY trial
Presenter: Changhoon Yoo
Session: Poster Display session 2
Resources:
Abstract
1563 - A randomized phase II study of Maintenance therapy with multiepitope vaccine Tedopi (OSE2101) ± nivolumab or FOLFIRI after induction chemotherapy (CT) with FOLFIRINOX in patients (Pts) with advanced Pancreatic ductal adenocarcinoma (aPDAC) (TEDOPaM – PRODIGE 63 GERCOR study)
Presenter: Cindy Neuzillet
Session: Poster Display session 2
Resources:
Abstract
2780 - A phase 3, randomized, double-blind, placebo-controlled, international study of durvalumab in combination with gemcitabine plus cisplatin for patients with advanced biliary tract cancers: TOPAZ-1
Presenter: Do-Youn Oh
Session: Poster Display session 2
Resources:
Abstract