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Pathological comple...
Pathological complete response after neoadjuvant chemotherapy is an independent predictive factor irrespective of simplified breast cancer intrinsic subtypes: a landmark and two-step approach analyses from the EORTC 10994/BIG 1-00 phase III trial
- Article/chapterEnglish2014
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LIBRIS-ID:oai:lup.lub.lu.se:0375add3-30bb-4a65-a0f3-3af80d413f40
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https://lup.lub.lu.se/record/4549120URI
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https://doi.org/10.1093/annonc/mdu118DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:129123581URI
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Language:English
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Summary in:English
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Pathological complete response (pCR) following chemotherapy is strongly associated with both breast cancer subtype and long-term survival. Within a phase III neoadjuvant chemotherapy trial, we sought to determine whether the prognostic implications of pCR, TP53 status and treatment arm (taxane versus non-taxane) differed between intrinsic subtypes. Patients were randomized to receive either six cycles of anthracycline-based chemotherapy or three cycles of docetaxel then three cycles of eprirubicin/docetaxel (T-ET). pCR was defined as no evidence of residual invasive cancer (or very few scattered tumour cells) in primary tumour and lymph nodes. We used a simplified intrinsic subtypes classification, as suggested by the 2011 St Gallen consensus. Interactions between pCR, TP53 status, treatment arm and intrinsic subtype on event-free survival (EFS), distant metastasis-free survival (DMFS) and overall survival (OS) were studied using a landmark and a two-step approach multivariate analyses. Sufficient data for pCR analyses were available in 1212 (65%) of 1856 patients randomized. pCR occurred in 222 of 1212 (18%) patients: 37 of 496 (7.5%) luminal A, 22 of 147 (15%) luminal B/HER2 negative, 51 of 230 (22%) luminal B/HER2 positive, 43 of 118 (36%) HER2 positive/non-luminal, 69 of 221(31%) triple negative (TN). The prognostic effect of pCR on EFS did not differ between subtypes and was an independent predictor for better EFS [hazard ratio (HR) = 0.40, P < 0.001 in favour of pCR], DMFS (HR = 0.32, P < 0.001) and OS (HR = 0.32, P < 0.001). Chemotherapy arm was an independent predictor only for EFS (HR = 0.73, P = 0.004 in favour of T-ET). The interaction between TP53, intrinsic subtypes and survival outcomes only approached statistical significance for EFS (P = 0.1). pCR is an independent predictor of favourable clinical outcomes in all molecular subtypes in a two-step multivariate analysis.
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Litiere, S.
(author)
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Piccart, M.
(author)
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MacGrogan, G.
(author)
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Fumoleau, P.
(author)
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Brain, E.
(author)
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Petit, T.
(author)
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Rouanet, P.
(author)
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Jassem, J.Karolinska Institutet
(author)
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Moldovan, C.
(author)
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Bodmer, A.
(author)
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Zaman, K.
(author)
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Cufer, T.
(author)
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Campone, M.
(author)
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Luporsi, E.
(author)
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Malmström, PerLund University,Lunds universitet,Bröstcancer-genetik,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Breastcancer-genetics,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)onk-pma
(author)
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Werutsky, G.
(author)
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Bogaerts, J.
(author)
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Bergh, J.
(author)
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Cameron, D. A.
(author)
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Karolinska InstitutetBröstcancer-genetik
(creator_code:org_t)
Related titles
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In:Annals of Oncology: Elsevier BV25:6, s. 1128-11361569-80410923-7534
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Bonnefoi, H.
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Litiere, S.
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Piccart, M.
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MacGrogan, G.
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Fumoleau, P.
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Brain, E.
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show more...
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Petit, T.
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Rouanet, P.
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Jassem, J.
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Moldovan, C.
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Bodmer, A.
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Zaman, K.
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Cufer, T.
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Campone, M.
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Luporsi, E.
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Malmström, Per
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Werutsky, G.
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Bogaerts, J.
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Bergh, J.
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Cameron, D. A.
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Lund University
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Karolinska Institutet