Abstract 176P
Background
Neoadjuvant chemotherapy (NACT) has recently become standard of care. Most of the real-life published series are from developed countries and were published before the advent of modern regimens. Here we describe results of neoadjuvant therapy for breast cancer treated in a single Brazilian cancer center.
Methods
We retrospectively identified 1160 non metastatic breast cancer patients receiving NACT between 2007 a 2020. Patients and disease characteristics, rates of complete pathological response (pCR) and survival outcomes were recorded.
Results
The identified 1160 patients had median age of 46 years. 59.3% had clinic stage III, 84.6% ductal histopathology (ICD) and 43.1% were histological grade 3 (GH3). 46.8% were estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, 17.4% (ER+/HER2+), 8.7% (ER-/HER2+) and 26,9% (ER-/HER2-). 95% received anthracycline and taxane, 26% dense-dose doxorubicin/cyclophosphamide (ACdd). 34.7% received trastuzumab and pertuzumab (double anti-HER2 block). 52% (ER-/HER2-) patients received carboplatin. 72% of patients underwent total mastectomy. Overall pCR rate was 32% differed according to disease subtype, receptor status, grade, histology. The highest pCR rates were in HER2+ 52.8% and (ER-/HER2-) 47.6% only 10.8% ER+/HER2- pCR. An pCR was 61% for the group of patients who received double block vs 55.1% not (p = 0.049). pCR for ER-/HER2- is 52% for received carboplatin vs 34% who did not (p = 0.002). With a median follow up of 57 months, (5y RFS) was 73% and (5y OS) was 84.7% . There was no difference in RFS among the group who received neoadjuvant anthracyclines (p=0.23), carboplatin (p=0.39), ACdd (p=0.21), but receiving double anti-HER2 block led to better survival (p=0.02). Patients who received double HER-2 blockade and carboplatin were associated with a greater chance of pCR. The average specific cancer survival (SCE) of pCR was 116 months vs 27 months for patients with residual disease (p = 0.004).
Conclusions
In our analysis, recently added options improved outcomes. Many patients still have residual disease following NACT and therefore new strategies are needed.
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.