Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy
A residual cancer burden after neoadjuvant therapy (NAT) for breast cancer (BC) is associated with worse treatment outcomes compared to patients who achieved pathologic complete remission. This single-institutional retrospective study of 767 consecutive patients, including 468 patients with assessab...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/7/1740 |
| _version_ | 1827597446489833472 |
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| author | Milos Holanek Iveta Selingerova Pavel Fabian Oldrich Coufal Ondrej Zapletal Katarina Petrakova Tomas Kazda Roman Hrstka Alexandr Poprach Maria Zvarikova Ondrej Bilek Marek Svoboda |
| author_facet | Milos Holanek Iveta Selingerova Pavel Fabian Oldrich Coufal Ondrej Zapletal Katarina Petrakova Tomas Kazda Roman Hrstka Alexandr Poprach Maria Zvarikova Ondrej Bilek Marek Svoboda |
| author_sort | Milos Holanek |
| collection | DOAJ |
| description | A residual cancer burden after neoadjuvant therapy (NAT) for breast cancer (BC) is associated with worse treatment outcomes compared to patients who achieved pathologic complete remission. This single-institutional retrospective study of 767 consecutive patients, including 468 patients with assessable residual cancer burden (aRCB) after NAT, with a median follow-up of 36 months, evaluated the biomarkers assessed before NAT from a biopsy and after NAT from a surgical specimen, their dynamics, and effect on long-term outcomes in specific breast cancer subtypes. The leading focus was on proliferation index Ki-67, which was significantly altered by NAT in all BC subtypes (<i>p</i> < 0.001 for HER2 positive and luminal A/B HER2 negative and <i>p</i> = 0.001 for TNBC). Multivariable analysis showed pre-NAT and post-NAT Ki-67 as independent predictors of survival outcomes for luminal A/B HER2 negative subtype. For TNBC, post-NAT Ki-67 was significant alone, and, for HER2 positive, the only borderline association of pre-NAT Ki-67 was observed in relation to the overall survival. Steroid and HER2 receptors were re-assessed just in a portion of the patients with aRCB. The concordance of both assessments was 92.9% for ER status, 80.1% for PR, and 92.2% for HER2. In conclusion, these real-world data of a consecutive cohort confirmed the importance of biomarkers assessment in patients with aRCB, and the need to consider specific BC subtypes when interpreting their influence on prognosis. |
| first_indexed | 2024-03-09T03:31:29Z |
| format | Article |
| id | doaj.art-683bdd4ed2e2407987165083b0d972a6 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T03:31:29Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-683bdd4ed2e2407987165083b0d972a62023-12-03T14:55:24ZengMDPI AGDiagnostics2075-44182022-07-01127174010.3390/diagnostics12071740Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant TherapyMilos Holanek0Iveta Selingerova1Pavel Fabian2Oldrich Coufal3Ondrej Zapletal4Katarina Petrakova5Tomas Kazda6Roman Hrstka7Alexandr Poprach8Maria Zvarikova9Ondrej Bilek10Marek Svoboda11Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicResearch Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Oncological Pathology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Breast, Skin and Oncoplastic Surgery, Department of Surgical Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Breast, Skin and Oncoplastic Surgery, Department of Surgical Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Radiation Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicResearch Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec 7, 656 53 Brno, Czech RepublicA residual cancer burden after neoadjuvant therapy (NAT) for breast cancer (BC) is associated with worse treatment outcomes compared to patients who achieved pathologic complete remission. This single-institutional retrospective study of 767 consecutive patients, including 468 patients with assessable residual cancer burden (aRCB) after NAT, with a median follow-up of 36 months, evaluated the biomarkers assessed before NAT from a biopsy and after NAT from a surgical specimen, their dynamics, and effect on long-term outcomes in specific breast cancer subtypes. The leading focus was on proliferation index Ki-67, which was significantly altered by NAT in all BC subtypes (<i>p</i> < 0.001 for HER2 positive and luminal A/B HER2 negative and <i>p</i> = 0.001 for TNBC). Multivariable analysis showed pre-NAT and post-NAT Ki-67 as independent predictors of survival outcomes for luminal A/B HER2 negative subtype. For TNBC, post-NAT Ki-67 was significant alone, and, for HER2 positive, the only borderline association of pre-NAT Ki-67 was observed in relation to the overall survival. Steroid and HER2 receptors were re-assessed just in a portion of the patients with aRCB. The concordance of both assessments was 92.9% for ER status, 80.1% for PR, and 92.2% for HER2. In conclusion, these real-world data of a consecutive cohort confirmed the importance of biomarkers assessment in patients with aRCB, and the need to consider specific BC subtypes when interpreting their influence on prognosis.https://www.mdpi.com/2075-4418/12/7/1740breast cancerneoadjuvant therapypathological complete responseresidual cancer burdenbiomarkersKI-67 |
| spellingShingle | Milos Holanek Iveta Selingerova Pavel Fabian Oldrich Coufal Ondrej Zapletal Katarina Petrakova Tomas Kazda Roman Hrstka Alexandr Poprach Maria Zvarikova Ondrej Bilek Marek Svoboda Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy Diagnostics breast cancer neoadjuvant therapy pathological complete response residual cancer burden biomarkers KI-67 |
| title | Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy |
| title_full | Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy |
| title_fullStr | Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy |
| title_full_unstemmed | Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy |
| title_short | Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy |
| title_sort | biomarker dynamics and long term treatment outcomes in breast cancer patients with residual cancer burden after neoadjuvant therapy |
| topic | breast cancer neoadjuvant therapy pathological complete response residual cancer burden biomarkers KI-67 |
| url | https://www.mdpi.com/2075-4418/12/7/1740 |
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