Identifying breast cancer patients at risk of relapse despite pathological complete response after neoadjuvant therapy

被引:23
作者
Huober, Jens [1 ,2 ]
van Mackelenbergh, Marion [3 ]
Schneeweiss, Andreas [4 ]
Seither, Fenja [5 ]
Blohmer, Jens-Uwe [6 ,7 ]
Denkert, Carsten [8 ]
Tesch, Hans [9 ]
Hanusch, Claus [10 ]
Salat, Christoph [11 ]
Rhiem, Kerstin [12 ]
Solbach, Christine [13 ]
Fasching, Peter A. [14 ]
Jackisch, Christian [15 ]
Reinisch, Mattea [16 ]
Lederer, Bianca [5 ]
Mehta, Keyur [5 ]
Link, Theresa [17 ]
Nekljudova, Valentina [5 ]
Loibl, Sibylle [5 ]
Untch, Michael [18 ]
机构
[1] Univ Frauenklin Ulm, Brustzentrum, Ulm, Germany
[2] Kantonsspital St Gallen, Brustzentrum, Dept Interdisziplinare Med Dienste, St Gallen, Switzerland
[3] Univ Klinikum Schleswig Holstein, Brustzentrum, Campus Kiel,Arnold Heller Str 3, D-24105 Kiel, Germany
[4] Natl Ctr Tumorerkrankungen, Heidelberg, Germany
[5] German Breast Grp, Neu Isenburg, Germany
[6] Charite Univ Med Berlin, Gynakol, Berlin, Germany
[7] Charite Univ Med Berlin, Brustzentrum, Berlin, Germany
[8] Philipps Univ Marburg, Inst Pathol, Marburg, Germany
[9] Ctr Hamatol & Onkol Bethanien Frankfurt, Frankfurt, Germany
[10] Klinikum Roten Kreuz Munchen, Munich, Germany
[11] Hamatol Onkol Schwerpunktpraxis Salat Stotzer, Munich, Germany
[12] Uniklin Koln, Zentrum Familiarer Brust & Eierstockkrebs, Cologne, Germany
[13] Univ Klinikum Frankfurt, Frankfurt, Germany
[14] Univ Klinikum Erlangen, Erlangen, Germany
[15] Sana Klinikum Offenbach, Offenbach, Germany
[16] Evang Kliniken Essen Mitte, Essen, Germany
[17] Tech Univ Dresden, Dept Gynecol & Obstet, Dresden, Germany
[18] HELIOS Klinikum Berlin Buch, Berlin, Germany
关键词
TAXANE-BASED CHEMOTHERAPY; STAGING SYSTEM; CAPECITABINE; BEVACIZUMAB; SURVIVAL; GEPARQUINTO; OUTCOMES; TRASTUZUMAB; CARBOPLATIN; EVEROLIMUS;
D O I
10.1038/s41523-023-00525-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
This retrospective pooled analysis aims to identify factors predicting relapse despite a pathologic complete response (pCR) in patients with breast cancer (BC). 2066 patients with a pCR from five neoadjuvant GBG/AGO-B trials fulfill the inclusion criteria of this analysis. Primary endpoint is disease-free survival (DFS); secondary endpoints is distant DFS (DDFS) and overall survival (OS). After a median follow-up of 57.6 months, DFS is significantly worse for patients with positive lymph nodes (cN+ vs cN0 hazard ratio [HR] 1.94, 95%CI 1.48-2.54; p < 0.001). In patients with triple-negative tumors, lobular histology (lobular vs other HR 3.55, 95%CI 1.53-8.23; p = 0.003), and clinical nodal involvement (cN+ vs cN0 HR 2.45, 95%CI 1.59-3.79; p < 0.001) predict a higher risk of DFS events. Patients with HER2-positive cT3/4 tumors have a significantly higher risk of relapse (cT3/4 vs cT1 HR 2.07, 95%CI 1.06-4.03; p = 0.033). Initial tumor load and histological type predict relapse in patients with a pCR.
引用
收藏
页数:12
相关论文
共 39 条
[21]   Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy [J].
Masuda, N. ;
Lee, S. -J. ;
Ohtani, S. ;
Im, Y. -H. ;
Lee, E. -S. ;
Yokota, I. ;
Kuroi, K. ;
Im, S. -A. ;
Park, B. -W. ;
Kim, S. -B. ;
Yanagita, Y. ;
Ohno, S. ;
Takao, S. ;
Aogi, K. ;
Iwata, H. ;
Jeong, J. ;
Kim, A. ;
Park, K. -H. ;
Sasano, H. ;
Ohashi, Y. ;
Toi, M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2017, 376 (22) :2147-2159
[22]   Validation of a Novel Staging System for Disease-Specific Survival in Patients With Breast Cancer Treated With Neoadjuvant Chemotherapy [J].
Mittendorf, Elizabeth A. ;
Jeruss, Jacqueline S. ;
Tucker, Susan L. ;
Kolli, Aparna ;
Newman, Lisa A. ;
Gonzalez-Angulo, Ana M. ;
Buchholz, Thomas A. ;
Sahin, Aysegul A. ;
Cormier, Janice N. ;
Buzdar, Aman U. ;
Hortobagyi, Gabriel N. ;
Hunt, Kelly K. .
JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (15) :1956-1962
[23]   Predictors of pathological complete response to neoadjuvant chemotherapy in stage II and III breast cancer: The impact of chemotherapeutic regimen [J].
Nwaogu, Iheoma Y. ;
Fayanju, Oluwadamilola M. ;
Jeffe, Donna B. ;
Margenthaler, Julie A. .
MOLECULAR AND CLINICAL ONCOLOGY, 2015, 3 (05) :1117-1122
[24]   20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years [J].
Pan, Hongchao ;
Gray, Richard ;
Braybrooke, Jeremy ;
Davies, Christina ;
Taylor, Carolyn ;
McGale, Paul ;
Peto, Richard ;
Pritchard, Kathleen I. ;
Bergh, Jonas ;
Dowsett, Mitch ;
Hayes, Daniel F. .
NEW ENGLAND JOURNAL OF MEDICINE, 2017, 377 (19) :1836-1846
[25]   Clinical implications of the intrinsic molecular subtypes of breast cancer [J].
Prat, Aleix ;
Pineda, Estela ;
Adamo, Barbara ;
Galvan, Patricia ;
Fernandez, Aranzazu ;
Gaba, Lydia ;
Diez, Marc ;
Viladot, Margarita ;
Arance, Ana ;
Munoz, Montserrat .
BREAST, 2015, 24 :S26-S35
[26]   Prognostic Impact of Circulating Tumor Cells for Breast Cancer Patients Treated in the Neoadjuvant "Geparquattro" Trial [J].
Riethdorf, Sabine ;
Mueller, Volkmar ;
Loibl, Sibylle ;
Nekljudova, Valentina ;
Weber, Karsten ;
Huober, Jens ;
Fehm, Tanja ;
Schrader, Iris ;
Hilfrich, Joern ;
Holms, Frank ;
Tesch, Hans ;
Schem, Christian ;
von Minckwitz, Gunter ;
Untch, Michael ;
Pantel, Klaus .
CLINICAL CANCER RESEARCH, 2017, 23 (18) :5384-5393
[27]   Relapsed Classic E-Cadherin (CDH1)-Mutated Invasive Lobular Breast Cancer Shows a High Frequency of HER2 (ERBB2) Gene Mutations [J].
Ross, Jeffrey S. ;
Wang, Kai ;
Sheehan, Christine E. ;
Boguniewicz, Ann B. ;
Otto, Geoff ;
Downing, Sean R. ;
Sun, James ;
He, Jie ;
Curran, John A. ;
Ali, Siraj ;
Yelensky, Roman ;
Lipson, Doron ;
Palmer, Gary ;
Miller, Vincent A. ;
Stephens, Philip J. .
CLINICAL CANCER RESEARCH, 2013, 19 (10) :2668-2676
[28]   NAB-Paclitaxel Improves Disease-Free Survival in Early Breast Cancer: GBG 69-GeparSepto [J].
Untch, Michael ;
Jackisch, Christian ;
Schneeweiss, Andreas ;
Schmatloch, Sabine ;
Aktas, Bahriye ;
Denkert, Carsten ;
Schem, Christian ;
Wiebringhaus, Hermann ;
Kuemmel, Sherko ;
Warm, Mathias ;
Fasching, Peter A. ;
Just, Marianne ;
Hanusch, Claus ;
Hackmann, John ;
Blohmer, Jens-Uwe ;
Rhiem, Kerstin ;
Schmitt, Wolfgang D. ;
Furlanetto, Jenny ;
Gerber, Bernd ;
Huober, Jens ;
Nekljudova, Valentina ;
von Minckwitz, Gunter ;
Loibl, Sibylle .
JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (25) :2226-+
[29]   Lapatinib versus trastuzumab in combination with neoadjuvant anthracycline-taxane-based chemotherapy (GeparQuinto, GBG 44): a randomised phase 3 trial [J].
Untch, Michael ;
Loibl, Sibylle ;
Bischoff, Joachim ;
Eidtmann, Holger ;
Kaufmann, Manfred ;
Blohmer, Jens-Uwe ;
Hilfrich, Joern ;
Strumberg, Dirk ;
Fasching, Peter A. ;
Kreienberg, Rolf ;
Tesch, Hans ;
Hanusch, Claus ;
Gerber, Bernd ;
Rezai, Mahdi ;
Jackisch, Christian ;
Huober, Jens ;
Kuehn, Thorsten ;
Nekljudova, Valentina ;
von Minckwitz, Gunter .
LANCET ONCOLOGY, 2012, 13 (02) :135-144
[30]   Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer [J].
von Minckwitz, G. ;
Huang, C. -S. ;
Mano, M. S. ;
Loibl, S. ;
Mamounas, E. P. ;
Untch, M. ;
Wolmark, N. ;
Rastogi, P. ;
Schneeweiss, A. ;
Redondo, A. ;
Fischer, H. H. ;
Jacot, W. ;
Conlin, A. K. ;
Arce-Salinas, C. ;
Wapnir, I. L. ;
Jackisch, C. ;
DiGiovanna, M. P. ;
Fasching, P. A. ;
Crown, J. P. ;
Wuelfing, P. ;
Shao, Z. ;
Caremoli, E. Rota ;
Wu, H. ;
Lam, L. H. ;
Tesarowski, D. ;
Smitt, M. ;
Douthwaite, H. ;
Singel, S. M. ;
Geyer, C. E., Jr. .
NEW ENGLAND JOURNAL OF MEDICINE, 2019, 380 (07) :617-628