Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative study
Purpose: : Pathological complete response(pCR) during neoadjuvant chemotherapy(NAC) has been proposed as a predictor for better prognosis in breast cancer. However, few studies compare the outcomes of patients receiving NAC and adjuvant chemotherapy(AC). Methods: : We retrospectively matched the pat...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Cancer Treatment and Research Communications |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468294223000400 |
| _version_ | 1827856123288354816 |
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| author | Jida Chen Lidan Jin Lini Chen Zilong Bian Zhaoqing Li Shuyin Cao Jichun Zhou Ling Xu Wenhe Zhao Qinchuan Wang |
| author_facet | Jida Chen Lidan Jin Lini Chen Zilong Bian Zhaoqing Li Shuyin Cao Jichun Zhou Ling Xu Wenhe Zhao Qinchuan Wang |
| author_sort | Jida Chen |
| collection | DOAJ |
| description | Purpose: : Pathological complete response(pCR) during neoadjuvant chemotherapy(NAC) has been proposed as a predictor for better prognosis in breast cancer. However, few studies compare the outcomes of patients receiving NAC and adjuvant chemotherapy(AC). Methods: : We retrospectively matched the patients who received NAC(N = 462) and AC(N = 462) by age, time of diagnosis, and primary clinical stage using the propensity score match in breast cancer patients treated in Sir Run Run Shaw Hospital with the median follow up of 67 months. Death from breast cancer and recurrence were used as endpoints. A multivariable Cox models were used to estimate the hazard ratios for breast-cancer specific survival (BCSS) and DFS. A multivariable logistic regression model was simulated to predict pCR. Results: : In patients who received NAC, 18.0%(83/462) patients achieved pCR, while the rest of the patients did not. pCR subgroup demonstrated significant better BCSS and DFS than patients receiving AC(BCSS: HR = 0.39, 95% CI:0.12–0.93, P = 0.03; DFS: HR = 0.16, 95%CI 0.009–0.73, P = 0.013) and non-pCR patients(BCSS: HR = 0.32, 95%CI 0.10–0.77, P = 0.008; DFS: HR = 0.12, 95%CI 0.007–0.55, P = 0.002). Patients who received AC demonstrated insignificant survival compared to non-pCR patients(BCSS: HR= 0.82, 95%CI 0.62–1.10, P = 0.19; DFS: HR = 0.75, 95%CI 0.53–1.07, P = 0.12). Patients with AC had significant better DFS than non-pCR patients(HR = 0.33, 95% CI 0.10–0.94, P = 0.04) in luminal B Her2+ patients. More NAC cycles(>2), TNBC, lower cT stage, and mixed histology indicate higher possibility of pCR(AUC = 0.89). Conclusion: : pCR patients with NAC indicated better prognosis than patients receiving AC or non-pCR patients from NAC. The timing of chemotherapy may need carefully pondering in luminal B Her2+ patients. |
| first_indexed | 2024-03-12T12:21:12Z |
| format | Article |
| id | doaj.art-f5f95b13134241e085072988b3716a4e |
| institution | Directory Open Access Journal |
| issn | 2468-2942 |
| language | English |
| last_indexed | 2024-03-12T12:21:12Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Cancer Treatment and Research Communications |
| spelling | doaj.art-f5f95b13134241e085072988b3716a4e2023-08-30T05:54:21ZengElsevierCancer Treatment and Research Communications2468-29422023-01-0136100719Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative studyJida Chen0Lidan Jin1Lini Chen2Zilong Bian3Zhaoqing Li4Shuyin Cao5Jichun Zhou6Ling Xu7Wenhe Zhao8Qinchuan Wang9Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, ChinaDepartment of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, ChinaDepartment of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, ChinaDepartment of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, ChinaDepartment of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, ChinaDepartment of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, ChinaDepartment of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, ChinaDepartment of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, ChinaDepartment of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, ChinaDepartment of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China; Corresponding author at: Department of Surgical Oncology, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.Purpose: : Pathological complete response(pCR) during neoadjuvant chemotherapy(NAC) has been proposed as a predictor for better prognosis in breast cancer. However, few studies compare the outcomes of patients receiving NAC and adjuvant chemotherapy(AC). Methods: : We retrospectively matched the patients who received NAC(N = 462) and AC(N = 462) by age, time of diagnosis, and primary clinical stage using the propensity score match in breast cancer patients treated in Sir Run Run Shaw Hospital with the median follow up of 67 months. Death from breast cancer and recurrence were used as endpoints. A multivariable Cox models were used to estimate the hazard ratios for breast-cancer specific survival (BCSS) and DFS. A multivariable logistic regression model was simulated to predict pCR. Results: : In patients who received NAC, 18.0%(83/462) patients achieved pCR, while the rest of the patients did not. pCR subgroup demonstrated significant better BCSS and DFS than patients receiving AC(BCSS: HR = 0.39, 95% CI:0.12–0.93, P = 0.03; DFS: HR = 0.16, 95%CI 0.009–0.73, P = 0.013) and non-pCR patients(BCSS: HR = 0.32, 95%CI 0.10–0.77, P = 0.008; DFS: HR = 0.12, 95%CI 0.007–0.55, P = 0.002). Patients who received AC demonstrated insignificant survival compared to non-pCR patients(BCSS: HR= 0.82, 95%CI 0.62–1.10, P = 0.19; DFS: HR = 0.75, 95%CI 0.53–1.07, P = 0.12). Patients with AC had significant better DFS than non-pCR patients(HR = 0.33, 95% CI 0.10–0.94, P = 0.04) in luminal B Her2+ patients. More NAC cycles(>2), TNBC, lower cT stage, and mixed histology indicate higher possibility of pCR(AUC = 0.89). Conclusion: : pCR patients with NAC indicated better prognosis than patients receiving AC or non-pCR patients from NAC. The timing of chemotherapy may need carefully pondering in luminal B Her2+ patients.http://www.sciencedirect.com/science/article/pii/S2468294223000400Breast cancerAdjuvant chemotherapyNeoadjuvant chemotherapypCROutcome |
| spellingShingle | Jida Chen Lidan Jin Lini Chen Zilong Bian Zhaoqing Li Shuyin Cao Jichun Zhou Ling Xu Wenhe Zhao Qinchuan Wang Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative study Cancer Treatment and Research Communications Breast cancer Adjuvant chemotherapy Neoadjuvant chemotherapy pCR Outcome |
| title | Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative study |
| title_full | Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative study |
| title_fullStr | Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative study |
| title_full_unstemmed | Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative study |
| title_short | Patients achieved pCR during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer: A comparative study |
| title_sort | patients achieved pcr during neoadjuvant chemotherapy had better outcome than adjuvant chemotherapy setting in breast cancer a comparative study |
| topic | Breast cancer Adjuvant chemotherapy Neoadjuvant chemotherapy pCR Outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2468294223000400 |
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