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Residual Cancer Burden After Neoadjuvant Chemo for BC
J Clin Oncol; ePub 2017 Jan 30; Symmans, et al
Residual cancer burden (RCB) predicted long-term survival after neoadjuvant chemotherapy in 3 phenotypic subsets of breast cancer, according to a pathologic review involving more than 1,150 individuals.
Investigators measured the continuous RCB index and yp-stage of residual disease. 3 cohorts received paclitaxel followed by fluorouracil, doxorubicin, and cyclophosphamide (FAC) (n=832). A validation cohort received FAC chemotherapy only (n=132), and a fifth cohort received concurrent trastuzumab with sequential paclitaxel and fluorouracil, epirubicin, and cyclophosphamide (FEC; H+T/FEC; n=203). Participants were broken into 3 phenotypic subsets: HR-positive/HER2-negative; HER2-positive; or triple receptor–negative.
Estimates of 10-year relapse-free survival rates in the 4 RCB classes (pathologic complete response, RCB-I, RCB-II, and RCB-III) were:
- 86%, 81%, 55%, and 23%, respectively, for triple receptor–negative patients.
- 83%, 97%, 74%, and 52%, respectively, for HR-positive/HER2-negative patients in the combined paclitaxel/FAC cohorts.
- 95%, 77%, 47%, and 21%, respectively, in the H+T/FEC cohort.
Symmans W, Wei C, Gould R, et al. Long term prognostic risk after neoadjuvant chemotherapy associated with residual cancer burden and breast cancer subtype. [Published online ahead of print January 30, 2017]. J Clin Oncol. doi:10.1200/JCO.2015.63.1010.