Identifying breast cancer patients at risk of relapse despite pathological complete response after neoadjuvant therapy

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Jens Huober - , Ulm University (Author)
  • Marion van Mackelenbergh - , Kiel University (Author)
  • Andreas Schneeweiss - , National Center for Tumor Diseases (NCT) Heidelberg (Author)
  • Fenja Seither - , German Breast Group (Author)
  • Jens Uwe Blohmer - , Charité – Universitätsmedizin Berlin (Author)
  • Carsten Denkert - , University of Marburg (Author)
  • Hans Tesch - , Agaplesion Markus Hospital Frankfurt (Author)
  • Claus Hanusch - , Klinikum zum Roten Kreuz (Author)
  • Christoph Salat - , Hämatologisch-Onkologische Schwerpunktpraxis Salat/Stötzer (Author)
  • Kerstin Rhiem - , University of Cologne (Author)
  • Christine Solbach - , University Hospital Frankfurt (Author)
  • Peter A. Fasching - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Christian Jackisch - , Sana Clinics Group (Author)
  • Mattea Reinisch - , University of Duisburg-Essen (Author)
  • Bianca Lederer - , German Breast Group (Author)
  • Keyur Mehta - , German Breast Group (Author)
  • Theresa Link - , Department of Gynecology and Obstetrics (Author)
  • Valentina Nekljudova - , German Breast Group (Author)
  • Sibylle Loibl - , German Breast Group (Author)
  • Michael Untch - , Fresenius AG (Author)

Abstract

This retrospective pooled analysis aims to identify factors predicting relapse despite a pathologic complete response (pCR) in patients with breast cancer (BC). 2066 patients with a pCR from five neoadjuvant GBG/AGO-B trials fulfill the inclusion criteria of this analysis. Primary endpoint is disease-free survival (DFS); secondary endpoints is distant DFS (DDFS) and overall survival (OS). After a median follow-up of 57.6 months, DFS is significantly worse for patients with positive lymph nodes (cN+ vs cN0 hazard ratio [HR] 1.94, 95%CI 1.48–2.54; p < 0.001). In patients with triple-negative tumors, lobular histology (lobular vs other HR 3.55, 95%CI 1.53–8.23; p = 0.003), and clinical nodal involvement (cN+ vs cN0 HR 2.45, 95%CI 1.59–3.79; p < 0.001) predict a higher risk of DFS events. Patients with HER2-positive cT3/4 tumors have a significantly higher risk of relapse (cT3/4 vs cT1 HR 2.07, 95%CI 1.06–4.03; p = 0.033). Initial tumor load and histological type predict relapse in patients with a pCR.

Details

Original languageEnglish
Article number23
Pages (from-to)1-12
Number of pages12
Journalnpj Breast Cancer
Volume9(2023)
Issue number1
Publication statusPublished - 4 Apr 2023
Peer-reviewedYes