Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer
Open accessAbstract
PURPOSE: Triple-negative breast cancer (TNBC) is defined by the lack of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2) expression. In this study, we compared response to neoadjuvant chemotherapy and survival between patients with TNBC and non-TNBC. PATIENTS AND METHODS: Analysis of a prospectively collected clinical database was performed. We included 1,118 patients who received neoadjuvant chemotherapy at M.D. Anderson Cancer Center for stage I-III breast cancer from 1985 to 2004 and for whom complete receptor information were available. Clinical and pathologic parameters, pathologic complete response rates (pCR), survival measurements, and organ-specific relapse rates were compared between patients with TNBC and non-TNBC. RESULTS: Two hundred fifty-five patients (23%) had TNBC. Patients with TNBC compared with non-TNBC had significantly higher pCR rates (22% v 11%; P = .034), but decreased 3-year progression-free survival rates (P < .0001) and 3-year overall survival (OS) rates (P < .0001). TNBC was associated with increased risk for visceral metastases (P = .0005), lower risk for bone recurrence (P = .027), and shorter postrecurrence survival (P < .0001). Recurrence and death rates were higher for TNBC only in the first 3 years. If pCR was achieved, patients with TNBC and non-TNBC had similar survival (P = .24). In contrast, patients with residual disease (RD) had worse OS if they had TNBC compared with non-TNBC (P < .0001). CONCLUSION: Patients with TNBC have increased pCR rates compared with non-TNBC, and those with pCR have excellent survival. However, patients with RD after neoadjuvant chemotherapy have significantly worse survival if they have TNBC compared with non-TNBC, particularly in the first 3 years.
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Achievement of a pathological complete response (path CR) in the breast and axillary lymph nodes after neoadjuvant trastuzumab or chemotherapy has been associated with improved long-term outcome.
“Achievement of a pathological complete response (path CR) in the breast and axillary lymph nodes after neoadjuvant trastuzumab or chemotherapy has been associated with improved long-term outcome (Gianni et al., 2010; Liedtke et al., 2008).”
From ERBB Receptors: From Oncogene Discovery to Basic Science to Mechanism-Based Cancer Therapeutics (2014) · cites this paper as Liedtke et al., 2008
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- Authors
- Liedtke, C., Mazouni, C., Hess, K. R., André, F., Tordai, A., Mejia, J. A., Symmans, W. F., Gonzalez-Angulo, A. M., Hennessy, B., Green, M., Cristofanilli, M., Hortobagyi, G. N., & Pusztai, L.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- From the Departments of Breast Medical Oncology, Biostatistics and Applied Mathematics, and Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX; Department of Gynecology and Obstetrics, University of Münster, Münster, Germany; Department of Obstetrics and Gynecology, Marseille Public Hospital System, Marseille; and Breast Cancer Unit and Translational Research Unit UPRES03535, Institut Gustave Roussy, Villejuif, France
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2008-03-10
- Volume
- 26
- Issue
- 8
- Pages
- 1275-1281
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2118605519
- Cited by
- 2,892
- References
- 12
- Citations by year
- 2026: 95 · 2025: 129 · 2024: 147 · 2023: 198 · 2022: 216 · 2021: 234 · 2020: 243 · 2019: 180 · 2018: 179 · 2017: 195 · 2016: 150 · 2015: 167 · 2014: 158 · 2013: 143 · 2012: 125
- FWCI
- 37.55
- Type
- journal article
- Language
- en
- Update notices
- new_edition (2023-03-29)
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Breast Cancer Research Foundation
- Hungarian-American Enterprise Scholarship Fund
- Deutsche Forschungsgemeinschaft
- National Cancer Institute (CA 016672, R01CA106290, RO1-CA106290, P30CA016672)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Keywords
- triple-negative breast cancer, neoadjuvant chemotherapy, pathological complete response, long-term survival, progression-free survival, overall survival, visceral metastases, bone recurrence, residual disease, hormone receptor status, HER2 status
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Female, Humans, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Neoplasms, Hormone-Dependent, Prognosis, Prospective Studies, Receptors, Estrogen, Receptors, Progesterone, Survival Rate, Chemotherapy, Adjuvant, Carcinoma, Ductal, Breast, Neoplasm, Residual, Erb-b2 Receptor Tyrosine Kinases, Neoadjuvant Therapy
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