Background: TNBC is an aggressive molecular subtype associated with increased risk of distant metastases and poor prognosis. In this study we report response to PST and clinical outcome of a cohort of patients with TNBC. Methods: We retrospectively evaluated 217 patients with nonmetastatic breast cancer receiving PST between March 1999 and July 2009. TNBC was defined as hormone receptors (HR) and human epidermal growth receptor-2 (HER-2) negative at immunohistochemistry. Treatment consisted of anthracycline regimens alone (FEC/EC; 88 patients) or followed by taxanes (129 patients). Nineteen out of 63 HER2-positive patients received trastuzumab in combination with taxanes. Primary endpoint was pCR, defined as absence of invasive cancer both in breast and axillary lymph nodes at surgery. Secondary endpoint was disease free-survival (DFS) evaluated by the Kaplan-Meier method. Results: Thirty-nine out of 217 patients (18%) were TNBC. Among 178 non-TNBC, 115 (53%) were HR positive/HER-2 negative, 31 (14%) were HR negative/HER-2 positive and 32 (15%) were HR positive/HER-2 positive. Patients with TNBC had a trend to a higher pCR rate compared with non-TNBC (15.4% vs. 12.4%, p=0.06). Tumor response according to the PST regimen is shown in the Table. A significantly higher pCR rate to anthracyclines followed by taxanes was observed in non-TNBC (18.2% vs. 2.9%, p<0.02), but not in TNBC (15% vs. 15.8%, p=n.s.). At a median follow-up of 40 months, patients with TNBC showed a shorter DFS compared to non-TNBC (p<0.01). Conclusions: In TNBC, the use of anthracyclines followed by taxanes is not superior to anthracyclines alone. TNBC patients were more likely to respond to PST, but had a worse DFS with respect to non-TNBC patients.
Effect of taxanes following anthracyclines on pathologic complete response (pCR) in patients with triple-negative breast cancer (TNBC) receiving primary systemic therapy (PST).
NATOLI, Clara;GRASSADONIA, Antonino;TINARI, Nicola;CIANCHETTI, Ettore;
2010-01-01
Abstract
Background: TNBC is an aggressive molecular subtype associated with increased risk of distant metastases and poor prognosis. In this study we report response to PST and clinical outcome of a cohort of patients with TNBC. Methods: We retrospectively evaluated 217 patients with nonmetastatic breast cancer receiving PST between March 1999 and July 2009. TNBC was defined as hormone receptors (HR) and human epidermal growth receptor-2 (HER-2) negative at immunohistochemistry. Treatment consisted of anthracycline regimens alone (FEC/EC; 88 patients) or followed by taxanes (129 patients). Nineteen out of 63 HER2-positive patients received trastuzumab in combination with taxanes. Primary endpoint was pCR, defined as absence of invasive cancer both in breast and axillary lymph nodes at surgery. Secondary endpoint was disease free-survival (DFS) evaluated by the Kaplan-Meier method. Results: Thirty-nine out of 217 patients (18%) were TNBC. Among 178 non-TNBC, 115 (53%) were HR positive/HER-2 negative, 31 (14%) were HR negative/HER-2 positive and 32 (15%) were HR positive/HER-2 positive. Patients with TNBC had a trend to a higher pCR rate compared with non-TNBC (15.4% vs. 12.4%, p=0.06). Tumor response according to the PST regimen is shown in the Table. A significantly higher pCR rate to anthracyclines followed by taxanes was observed in non-TNBC (18.2% vs. 2.9%, p<0.02), but not in TNBC (15% vs. 15.8%, p=n.s.). At a median follow-up of 40 months, patients with TNBC showed a shorter DFS compared to non-TNBC (p<0.01). Conclusions: In TNBC, the use of anthracyclines followed by taxanes is not superior to anthracyclines alone. TNBC patients were more likely to respond to PST, but had a worse DFS with respect to non-TNBC patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
