The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study
Purpose: Neoadjuvant endocrine treatment (NET) has become a useful tool for the downstaging of luminal-like breast cancers in postmenopausal patients. It enables us to increase breast- conserving surgery (BCS) rates, provides an opportunity for us to assess in vivo NET effectiveness, and allows us t...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/4/179 |
| _version_ | 1827621137182359552 |
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| author | Covadonga Martí Laura Yébenes José María Oliver Elisa Moreno Laura Frías Alberto Berjón Adolfo Loayza Marcos Meléndez María José Roca Vicenta Córdoba David Hardisson María Ángeles Rodríguez José Ignacio Sánchez-Méndez |
| author_facet | Covadonga Martí Laura Yébenes José María Oliver Elisa Moreno Laura Frías Alberto Berjón Adolfo Loayza Marcos Meléndez María José Roca Vicenta Córdoba David Hardisson María Ángeles Rodríguez José Ignacio Sánchez-Méndez |
| author_sort | Covadonga Martí |
| collection | DOAJ |
| description | Purpose: Neoadjuvant endocrine treatment (NET) has become a useful tool for the downstaging of luminal-like breast cancers in postmenopausal patients. It enables us to increase breast- conserving surgery (BCS) rates, provides an opportunity for us to assess in vivo NET effectiveness, and allows us to study any biological changes that may act as valid biomarkers. The purpose of this study was to evaluate the safety and effectiveness of NET, and to assess the role of Ki67 proliferation rate changes as an indicator of endocrine responsiveness. Methods: From 2016 to 2020, a single-institution cohort of patients, treated with NET and further surgery, was evaluated. In patients with Ki67 ≥ 10%, a second core biopsy was performed after four weeks. Information regarding histopathological and clinical changes was gathered. Results: A total of 115 estrogen receptor-positive (ER+)/HER2-negative patients were included. The median treatment duration was 5.0 months (IQR: 2.0–6.0). The median maximum size in the surgical sample was 40% smaller than the pretreatment size measured by ultrasound (<i>p</i> < 0.0001). The median pretreatment Ki67 expression was 20.0% (IQR: 12.0–30.0), and was reduced to 5.0% (IQR: 1.8–10.0) after four weeks, and to 2.0% (IQR: 1.0–8.0) in the surgical sample (<i>p</i> < 0.0001). BCS was performed on 98 patients (85.2%). No pathological complete responses were recorded. A larger Ki67 fold change after four weeks was significantly related to a PEPI score of zero (<i>p</i> < 0.002). No differences were observed between luminal A- and B-like tumors, with regard to fold change and PEPI score. Conclusions: In our cohort, NET was proven to be effective for tumor size and Ki67 downstaging. This resulted in a higher rate of conservative surgery, aided in therapeutic decision making, provided prognostic information, and constituted a safe and well-tolerated approach. |
| first_indexed | 2024-03-09T10:59:23Z |
| format | Article |
| id | doaj.art-aa53f7df5d3a40bcb209222e0e2b3a81 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T10:59:23Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-aa53f7df5d3a40bcb209222e0e2b3a812023-12-01T01:26:24ZengMDPI AGCurrent Oncology1198-00521718-77292022-03-012942199221010.3390/curroncol29040179The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort StudyCovadonga Martí0Laura Yébenes1José María Oliver2Elisa Moreno3Laura Frías4Alberto Berjón5Adolfo Loayza6Marcos Meléndez7María José Roca8Vicenta Córdoba9David Hardisson10María Ángeles Rodríguez11José Ignacio Sánchez-Méndez12Breast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainBreast Cancer Unit, Hospital Universitario La Paz, 28046 Madrid, SpainPurpose: Neoadjuvant endocrine treatment (NET) has become a useful tool for the downstaging of luminal-like breast cancers in postmenopausal patients. It enables us to increase breast- conserving surgery (BCS) rates, provides an opportunity for us to assess in vivo NET effectiveness, and allows us to study any biological changes that may act as valid biomarkers. The purpose of this study was to evaluate the safety and effectiveness of NET, and to assess the role of Ki67 proliferation rate changes as an indicator of endocrine responsiveness. Methods: From 2016 to 2020, a single-institution cohort of patients, treated with NET and further surgery, was evaluated. In patients with Ki67 ≥ 10%, a second core biopsy was performed after four weeks. Information regarding histopathological and clinical changes was gathered. Results: A total of 115 estrogen receptor-positive (ER+)/HER2-negative patients were included. The median treatment duration was 5.0 months (IQR: 2.0–6.0). The median maximum size in the surgical sample was 40% smaller than the pretreatment size measured by ultrasound (<i>p</i> < 0.0001). The median pretreatment Ki67 expression was 20.0% (IQR: 12.0–30.0), and was reduced to 5.0% (IQR: 1.8–10.0) after four weeks, and to 2.0% (IQR: 1.0–8.0) in the surgical sample (<i>p</i> < 0.0001). BCS was performed on 98 patients (85.2%). No pathological complete responses were recorded. A larger Ki67 fold change after four weeks was significantly related to a PEPI score of zero (<i>p</i> < 0.002). No differences were observed between luminal A- and B-like tumors, with regard to fold change and PEPI score. Conclusions: In our cohort, NET was proven to be effective for tumor size and Ki67 downstaging. This resulted in a higher rate of conservative surgery, aided in therapeutic decision making, provided prognostic information, and constituted a safe and well-tolerated approach.https://www.mdpi.com/1718-7729/29/4/179breast cancerendocrine therapyneoadjuvantresistance |
| spellingShingle | Covadonga Martí Laura Yébenes José María Oliver Elisa Moreno Laura Frías Alberto Berjón Adolfo Loayza Marcos Meléndez María José Roca Vicenta Córdoba David Hardisson María Ángeles Rodríguez José Ignacio Sánchez-Méndez The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study Current Oncology breast cancer endocrine therapy neoadjuvant resistance |
| title | The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study |
| title_full | The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study |
| title_fullStr | The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study |
| title_full_unstemmed | The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study |
| title_short | The Clinical Impact of Neoadjuvant Endocrine Treatment on Luminal-like Breast Cancers and Its Prognostic Significance: Results from a Single-Institution Prospective Cohort Study |
| title_sort | clinical impact of neoadjuvant endocrine treatment on luminal like breast cancers and its prognostic significance results from a single institution prospective cohort study |
| topic | breast cancer endocrine therapy neoadjuvant resistance |
| url | https://www.mdpi.com/1718-7729/29/4/179 |
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