Pathological complete response predictor of favorable breast cancer outcome

April 2, 2014
Pathological complete response predictor of favorable breast cancer outcome

Results of EORTC trial 10994 appearing in the Annals of Oncology show that pathological complete response after neoadjuvant chemotherapy is an independent predictive factor of favorable clinical outcomes in all molecular subtypes of breast cancer.

Professor Hervé Bonnefoi of the Institut Bergonié Comprehensive Cancer Centre in Bordeaux and coordinator of this study says, "An analysis such as the EORTC's was needed to consider heterogeneity. Until recently, a link between pathological complete response and excellent prognosis had only been shown for some specific subtypes of breast cancer, e.g. triple negative and HER2-positive breast cancers, albeit with conflicting results. We wanted to see if the prognostic implications of pathological complete response, TP53 status, and the treatment administered (taxane or non-taxane) differed among breast cancer subtypes. We performed a landmark and two-step approach multivariate analyses to address these questions."

Patients in the intergroup EORTC 10994/BIG 1-00 phase III trial were randomized to receive either six cycles of anthracycline-based chemotherapy (non-taxane) or three cycles of docetaxel followed by three cycles of eprirubicin/docetaxel (taxane). Researchers used a landmark approach and a two-step multivariate analysis to study the potential effects of three interactions: breast cancer subtype and pathological complete response; breast cancer subtype and TP53 status; breast cancer subtype and treatment arm (i.e., taxane or non-taxane).

A patient was determined to have pathological complete response when no evidence was found of residual invasive cancer (or very few scattered tumor cells only) in the primary tumor and lymph nodes. According to this definition, pathological complete response was observed in 18% of the patients in this trial for whom sufficient data was available (1212 of the 1856 patients randomized).

In the univariate analyses there is no heterogeneity between the Hazard Ratios for pathological complete response in our study across the different subtypes. The prognostic effect of pathological complete response on event-free survival did not differ between breast cancer subtypes in a two-step multivariate analysis and was an independent predictor for better event-free survival (Hazard ratio (HR) = 0.40, P < 0.001 in favor of pathological complete response), distant metastasis-free survival (HR = 0.32, P < 0.001), and overall survival (HR = 0.32, P < 0.001). The findings have been confirmed in the recent FDA meta-analysis.

The treatment administered, i.e., taxane or non-taxane, was an independent predictor only for event-free survival and favored treatment with taxane (HR = 0.73, P = 0.004 ). The interaction between breast cancer subtype and TP53 only approached statistical significance for event-free (P = 0.1).

Explore further: Clinical trial finds concurrent therapy not necessary to achieve high pathological in breast cancer

Related Stories

Clinical trial finds concurrent therapy not necessary to achieve high pathological in breast cancer

November 13, 2013
Giving trastuzumab and anthracyclines at the same time is effective at treating HER-2-positive breast cancer, but there is concern that this combination can be associated with an increased risk of cardiac toxicity. New research ...

Researchers to present event-free and overall survival results from NeoALTTO trial

December 11, 2013
Results from the initial analysis of event-free and overall survival for patients enrolled in the randomized, phase III Neoadjuvant Lapatinib and/or Trastuzumab Treatment Optimization (NeoALTTO) trial are to be presented ...

Taxane-induced neuropathy not tied to breast cancer outcome

August 2, 2012
(HealthDay) -- For patients with operable breast cancer, peripheral neuropathy due to adjuvant taxane therapy does not correlate with improved outcomes, according to research published online July 30 in the Journal of Clinical ...

PIK3CA gene mutations make HER2- and hormone receptor-positive breast cancers treatment-resistant

December 12, 2013
Women with breast cancer characterized by high levels of the protein HER2 and hormone receptors gained much less benefit from presurgery treatment with chemotherapy and HER2-targeted therapies if their cancer had one or more ...

Study finds greater potential benefit in overall survival for eribulin compared with capecitabine

June 12, 2013
Subgroup analyses from a phase III clinical trial comparing a newer chemotherapy agent called eribulin mesylate, with capecitabine, a standard chemotherapy medication in women with previously treated metastatic breast cancer, ...

New presurgery combination therapy may improve outcomes for women with triple-negative breast cancer

December 13, 2013
The I-SPY 2 trial, an innovative, multidrug, phase II breast cancer trial, has yielded positive results with the first drug to complete testing in the trial. Adding the chemotherapy carboplatin and the molecularly targeted ...

Recommended for you

Researchers release first draft of a genome-wide cancer 'dependency map'

July 27, 2017
In one of the largest efforts to build a comprehensive catalog of genetic vulnerabilities in cancer, researchers from the Broad Institute of MIT and Harvard and Dana-Farber Cancer Institute have identified more than 760 genes ...

Cancer-death button gets jammed by gut bacterium

July 27, 2017
Researchers at Michigan Medicine and in China showed that a type of bacterium is associated with the recurrence of colorectal cancer and poor outcomes. They found that Fusobacterium nucleatum in the gut can stop chemotherapy ...

Long-sought mechanism of metastasis is discovered in pancreatic cancer

July 27, 2017
Cells, just like people, have memories. They retain molecular markers that at the beginning of their existence helped guide their development. Cells that become cancerous may be making use of these early memories to power ...

Blocking the back-door that cancer cells use to escape death by radiotherapy

July 27, 2017
A natural healing mechanism of the body may be reducing the efficiency of radiotherapy in breast cancer patients, according to a new study.

Manmade peptides reduce breast cancer's spread

July 27, 2017
Manmade peptides that directly disrupt the inner workings of a gene known to support cancer's spread significantly reduce metastasis in a mouse model of breast cancer, scientists say.

Glowing tumor technology helps surgeons remove hidden cancer cells

July 27, 2017
Surgeons were able to identify and remove a greater number of cancerous nodules from lung cancer patients when combining intraoperative molecular imaging (IMI) - through the use of a contrast agent that makes tumor cells ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.