Prognostic value of pathologic complete response after primary chemotherapy in patients with hormone receptor-positive breast cancer.

The achievement of a pathologic complete response (pCR) in breast cancer patients treated with primary chemotherapy is the most reliable predictor of survival. Patients with hormone receptor (HR) positive tumors hare less likely to achieve a pCR; however, the prognostic role of pCR in these patients is not well characterized. In this study including 1731 patients, we have demonstrated that the achievement of pCR is associated with better outcome regardless of HR status

Women age <= 35 years with primary breast carcinoma - Disease features at presentation

BACKGROUND. The purpose of the current study was to describe a population of young patients with breast carcinoma, their characteristics at the time of diagnosis, and the association of these characteristics with disease recurrence and survival

Prognostic value of pathologic complete response after primary chemotherapy in relation to hormone receptor status and other factors

Purpose To evaluate whether hormonal receptor (HR) status can influence the prognostic significance of pathologic complete response (pCR). Patients and Methods This retrospective analysis included 1,731 patients with stage I to III noninflammatory breast cancer treated between 1988 and 2005 with primary chemotherapy (PC). Ninety-one percent of patients received anthracycline-based PC, and 66% received additional taxane therapy. pCR was defined as no evidence of invasive tumor in the breast and axillary lymph nodes. Results Median age was 49 years (range, 19 to 83 years). Sixty-seven percent of patients (n = 1,163) had HR-positive tumors. A pCR was observed in 225 (13%) of 1,731 patients; pCR rates were 24% in HR-negative tumors and 8% in HR-positive tumors (P < .001). A significant survival benefit for patients who achieved pCR compared with no pCR was observed regardless of HIR status. In the HR-positive group, 5-year overall survival (OS) rates were 96.4% v 84.5% (P = .04) and 5-year progression-free survival (PFS) rates were 91.1 % v 65.3% (P < .0001) for patients with and without pCIR, respectively. For the H R-negative group, 5-year OS rates were 83.9% v 67.4% (P = .003) and 5-year PFS rates were 83.4% v 50.0% (P < .0001) for patients with and without pCIR, respectively. After adjustment for adjuvant hormonal treatment, HR status, clinical stage, and nuclear grade, patients who achieved a pCR had 0.36 times the risk of death. Conclusion pCR is associated with better outcome regardless of HIR status in breast cancer patients who receive PC

Phase III randomized trial of dose intensive neoadjuvant chemotherapy with or without G-CSF in locally advanced breast cancer: Long-term results

Objective. To compare the pathologic complete response (pCR) rate of patients treated with 5-fluorouracil (5-FU), doxorubicin, and cyclophosphamide (FAC) versus dose-intense FAC plus G-CSF in the neoadjuvant setting and to compare the delivered dose intensity, disease-free survival (DFS) and overall survival (OS) times, and toxicity between treatment arms in patients with breast cancer. Methods. Patients were randomized to receive preoperative FAC (5-FU, 500 mg/m 2 doxorubicin, 50 mg/m 2 cyclophosphamide, 500 mg/m 2) every 21 days for four cycles or dose-intense FAC (5-FU, 600 mg/m 2 doxorubicin, 60 mg/m 2 cyclophosphamide, 1,000 mg/m 2) plus G-CSF every 18 days for four cycles. Results. Two hundred two patients were randomly assigned. The median follow-up was 7.5 years. Patients randomized to FAC plus G-CSF had a higher pCR rate as well as clinical complete response rate; however, these differences were not statistically different from those with the FAC arm. Patients in the FAC G-CSF arm had a higher delivered dose intensity of doxorubicin in the neoadjuvant and adjuvant settings than those in the standard FAC arm. DFS and OS times were not significantly different between the two groups. However, the OS and DFS rates were significantly higher for patients who achieved a pCR than for those who did not. Thrombocytopenia, febrile neutropenia, and infection rates were higher in the FAC G-CSF arm. Conclusions. A higher delivered dose intensity of doxorubicin with the FAC G-CSF regimen did not result in a statistically significant higher pCR rate. However, patients who achieved a pCR experienced longer DFS and OS times. © Alpha Med Press.link_to_subscribed_fulltex