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Prognostic value of receptor conversion after neoadjuvant chemotherapy in breast cancer patients: a prospective observational study.

Jin X, Jiang YZ, Chen S, Yu KD, Shao ZM, Di GH - Oncotarget (2015)

Bottom Line: The loss of HR positivity was an independent prognostic factor for worse disease-free survival (DFS) and worse overall survival (OS) in multivariate survival analysis.Furthermore, the switch to the TN phenotype after NCT was another independent prognostic factor for worse survival for both DFS and OS.The loss of HR positivity and the switch to the TN phenotype after NCT were associated with a worse patient outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.

ABSTRACT
The hormone receptor (HR) status and human epidermal growth hormone receptor 2 (HER2) status of patients with breast cancer may change following neoadjuvant chemotherapy (NCT). This prospective observational study aimed to evaluate the prognostic impact of receptor conversion in breast cancer patients treated with NCT.Of the 423 consecutive patients who had residual disease in the breast after NCT, 55 (13.0%) changed from HR (+) to HR (-), 23 (5.4%) changed from HR (-) to HR (+), 27 (6.4%) changed from HER2 (+) to HER2 (-), and 13 (3.1%) changed from HER2 (-) to HER2 (+). A total of 54 (12.8%) changed to the triple-negative (TN) tumor phenotype. The loss of HR positivity was an independent prognostic factor for worse disease-free survival (DFS) and worse overall survival (OS) in multivariate survival analysis. Furthermore, the switch to the TN phenotype after NCT was another independent prognostic factor for worse survival for both DFS and OS. In conclusion, patients with breast cancer may experience changes in HR status, HER2 status and tumor phenotype after NCT. The loss of HR positivity and the switch to the TN phenotype after NCT were associated with a worse patient outcome.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier estimates of DFS and OS by tumor phenotype conversion(a) DFS (log-rank test: P < 0.001), (b) OS (log-rank test: P = 0.001). Kaplan–Meier estimates of DFS and OS for the groups with concordant triple-negative (TN) group, concordant non-TN (nTN) group, discordant TN group and discordant nTN group: (c) DFS (log-rank test: P < 0.001), (d) OS (log-rank test: P = 0.003).
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Figure 3: Kaplan–Meier estimates of DFS and OS by tumor phenotype conversion(a) DFS (log-rank test: P < 0.001), (b) OS (log-rank test: P = 0.001). Kaplan–Meier estimates of DFS and OS for the groups with concordant triple-negative (TN) group, concordant non-TN (nTN) group, discordant TN group and discordant nTN group: (c) DFS (log-rank test: P < 0.001), (d) OS (log-rank test: P = 0.003).

Mentions: Patients showing a conversion of the tumor phenotype were divided into four groups: concordant non-TN (nTN): the tumor phenotype was unchanged and not TN; concordant TN: the tumor phenotype was unchanged and TN; discordant nTN: the tumor phenotype was changed and the residual tumor was not TN; discordant TN: the tumor phenotype was changed and the residual tumor was TN. We performed Kaplan-Meier analyses of the tumor phenotype conversion (Figure 3). Patients who maintained the same tumor phenotype with no changes had significantly better outcomes compared with discordant cases (P < 0.001 for DFS and P = 0.001 for OS) (Figure 3a and 3b).


Prognostic value of receptor conversion after neoadjuvant chemotherapy in breast cancer patients: a prospective observational study.

Jin X, Jiang YZ, Chen S, Yu KD, Shao ZM, Di GH - Oncotarget (2015)

Kaplan–Meier estimates of DFS and OS by tumor phenotype conversion(a) DFS (log-rank test: P < 0.001), (b) OS (log-rank test: P = 0.001). Kaplan–Meier estimates of DFS and OS for the groups with concordant triple-negative (TN) group, concordant non-TN (nTN) group, discordant TN group and discordant nTN group: (c) DFS (log-rank test: P < 0.001), (d) OS (log-rank test: P = 0.003).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496242&req=5

Figure 3: Kaplan–Meier estimates of DFS and OS by tumor phenotype conversion(a) DFS (log-rank test: P < 0.001), (b) OS (log-rank test: P = 0.001). Kaplan–Meier estimates of DFS and OS for the groups with concordant triple-negative (TN) group, concordant non-TN (nTN) group, discordant TN group and discordant nTN group: (c) DFS (log-rank test: P < 0.001), (d) OS (log-rank test: P = 0.003).
Mentions: Patients showing a conversion of the tumor phenotype were divided into four groups: concordant non-TN (nTN): the tumor phenotype was unchanged and not TN; concordant TN: the tumor phenotype was unchanged and TN; discordant nTN: the tumor phenotype was changed and the residual tumor was not TN; discordant TN: the tumor phenotype was changed and the residual tumor was TN. We performed Kaplan-Meier analyses of the tumor phenotype conversion (Figure 3). Patients who maintained the same tumor phenotype with no changes had significantly better outcomes compared with discordant cases (P < 0.001 for DFS and P = 0.001 for OS) (Figure 3a and 3b).

Bottom Line: The loss of HR positivity was an independent prognostic factor for worse disease-free survival (DFS) and worse overall survival (OS) in multivariate survival analysis.Furthermore, the switch to the TN phenotype after NCT was another independent prognostic factor for worse survival for both DFS and OS.The loss of HR positivity and the switch to the TN phenotype after NCT were associated with a worse patient outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.

ABSTRACT
The hormone receptor (HR) status and human epidermal growth hormone receptor 2 (HER2) status of patients with breast cancer may change following neoadjuvant chemotherapy (NCT). This prospective observational study aimed to evaluate the prognostic impact of receptor conversion in breast cancer patients treated with NCT.Of the 423 consecutive patients who had residual disease in the breast after NCT, 55 (13.0%) changed from HR (+) to HR (-), 23 (5.4%) changed from HR (-) to HR (+), 27 (6.4%) changed from HER2 (+) to HER2 (-), and 13 (3.1%) changed from HER2 (-) to HER2 (+). A total of 54 (12.8%) changed to the triple-negative (TN) tumor phenotype. The loss of HR positivity was an independent prognostic factor for worse disease-free survival (DFS) and worse overall survival (OS) in multivariate survival analysis. Furthermore, the switch to the TN phenotype after NCT was another independent prognostic factor for worse survival for both DFS and OS. In conclusion, patients with breast cancer may experience changes in HR status, HER2 status and tumor phenotype after NCT. The loss of HR positivity and the switch to the TN phenotype after NCT were associated with a worse patient outcome.

No MeSH data available.


Related in: MedlinePlus