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  • Matikas, AlexiosKarolinska Institutet,Karolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)

Survival Outcomes, Digital TILs, and On-treatment PET/CT During Neoadjuvant Therapy for HER2-positive Breast Cancer : Results from the Randomized PREDIX HER2 Trial

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • American Association For Cancer Research (AACR),2023
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:uu-498440
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-498440URI
  • https://doi.org/10.1158/1078-0432.CCR-22-2829DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:151966223URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Purpose:PREDIX HER2 is a randomized Phase II trial that compared neoadjuvant docetaxel, trastuzumab, and pertuzumab (THP) with trastuzumab emtansine (T-DM1) for HER2-positive breast cancer. Rates of pathologic complete response (pCR) did not differ between the two groups. Here, we present the survival outcomes from PREDIX HER2 and investigate metabolic response and tumor-infiltrating lymphocytes (TIL) as prognostic factors.Patients and Methods:In total, 202 patients with HER2-positive breast cancer were enrolled and 197 patients received six cycles of either THP or T-DM1. Secondary endpoints included event-free survival (EFS), recurrence-free survival (RFS), and overall survival (OS). Assessment with PET/CT was performed at baseline, after two and six treatment cycles. TILs were assessed manually at baseline biopsies, while image-based evaluation of TILs [digital TILs (DTIL)] was performed in digitized full-face sections.Results:After a median follow-up of 5.21 years, there was no difference between the two treatment groups in terms of EFS [HR = 1.26; 95% confidence interval (CI), 0.54–2.91], RFS (HR = 0.69; 95% CI, 0.24–1.93), or OS (HR = 0.52; 95% CI, 0.09–2.82). Higher SUVmax at cycle 2 (C2) predicted lower pCR (ORadj = 0.65; 95% CI, 0.48–0.87; P = 0.005) and worse EFS (HRadj = 1.27; 95% CI, 1.12–1.41; P < 0.001). Baseline TILs and DTILs provided additional prognostic information to clinical parameters and C2 SUVmax.Conclusions:Long-term outcomes following neoadjuvant T-DM1 were similar to neoadjuvant THP. SUVmax after two cycles of neoadjuvant therapy for HER2-positive breast cancer may be an independent predictor of both short- and long-term outcomes. Combined assessment with TILs may facilitate early selection of poor responders for alternative treatment strategies.

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  • Johansson, HemmingKarolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)
  • Grybäck, PerKarolinska Institutet,Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden. (author)
  • Bjöhle, JudithKarolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden. (author)
  • Acs, BalazsKarolinska Institutet,Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Clin Pathol & Canc Diagnost, Stockholm, Sweden. (author)
  • Boyaci, CerenKarolinska Institutet,Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Clin Pathol & Canc Diagnost, Stockholm, Sweden. (author)
  • Lekberg, TobiasKarolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)
  • Fredholm, HannaKarolinska Institutet,Karolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden. (author)
  • Elinder, EllinorSoder Sjukhuset, Dept Oncol, Stockholm, Sweden. (author)
  • Margolin, SaraKarolinska Institutet,Soder Sjukhuset, Dept Oncol, Stockholm, Sweden.;Karolinska Inst, Sodersjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden. (author)
  • Isaksson-Friman, ErikaSt Goran Hosp, Breast Ctr, Stockholm, Sweden. (author)
  • Bosch, AnaSkane Univ Hosp, Dept Hematol Oncol & Radiat Phys, Lund, Sweden. (author)
  • Lindman, HenrikUppsala universitet,Institutionen för immunologi, genetik och patologi,Department of Oncology, Uppsala University Hospital, Uppsala, Sweden,Klinisk onkologi(Swepub:uu)henrlind (author)
  • Adra, JamilaSahlgrens Univ Hosp, Dept Oncol, S-17176 Gothenburg, Sweden. (author)
  • Andersson, AnneUmeå Univ Hosp, Dept Radiat Sci, Oncol Unit, Umeå, Sweden. (author)
  • Agartz, SusanneKarolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)
  • Hellström, MatsKarolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden. (author)
  • Zerdes, IoannisKarolinska Institutet,Karolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)
  • Hartman, JohanKarolinska Institutet,Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Clin Pathol & Canc Diagnost, Stockholm, Sweden. (author)
  • Bergh, JonasKarolinska Institutet,Karolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)
  • Hatschek, ThomasKarolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)
  • Foukakis, TheodorosKarolinska Institutet,Karolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (author)
  • Karolinska InstitutetKarolinska Univ Hosp, Breast Ctr, Theme Canc, Stockholm, Sweden.;Karolinska Comprehens Canc Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden. (creator_code:org_t)

Related titles

  • In:Clinical Cancer Research: American Association For Cancer Research (AACR)29:3, s. 532-5401078-04321557-3265

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