| Title: |
Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer: a multicentre pooled analysis of 5161 patients |
| Authors: |
Yau, Christina; Osdoit, Marie; van der Noordaa, Marieke; Shad, Sonal; Wei, Jane; de Croze, Diane; Hamy, Anne-Sophie; Laé, Marick; Reyal, Fabien; Sonke, Gabe S; Steenbruggen, Tessa G; van Seijen, Maartje; Wesseling, Jelle; Martín, Miguel; del Monte-Millán, Maria; López-Tarruella, Sara; Consortium, I-SPY 2 Trial; Adamson, Kathi; Albain, Kathy S; Asare, Adam L; Asare, Smita M; Balassanian, Ron; Beckwith, Heather; Berry, Scott M; Berry, Donald A; Boughey, Judy C; Buxton, Meredith B; Chen, Yunn-Yi; Chen, Beiyun; Chien, A Jo; Chui, Stephen Y; Clark, Amy S; Clennell, Julia L; Datnow, Brian; DeMichele, Angela M; Duan, Xiuzhen; Edmiston, Kirsten K; Elias, Anthony D; Ellis, Erin D; Esserman, Laura L; Euhus, David M; Fadare, Oluwole; Fan, Fang; Feldman, Michael D; Forero-Torres, Andres; Haley, Barbara B; Han, Hyo S; Harada, Shuko; Haugen, Patricia; Helsten, Teresa; Hirst, Gillian L; Hylton, Nola M; Isaacs, Claudine; Kemmer, Kathleen; Khan, Qamar J; Khazai, Laila; Klein, Molly E; Krings, Gregor; Lang, Julie E; LeBeau, Lauren G; Leyland-Jones, Brian; Liu, Minetta C; Lo, Shelly; Lu, Janice; Magliocco, Anthony; Matthews, Jeffrey B; Melisko, Michelle E; Mhawech-Fauceglia, Paulette; Moulder, Stacy L; Murthy, Rashmi K; Nanda, Rita; Northfelt, Donald W; Ocal, Idris T; Olopade, Olufunmilayo; Pambuccian, Stefan; Paoloni, Melissa; Park, John W; Parker, Barbara A; Perlmutter, Jane; Peterson, Garry; Pusztai, Lajos; Rendi, Mara; Rugo, Hope S; Sahoo, Sunati; Sams, Sharon; Sanil, Ashish; Sattar, Husain; Schwab, Richard B; Singhrao, Ruby; Steeg, Katherine; Stringer-Reasor, Erica; Symmans, W Fraser; Tawfik, Ossama; Tripathy, Debasish; Troxell, Megan L; Veer, Laura J van't; Venters, Sara J; Vinh, Tuyethoa; Viscusi, Rebecca K; Wallace, Anne M |
| Source: |
The Lancet Oncology, vol 23, iss 1 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2022 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
32 Biomedical and Clinical Sciences (for-2020); 3211 Oncology and Carcinogenesis (for-2020); Breast Cancer (rcdc); Clinical Research (rcdc); Women's Health (rcdc); Cancer (rcdc); Patient Safety (rcdc); Precision Medicine (rcdc); Cancer (hrcs-hc); Adolescent (mesh); Adult (mesh); Aged (mesh); Aged; 80 and over (mesh); Breast Neoplasms (mesh); Chemotherapy; Adjuvant (mesh); Female (mesh); Humans (mesh); Middle Aged (mesh); Neoadjuvant Therapy (mesh); Neoplasm; Residual (mesh); Receptor; ErbB-2 (mesh); Young Adult (mesh); I-SPY 2 Trial Consortium |
| Subject Geographic: |
149 - 160 |
| Description: |
BACKGROUND: Previous studies have independently validated the prognostic relevance of residual cancer burden (RCB) after neoadjuvant chemotherapy. We used results from several independent cohorts in a pooled patient-level analysis to evaluate the relationship of RCB with long-term prognosis across different phenotypic subtypes of breast cancer, to assess generalisability in a broad range of practice settings. METHODS: In this pooled analysis, 12 institutes and trials in Europe and the USA were identified by personal communications with site investigators. We obtained participant-level RCB results, and data on clinical and pathological stage, tumour subtype and grade, and treatment and follow-up in November, 2019, from patients (aged ≥18 years) with primary stage I-III breast cancer treated with neoadjuvant chemotherapy followed by surgery. We assessed the association between the continuous RCB score and the primary study outcome, event-free survival, using mixed-effects Cox models with the incorporation of random RCB and cohort effects to account for between-study heterogeneity, and stratification to account for differences in baseline hazard across cancer subtypes defined by hormone receptor status and HER2 status. The association was further evaluated within each breast cancer subtype in multivariable analyses incorporating random RCB and cohort effects and adjustments for age and pretreatment clinical T category, nodal status, and tumour grade. Kaplan-Meier estimates of event-free survival at 3, 5, and 10 years were computed for each RCB class within each subtype. FINDINGS: We analysed participant-level data from 5161 patients treated with neoadjuvant chemotherapy between Sept 12, 1994, and Feb 11, 2019. Median age was 49 years (IQR 20-80). 1164 event-free survival events occurred during follow-up (median follow-up 56 months [IQR 0-186]). RCB score was prognostic within each breast cancer subtype, with higher RCB score significantly associated with worse event-free survival. The univariable hazard ratio (HR) ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt0f60710w; https://escholarship.org/uc/item/0f60710w; https://escholarship.org/content/qt0f60710w/qt0f60710w.pdf |
| DOI: |
10.1016/s1470-2045(21)00589-1 |
| Availability: |
https://escholarship.org/uc/item/0f60710w; https://escholarship.org/content/qt0f60710w/qt0f60710w.pdf; https://doi.org/10.1016/s1470-2045(21)00589-1 |
| Rights: |
CC-BY |
| Accession Number: |
edsbas.652D8DA4 |
| Database: |
BASE |