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ePoster Display

197P - Application of neo-bioscore staging to predict the benefit of pertuzumab in HER2 positive early breast cancer

Date

16 Sep 2021

Session

ePoster Display

Presenters

Laura Sánchez Escudero

Citation

Annals of Oncology (2021) 32 (suppl_5): S407-S446. 10.1016/annonc/annonc687

Authors

L. Sánchez Escudero1, D. Morales Pancorbo2, J. Bayo3, I. Aragon Manrique4

Author affiliations

  • 1 Oncology Department, Hospital Juan Ramon Jimenez, 21005 - Huelva/ES
  • 2 Medicine, Hospital Juan Ramon Jimenez, 21005 - Huelva/ES
  • 3 Oncología Médica, Hospital Juan Ramón Jiménez, 21005 - HUELVA/ES
  • 4 Oncología Médica, Hospital Juan Ramon Jimenez, 21005 - Huelva/ES
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Abstract 197P

Background

The Neo-bioscore (NB) staging system predicts the survival of patients (Pt) with early breast cancer (EBC) according to the initial clinical stage (CS), grade, estrogen receptor (ER), Her 2, and final pathological stage (PS) after neoadjuvant treatment (NeoT). Its application may be useful to assess the benefit of Pertuzumab (Pz) in the NeoT of Her 2 positive (HEBC). An NB greater than 2 is known to predict a worse prognosis.

Methods

We analyzed the role of double blockade to reduce the NB staging system by assessing the difference between the pretreatment score (CS + Grade + ER) and the final score after NeoT with chemo-trastuzumab (Tz) versus the chemo-Tz-Pz combination. We also analyzed the differences in the pathological complete response (pCR) and according to stages II and III.

Results

115 Pt completed preplanned NeoT with antiHer2 and Chemotherapy (89% Carboplatin-Docetaxel) in our site from 2015 to 2020. 79 Pt treated with Chemo-Tz and 36 Pt given Chemo-Tz-Pz, median age 53 and 50 years. The median follow-up was higher in Tz-Pz (51 vs 27 months). The pCR was higher in the Tz-Pz group (61% vs 32.9%, OR 3.2 p=0.008), benefiting both stage II and III. The increase in NB was lower in the group that received Pz-Tz vs Tz (18% difference, OR 0.44 p = 0.096). Post-treatment analysis predicted a worse prognosis in patients without Pz, with a difference in the increase in NB of 21% (95% CI -0.05 0 to 42.5%) and 17% (95% CI - 12 to 46%) in stages II and III compared to those treated with double blockade. Table: 197P

N=115 pt Tz (69%) Tz+ Pz (31%) OR (95% CI)
pCR 32.9% 61.1% 3.2 (1.4-7.2) p=0.008
Pretreatment score>2 7.6% 25% 4.05 (1.3-12.4) p=0.016
Nb >2 24.1% 38.9% 2.01 (0.8-4.6) p=0.122
Increase Nb vs. Pretreatment Score 43% 25% 0.44 (0.18-10.5) p=0.096
Stage II (64 pt) 44 20
pCR 40.9% 65% 2.6 (0.8-8) p=0.106
Pretreatment Score>2 2.3% 5% 2.26 (0.13-38) p=0.531
Nb >2 6.8% 15% 2.41 (0.44-13.1) p=0.366
Increase Nb vs. Pretreatment Score 36.4% 15% 0.30 (0.78-1.21) p=0.139
Stage III (49 pt) 33 16
pCR 24.2% 56.3% 4.01 (1.13-14.28) p=0.053
Pretreatment Score >2 15.2% 50% 5.6 (1.42-21.9) p=0.01
Nb >2 48.5% 68.8% 2.33 (0.66-8.22) p=0.229
Increase Nb vs. Pretreatment Score 54.5% 37.5% 0.5 (0. 14-1.69) p=0.364

Conclusions

In our review, when applying NB staging system, the combined therapy with Pz and Tz not only increases the pCR but, taking other factors (ER, Grade, pre and post-treatment stage), it also induces a better prognosis in both stages II and III of HEBC. An increase in sample size and follow-up in the Pz arm is likely to show the expected benefit according to this prognostic scale.

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.

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