Patterns of Recurrence after Neoadjuvant Therapy in Early Breast Cancer, according to the Residual Cancer Burden Index and Reductions in Neoadjuvant Treatment Intensity.

Suppan, Christoph; Posch, Florian; Mueller, Hannah Deborah; Mischitz, Nina; Steiner, Daniel; Klocker, Eva Valentina; Setaffy, Lisa; Bargfrieder, Ute; Hammer, Robert; Hauser, Hubert; Jost, Philipp J; Dandachi, Nadia; Lax, Sigurd; Balic, Marija

doi:10.3390/cancers13102492

Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie (Prof. Bassermann)

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Document type:: Journal Article
Author(s):: Suppan, Christoph; Posch, Florian; Mueller, Hannah Deborah; Mischitz, Nina; Steiner, Daniel; Klocker, Eva Valentina; Setaffy, Lisa; Bargfrieder, Ute; Hammer, Robert; Hauser, Hubert; Jost, Philipp J; Dandachi, Nadia; Lax, Sigurd; Balic, Marija
Title:: Patterns of Recurrence after Neoadjuvant Therapy in Early Breast Cancer, according to the Residual Cancer Burden Index and Reductions in Neoadjuvant Treatment Intensity.
Abstract:: BACKGROUND: The prognostic performance of the residual cancer burden (RCB) score is a promising tool for breast cancer patients undergoing neoadjuvant therapy. We independently evaluated the prognostic value of RCB scores in an extended validation cohort. Additionally, we analyzed the association between chemotherapy dose reduction and RCB scores. METHODS: In this extended validation study, 367 breast cancer patients with available RCB scores were followed up for recurrence-free survival (RFS), distant disease-free survival (DDFS), and overall survival (OS). We also computed standardized cumulative doses of anthracyclines and taxanes (A/Ts) to investigate a potential interaction between neoadjuvant chemotherapy dose reduction and RCB scores. RESULTS: Higher RCB scores were consistently associated with adverse clinical outcomes across different molecular subtypes (HR for RFS = 1.60, 95% CI 1.33-1.93, p < 0.0001; HR for DDFS = 1.70, 95% CI 1.39-2.05, p < 0.0001; HR for OS = 1.67, 95% CI 1.34-2.08, p < 0.0001). The adverse impact prevailed throughout 5 years of follow-up, with a peak for relapse risk between 1-2 years after surgery. Clinical outcomes of patients with RCB class 1 did not differ substantially at 5 years compared to RCB class 0. A total of 180 patients (49.1%) underwent dose reduction of neoadjuvant A/T chemotherapy. We observed a statistically significant interaction between dose reduction and higher RCB scores (interaction p-value = 0.042). CONCLUSION: Our results confirm RCB score as a prognostic marker for RFS, DDFS, and OS independent of the molecular subtype. Importantly, we show that lower doses of cumulative neoadjuvant A/T were associated with higher RCB scores in patients who required a dose reduction.
Journal title abbreviation:: Cancers (Basel)
Year:: 2021
Journal volume:: 13
Journal issue:: 10
Fulltext / DOI:: doi:10.3390/cancers13102492
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/34065332
TUM Institution:: III. Medizinische Klinik und Poliklinik (Hämatologie / Onkologie)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin III, Hämatologie und Onkologie (Prof. Bassermann)2021