Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer

Cornelia Liedtke, Chafika Mazouni, Kenneth R. Hess, Fabrice André, A. Tordai, Jaime A. Mejia, W. Fraser Symmans, Ana M. Gonzalez-Angulo, Bryan Hennessy, Marjorie Green, Massimo Cristofanilli, Gabriel N. Hortobagyi, Lajos Pusztai

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)1275-1281
Number of pages7
JournalJournal of Clinical Oncology
Volume26
Issue number8
DOIs
Publication statusPublished - Mar 10 2008

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Triple Negative Breast Neoplasms
Neoadjuvant Therapy
Survival
Breast Neoplasms
Survival Rate
Recurrence
Drug Therapy
Tissue Survival
Progesterone Receptors
Estrogen Receptors
Disease-Free Survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. / Liedtke, Cornelia; Mazouni, Chafika; Hess, Kenneth R.; André, Fabrice; Tordai, A.; Mejia, Jaime A.; Symmans, W. Fraser; Gonzalez-Angulo, Ana M.; Hennessy, Bryan; Green, Marjorie; Cristofanilli, Massimo; Hortobagyi, Gabriel N.; Pusztai, Lajos.

In: Journal of Clinical Oncology, Vol. 26, No. 8, 10.03.2008, p. 1275-1281.

Research output: Contribution to journalArticle

Liedtke, C, Mazouni, C, Hess, KR, André, F, Tordai, A, Mejia, JA, Symmans, WF, Gonzalez-Angulo, AM, Hennessy, B, Green, M, Cristofanilli, M, Hortobagyi, GN & Pusztai, L 2008, 'Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer', Journal of Clinical Oncology, vol. 26, no. 8, pp. 1275-1281. https://doi.org/10.1200/JCO.2007.14.4147
Liedtke, Cornelia ; Mazouni, Chafika ; Hess, Kenneth R. ; André, Fabrice ; Tordai, A. ; Mejia, Jaime A. ; Symmans, W. Fraser ; Gonzalez-Angulo, Ana M. ; Hennessy, Bryan ; Green, Marjorie ; Cristofanilli, Massimo ; Hortobagyi, Gabriel N. ; Pusztai, Lajos. / Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 8. pp. 1275-1281.
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abstract = "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.",
author = "Cornelia Liedtke and Chafika Mazouni and Hess, {Kenneth R.} and Fabrice Andr{\'e} and A. Tordai and Mejia, {Jaime A.} and Symmans, {W. Fraser} and Gonzalez-Angulo, {Ana M.} and Bryan Hennessy and Marjorie Green and Massimo Cristofanilli and Hortobagyi, {Gabriel N.} and Lajos Pusztai",
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T1 - Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer

AU - Liedtke, Cornelia

AU - Mazouni, Chafika

AU - Hess, Kenneth R.

AU - André, Fabrice

AU - Tordai, A.

AU - Mejia, Jaime A.

AU - Symmans, W. Fraser

AU - Gonzalez-Angulo, Ana M.

AU - Hennessy, Bryan

AU - Green, Marjorie

AU - Cristofanilli, Massimo

AU - Hortobagyi, Gabriel N.

AU - Pusztai, Lajos

PY - 2008/3/10

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N2 - 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.

AB - 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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