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

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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

Bonnefoi, H. (author)

Litiere, S. (author)

Piccart, M. (author)

MacGrogan, G. (author)

Fumoleau, P. (author)

Brain, E. (author)

Petit, T. (author)

Rouanet, P. (author)

Jassem, J. (author): Karolinska Institutet

Moldovan, C. (author)

Bodmer, A. (author)

Zaman, K. (author)

Cufer, T. (author)

Campone, M. (author)

Luporsi, E. (author)

Malmström, Per (author): Lund 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

Werutsky, G. (author)

Bogaerts, J. (author)

Bergh, J. (author)

Cameron, D. A. (author)

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(creator_code:org_t)

Elsevier BV, 2014
2014
English.
In: Annals of Oncology. - : Elsevier BV. - 1569-8041 .- 0923-7534. ; 25:6, s. 1128-1136

Related links:: http://dx.doi.org/10... (free); show more...; https://doi.org/10.1...; https://lup.lub.lu.s...; https://doi.org/10.1...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

breast cancer
neoadjuvant chemotherapy
TP53
landmark analysis
pathological complete response

Publication and Content Type

art (subject category)
ref (subject category)

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By the author/editor: Bonnefoi, H.; Litiere, S.; Piccart, M.; MacGrogan, G.; Fumoleau, P.; Brain, E.; show more...; Petit, T.; Rouanet, P.; Jassem, J.; Moldovan, C.; Bodmer, A.; Zaman, K.; Cufer, T.; Campone, M.; Luporsi, E.; Malmström, Per; Werutsky, G.; Bogaerts, J.; Bergh, J.; Cameron, D. A.; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

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By the university: Lund University; Karolinska Institutet

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