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- Title
Pathological Response to Neoadjuvant Chemotherapy and the Molecular Classification of Locally Advanced Breast Cancer in a Latin American Cohort.
- Authors
Díaz‐Casas, Sandra Esperanza; Castilla‐Tarra, Jorge Alberto; Pena‐Torres, Esperanza; Orozco‐Ospino, Martha; Mendoza‐Diaz, Sara; Nuñez‐Lemus, Marcela; Garcia‐Angulo, Oscar; Garcia‐Mora, Mauricio; Guzman‐AbiSaab, Luis; Lehmann‐Mosquera, Carlos; Angel‐Aristizabal, Javier; Duarte‐Torres, Carlos; Vergel‐Martinez, Juan Carlos
- Abstract
Background: The majority of patients with breast cancer in Colombia are admitted into oncological centers at locally advanced stages of the disease (53.9%). The aim of this study was to describe the pathological response obtained with neoadjuvant chemotherapy (NACT) according to the molecular classification of breast cancer in patients with locally advanced tumors treated within the National Cancer Institute (NCI) Functional Breast Cancer Unit (FBCU) in Bogotá, Colombia. Materials and Methods: This was an observational, descriptive, historical cohort study of patients with locally advanced breast cancer treated within the NCI FBCU. Results: We included 414 patients who received NACT and surgical management. Most patients had luminal B HER2‐negative tumors (n = 134, 32.4%). The overall rate of pathological complete response (pCR) ypT0/ypN0 was 15.2% (n = 63). Tumors that presented the highest rate of pCR were pure HER2, at 40.5% (n = 15; odds ratio [OR], 6.7); however, with a follow‐up of 60 months, only the triple negative tumors presented a statistically significant difference for event‐free survival (EFS; median recurrence time, 18 months; range, 1–46) and overall survival (OS; median follow‐up, 31 months; range 10–57). The molecular subtype that most recurrences presented was luminal B HER2 negative, at 38.3% (n = 28). The majority of recurrences (93.2 %; n = 68; OR, 5.9) occurred in patients in whom no pathological response was obtained (Chevallier 3 and 4). Conclusion: Pathological response in locally advanced tumors is related to the molecular subtype of breast cancer, finding higher pCR rates in pure HER2 and triple‐negative tumors. A direct relationship was found between disease recurrences and the pathological response, evidencing greater tumor recurrence in patients who did not respond to NACT (Chevallier 3 and 4). EFS and OS were greater in patients with pCR, with statistical significance only in triple‐negative tumors. Implications for Practice: This research article is of scientific interest, because it describes the clinical and pathological features and analyzes the correlation between pathological response to neoadjuvant chemotherapy and the molecular classification of locally advanced breast cancer in patients treated in the National Cancer Institute in Bogotá, Colombia. It was found that pathological response is related to the molecular subtype of breast cancer. In addition, there is a direct relationship between disease recurrences and pathological response. The survival results were greater in patients with pathological complete response. This article describes pathological response with neoadjuvant chemotherapy according to molecular classification of breast cancer in patients with locally advanced tumors. Patients were treated at the National Cancer Institute Functional Breast Cancer Unit in Colombia, a country with a multicultural population, and so it is believed that the results reported can also be used to develop treatment guidelines for other countries in the region.
- Subjects
COLOMBIA; BREAST tumor treatment; BREAST tumors; CANCER chemotherapy; COMBINED modality therapy; HISTORICAL research; RESEARCH methodology; SCIENTIFIC observation; POLYMERASE chain reaction; SURVIVAL; DESCRIPTIVE statistics; ODDS ratio
- Publication
Oncologist, 2019, Vol 24, Issue 12, pe1360
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2019-0300