Abstract 5629
Background
Inflammatory breast cancers (IBC) particularly triple negative (TN) subtype have poor prognosis.
Methods
Between January 2010 and December 2016, all patients with TNIBC seen at breast cancer disease center, St Louis hospital, Paris, France, were treated with neoadjuvant dose dense Cyclophophamide (1.2g/m2 d1) - Epirubicin (75mg/m2 d1) q2w (SIM regimen) followed with 12 injections of paclitaxel (80 mg/m2) qw or 4 injections of docetaxel (100 mg/m2) q3w. All patients have histologically proven TN tumors and no evidence of metastases. Mastectomy and axillary clearance was performed after chemotherapy. pCR was defined as no residual invasive tumor in breast and lymph nodes. TIL and lymphovascular invasion were evaluated pre and post NAC by 2 independent anatomopathologists dedicated to breast cancer. Delta TIL was defined as the difference between post chemotherapy and pre chemotherapy TIL.
Results
Thirty TNIBC patients were treated, 28 underwent surgery and 2 progressed during chemotherapy. Median follow-up was 45 months (8 – 103). 9/30 patients (30%) achieved pCR. Median disease free survival was not reached. Median TIL infiltration at diagnosis was 11% (0-60) and dropped to 1% after chemotherapy (0 – 80). On univariate analysis, LVI after chemotherapy (HR = 2.1 [95% CI, 1.1–3.6], p = 0.02), TIL on mastectomy (HR = 1.8 [95% CI, 1.1–3.1], p = 0.03), delta TIL (HR = 2.2 [95% CI, 1.4–3.5], p = 0,001) were associated with DFS but no pCR (p = 0,051). On multivariate analysis, only delta TIL remainedstatistically significant (HR = 1.9 [95% CI, 1.1–3.4], p = 0.03).
Conclusions
We showed in this retrospective series of 30 TNIBC that dose dense dose intense chemotherapy is efficient in this population. Delta TIL is a strong prognostic factor associated with DFS. We show that a positive Delta TILis, among others, a strong and independent predictor of DFS: in TNIBC contrary to the results obtained in TN non inflammatory breast cancers, an increase in TIL after chemotherapy is associated with a decrease in DFS.The exact impact of LVI must be further investigated.
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
1571 - Thyroid Lobectomy versus Total Thyroidectomy among Early-Stage Papillary Thyroid Carcinoma Patient
Presenter: Sara Ahmed
Session: Poster Display session 2
Resources:
Abstract
5051 - Classification of thyroid nodule using DNA methylation profiling on tissue and circulating tumor DNA
Presenter: Shubin Hong
Session: Poster Display session 2
Resources:
Abstract
4155 - Durvalumab plus Tremelimumab for the Treatment of Patients (pts) with Refractory and Progressive Advanced Thyroid Carcinoma. A Phase II Multicohort Trial (DUTHY / GETNE T1812)
Presenter: Jorge Hernando Cubero
Session: Poster Display session 2
Resources:
Abstract