Biomarker Dynamics and Long-Term Treatment Outcomes in Breast Cancer Patients with Residual Cancer Burden after Neoadjuvant Therapy

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Authors

HOLÁNEK Miloš SELINGEROVÁ Iveta FABIAN Pavel COUFAL Oldřich ZAPLETAL Ondřej PETRÁKOVÁ Katarína KAZDA Tomáš HRSTKA Roman POPRACH Alexandr ZVARÍKOVÁ Mária BÍLEK Ondřej SVOBODA Marek

Year of publication 2022
Type Article in Periodical
Magazine / Source Diagnostics
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.mdpi.com/2075-4418/12/7/1740
Doi http://dx.doi.org/10.3390/diagnostics12071740
Keywords breast cancer; neoadjuvant therapy; pathological complete response; residual cancer burden; biomarkers; KI-67; long-term outcomes
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Description A residual cancer burden after neoadjuvant therapy (NAT) for breast cancer (BC) is associated with worse treatment outcomes compared to patients who achieved pathologic complete remission. This single-institutional retrospective study of 767 consecutive patients, including 468 patients with assessable residual cancer burden (aRCB) after NAT, with a median follow-up of 36 months, evaluated the biomarkers assessed before NAT from a biopsy and after NAT from a surgical specimen, their dynamics, and effect on long-term outcomes in specific breast cancer subtypes. The leading focus was on proliferation index Ki-67, which was significantly altered by NAT in all BC subtypes (p < 0.001 for HER2 positive and luminal A/B HER2 negative and p = 0.001 for TNBC). Multivariable analysis showed pre-NAT and post-NAT Ki-67 as independent predictors of survival outcomes for luminal A/B HER2 negative subtype. For TNBC, post-NAT Ki-67 was significant alone, and, for HER2 positive, the only borderline association of pre-NAT Ki-67 was observed in relation to the overall survival. Steroid and HER2 receptors were re-assessed just in a portion of the patients with aRCB. The concordance of both assessments was 92.9% for ER status, 80.1% for PR, and 92.2% for HER2. In conclusion, these real-world data of a consecutive cohort confirmed the importance of biomarkers assessment in patients with aRCB, and the need to consider specific BC subtypes when interpreting their influence on prognosis.
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