P193 Ki-67 as predictor of chemotherapy response in neoadjuvant chemotherapy for breast cancer
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Complete response
Neoadjuvant Therapy
We treated 60 patients with cisplatin‐based combination chemotherapy before definitive surgery and/or radiation. All had squamous cell tumors of the head and neck, stages II to IV, M 0 . Twelve patients (20%) achieved a complete remission after chemotherapy. Eight of these patients showed no histologic evidence of residual disease after biopsy or surgery. Definitive local therapy with surgery and/or radiation was carried out on almost all patients regardless of the extent of the response to preceding chemotherapy. Chemotherapy‐induced complete responders have had an improved survival rate in comparison with patients achieving a partial response or less. The extent of primary tumor correlates inversely with a complete response to chemotherapy.
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Neoadjuvant Therapy
Complete response
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Neoadjuvant Therapy
Complete response
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Limited evidence suggests that inherited predisposing risk variants might affect the disease outcome. In this study, we analyzed the effect of genome-wide association studies—identified breast cancer-risk single nucleotide polymorphisms on survival of early-stage breast cancer patients in a Chinese population. This retrospective study investigated the relationship between 21 GWAS-identified breast cancer-risk single nucleotide polymorphisms and the outcome of 1177 early stage breast cancer patients with a long median follow-up time of 174 months. Cox proportional hazards regression models were used to estimate the hazard ratios and their 95% confidence intervals. Primary endpoints were breast cancer special survival and overall survival while secondary endpoints were invasive disease free survival and distant disease free survival. Multivariate survival analysis showed only the rs2046210 GA genotype significantly decreased the risk of recurrence and death for early stage breast cancer. After grouping breast cancer subtypes, significantly reduced survival was associated with the variant alleles of rs9485372 for luminal A and rs4415084 for triple negative breast cancer. Importantly, all three single-nucleotide polymorphisms, rs889312, rs4951011 and rs9485372 had remarkable effects on survival of luminal B EBC, either individually or synergistically. Furthermore, statistically significant multiplicative interactions were found between rs4415084 and age at diagnosis and between rs3803662 and tumor grade. Our results demonstrate that breast cancer risk susceptibility loci identified by GWAS may influence the outcome of early stage breast cancer patients’ depending on intrinsic tumor subtypes in Chinese women.
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Abstract Neoadjuvant therapy has become the standard of care for locally advanced mid‐low rectal cancer. Pathological complete response (pCR) can be achieved in 12%–38% of patients. Patients with pCR have the most favorable long‐term outcomes. Intensifying neoadjuvant therapy and extending the interval between termination of neoadjuvant treatment and surgery may increase the pCR rate. Growing evidence has raised the issue of whether local excision or observation rather than radical surgery is an alternative for patients who achieve a clinical complete response after neoadjuvant therapy. Herein, we highlight many of the advances and resultant controversies that are likely to dominate the research agenda for pCR of rectal cancer in the modern era.
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Radical surgery
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Breast cancer neoadjuvant treatment response gives a unique opportunity to assess the therapy effectiveness only a few months after the therapy was initiated. In many neoadjuvant trials, patients achieving a pathologic complete response, showed a better long-term outcome, indicating pathologic complete response as a strong prognostic marker. However, there are some discrepancies in pathologic complete response assessment, thus standardization is needed. The review addresses the important issues regarding pathologic complete response assessment.
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Complete response
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Long-term outcomes for women with a diagnosis of human epidermal growth factor receptor 2 (HER2)-driven early-stage breast cancer have significantly improved since the advent of HER2-targeted therapy. Although the first studies in the early-stage setting focused on the adjuvant use of trastuzumab plus chemotherapy, clinical trials increasingly are using a neoadjuvant design to evaluate novel HER2-targeted therapies. Neoadjuvant therapy downstages locally advanced breast cancer, improves rates of breast conservation, and provides information regarding the responsiveness of a cancer to systemic therapy; in addition, studies have shown that the pathologic response to neoadjuvant therapy is correlated with event-free and overall survival. Given these advantages, multiple studies of neoadjuvant therapy, several of which have reported longer-term outcomes, have been conducted to evaluate HER2-targeted therapies. This review summarizes available data from prior and ongoing neoadjuvant trials in HER2-positive breast cancer, focusing on those studies that have reported not only pathologic response rates but also event-free, disease-free, and/or overall survival. The long-term outcomes associated with the achievement of a pathologic complete response are explored, and the comparisons of pathologic complete response rates, event-free survival, and overall survival reported for different HER2-targeted regimens are reviewed.
Neoadjuvant Therapy
Targeted Therapy
Systemic therapy
Adjuvant Therapy
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Adjuvant Chemotherapy
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Although the effect of trimodality(neoadjuvant treatment) on survival rate is contradic tionary,who achieves pathological response can derive a survival benefit Predictive markers of pathological response would be valuable in individualising patient treatment,it would enable discrimination of those patients likely to respond to combination therapy from those likely to be non-responsive and may progress during therapy.Here we review roles of histopathology,functional imaging and molecular markers in predicting response to neoadjuvant treatment.
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Esophageal neoplasms; Neoadjuvant therapy; Prognosis; Pathology
Neoadjuvant Therapy
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Histopathology
Multimodal therapy
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