Platinum-Based Neoadjuvant Chemotherapy for Breast Cancer With BRCA Mutations: A Meta-Analysis
Changjun WangYing XuYan LinHanjiang ZhuYidong ZhouFeng MaoXiaohui ZhangXin HuangYing ZhongQiang SunChenggang Li
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Abstract:
Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer and the major phenotype of BRCA related hereditary breast cancer. Platinum is a promising chemotherapeutic agent for TNBC. However, its efficacy for breast cancer with BRCA germline mutation remains inconclusive. Here we present a meta-analysis to evaluate the effect of platinum agents for breast cancer patients with BRCA mutation in neoadjuvant setting.Pubmed, Embase, and Cochrane Central Register of Controlled Trials databases were searched for relevant studies on neoadjuvant platinum treatment and BRCA related breast cancer. Fixed- and random-effect models were adopted for meta-analyses. Heterogeneity investigation was conducted by sensitivity and subgroup analyses. Publication bias was evaluated by funnel plot and Begg's test.In all, five studies with 363 patients were included for meta-analysis. The pooled pathological complete response (pCR) rates were 43.4% (59/136) and 33.9% (77/227) for platinum and control groups, respectively. Adding platinum to neoadjuvant regimen did not significantly improved pCR rate (odds ratio [OR]: 1.340, 95% confidence interval [CI] = 0.677-2.653, p = 0.400). Sensitivity analyses also revealed platinum did not significantly increase pCR rate in either TNBC or HER2- patients (TNBC subgroup: OR: 1.028, 95% CI = 0.779-1.356, p = 0.846; HER2- subgroup: OR: 0.935, 95% CI = 0.716-1.221, p = 0.622).Our meta-analysis suggested that the addition of platinum to neoadjuvant chemotherapy did not significantly improve pCR rate for patients with BRCA mutations. Further large-scale randomized control trial with survival data may provide more robust evidence on therapeutic value of platinum for breast cancer neoadjuvant treatment.Keywords:
BRCA Mutation
Triple-negative breast cancer
Regimen
Subgroup analysis
Neoadjuvant Therapy
Background: Because of its high-risk biological features and lack of effective treatment options, triple-negative breast cancer (TNBC) has received greater clinical and experimental interest.
Aim and objectives: The aim of this study was to compare and analyze the clinicopathological features, recurrence, metastasis, and prognosis of patients with TNBC and non-triple negative breast cancer (non-TNBC).
Material and methods: This single hospital-based retrospective study was conducted on patients who were histopathologically diagnosed with breast cancer and subsequently treated from 2017 to 2018 at the Acharya Harihar Postgraduate Institute of Cancer. The clinical features and prognosis of TNBC and non-TNBC were compared.
Results: This study comprised a total of 111 patients, with 36 (32.43%) being TNBC and 75 (67.56%) being non-TNBC. TNBC has 22 patients under the age of 40 (61.1%). Grade III tumors were seen in 47% of TNBC patients and 21% of non-TNBC patients (p-value = 0.05). The disease free survival (DFS) was determined to be 58 % for TNBC and 82% for non-TNBC groups, respectively (p-value = 0.05). These two groups had an overall survival rate (OS) of 72% and 92%, respectively (p-value = 0.05).
Conclusion: When compared to non-TNBC, TNBC was related to high-grade malignancies, worse disease-free survival , and overall survival (OS) rates. Understanding the molecular features of TNBC, clarifying its mechanism at the molecular level, interpreting the gene expression profiles of TNBC, and studying and creating new therapeutic targets should be the focus of future research. To enhance the prognosis of TNBC patients, try to find a focused and effective therapy.
Keywords:
Breast cancer; survival; triple-negative breast cancer.
Triple-negative breast cancer
Single Center
Tertiary care
Triple negative
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<p>Patterns of recurrence in triple negative breast cancer (TNBC) and non-TNBC patients</p>
Triple-negative breast cancer
Triple negative
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Triple negative breast cancer (TNBC) is a special type of breast cancer.Its special clinical pathological characteristic and molecule expression type make the treatment of TNBC become an international problem.In recent years,a variety of attempts and explorations to the treatment of TNBC have made some initial results,which provides a direction for the treatment of TNBC and offers hope for the patients with TNBC.
Key words:
Breast neoplasms; Combined modality therapy; Triple-negative
Triple-negative breast cancer
Triple negative
Modality (human–computer interaction)
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Abstract Objective: The objective of this study was to compare ultrasound features and establish a predictive nomogram for distinguishing between triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (non-TNBC). Materials and Methods: The study included a total of 205 patients with confirmed TNBC and 574 patients with non-TNBC, randomly divided into a training set and a validation set at a ratio of 7:3. All patients underwent ultrasound examination and received a confirmatory pathological diagnosis. Nodules were classified according to the Breast Imaging-Reporting and Data System (BI-RADS) standard. Subsequently, the study conducted a comparative analysis of clinical characteristics and ultrasonic features. Results: A statistically significant difference was observed in multiple clinical and ultrasonic features between TNBC and non-TNBC. Specifically, in the logistic regression analysis conducted on the training set, indicators such as posterior echo, lesion size, presence of clinical symptoms, margin characteristics, internal blood flow signals, halo, and microcalcification were found to be statistically significant ( P <0.05). These significant indicators were then effectively incorporated into a static and dynamic nomogram model, demonstrating high predictive performance in distinguishing TNBC from non-TNBC. Conclusion: The results of our study demonstrated that ultrasound features can be valuable in distinguishing between TNBC and non-TNBC. The presence of posterior echo, size, clinical symptoms, margin, internal flow, halo and microcalcification were identified as predictive factors for this differentiation. Microcalcification, hyperechoic halo, internal flow, and clinical symptoms emerged as the strongest predictive factors, indicating their potential as reliable indicators for identifying TNBC and non-TNBC.
Triple-negative breast cancer
Triple test
Triple negative
Nomogram
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Abstract Abstract #5121 Purpose: It is said that triple negative breast cancer (TNBC) has poor prognosis. However, many study shows TNBC has better response to chemotherapy. Since neoadjuvant chemotherapy plays an important role to TNBC, we compared clinical and pathological response rate and prognosis between TNBC and non-TNBC.
 Patients and methods: This analysis retrospectively collected 2563 breast cancer patients for StageI-III who underwent surgery between January 2000 and September 2004 (median: 3.9 years) at National Cancer Center, Tokyo, Japan. We defined TNBC as Estorpgen and progesterone receptor negative and HER2 score 0-2+ by immnohistological report. There were 91 TNBC patients (23.1%) out of 400 patients (15.6%) who underwent neoadjuvant chemotherapy. Clinical and pathological response rate and Four-year progression free survival were compared between TNBC and non-TNBC.
 Results: There were 91 TNBC patients (23.1%). TNBC patients compared with non-TNBC had tendency to achieve cCR (91% vs 78%; p=.058) although TNBC had higher rate for cPD (6.6% vs 1.7%; p <.0001). Also TNBC tended to have higher pathological CR rate of which we classified pCR only for grade 3 cases, compared to non-TNBC (13.1% vs 7.2%; p= .042 ). Interestingly HER2 overexpression type also had higher rate for pCR. As for pPD rate, TNBC had similar rate compared to non-TNBC (5.5% v 4.3%). Four-year progression free- survival rate was higher for non-TNBC. However, TNBC had higher Four-year survival free rate only when pCR were achieved after neoadjuvant chemotherapy (99% vs 82%; p=.02).
 Conclusion: Patients with TNBC tend to have clinical and pathological response of either CR or PD. Although non-TNBC had better prognosis by four-year survival free rate, TNBC could have better prognosis if neoadjuvant chemotherapy resulted in pCR. There may be some way to predict the efficacy of neoadjuvant chemotherapy and prognosis by analyzing the shrink pattern. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5121.
Triple-negative breast cancer
Neoadjuvant Therapy
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BACKGROUNDTriple-negative breast cancer patients have no expression of Oestrogen Receptor (ER), Progesterone Receptor (PR) and there is neither expression nor amplification of human epidermal growth factor receptor 2 in a tumour.But non-triple negative breast cancer patients have either oestrogen receptor or progesterone receptor or both positive with or without amplification of Human epidermal growth factor receptor 2 in a tumour.The purpose of this retrospective study is to compare and analyse the clinico-pathological features, recurrence, metastasis and prognosis of triple-negative breast cancer patients and non-triple negative breast cancer patients. MATERIALS AND METHODSA retrospective descriptive study for a total of 200 stage III female breast cancer patients (100 triple-negative patients and 100 non-triple-negative patients) were diagnosed and treated at the Department of Radiotherapy, T.D Medical College Hospital, Alappuzha from January 1 st 2011 to December 31 st 2011.The clinical features, recurrence, metastasis and prognosis of the two groups were compared. RESULTSThe triple-negative breast cancer patients were characterised as younger age, higher histological grade, bigger tumour size, higher clinical stage at diagnosis, more recurrence and metastasis, lower 5-year disease free survival rate and 5-year overall survival rate.The lungs, liver and brain were the first three most common sites of metastases. CONCLUSIONIn our study, we found that triple-negative breast cancer was a distinct subgroup of breast cancer with particular clinico-pathologic behaviour.Compared with the non-triple-negative breast cancer, triple-negative breast cancer was characterised by more aggressive behaviour, metastasis tendency and lower disease-free survival and overall survival rate.This result suggested that characteristics like family history, premenopausal status, tumour size, histological grade of triple-negative breast cancer patients had more local relapse and metastases than that of in non-triple-negative breast cancer that was statistically significant.
Triple-negative breast cancer
Triple negative
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Prognostication of breast cancer using clinico-pathologic variables, although useful, remains imperfect. Recent research has focused on finding new markers of prognosis using gene expression profiling. Panels of proteins assessed by immunohistochemistry might also be useful in this regard. This study focused on Bcl-2 protein expression in triple-negative (TNBC) and non- triple-negative breast cancer (non-TNBC) with correlation to clinico-pathologic variables.We analyzed Bcl-2 expression in 77 women with primary breast carcinoma divided into two groups; triple-negative and non- triple-negative according to expression of estrogen (ER), progesterone (PR) and human epidermal growth factor receptors (Her2/neu). Bcl-2 expression was assessed in relation to age, histo-pathological subtype, grade, nodal status and tumor size.Bcl-2 was expressed in 74% of triple-negative breast cancers and 70% of non- triple-negative cancers. In TNBC, expression was significantly correlated with invasive ductal subtype, while in non-TNBC it was significantly correlated with age and negative nodal status. In both groups higher Bcl-2 expression associated with favourable prognostic factors in breast cancer, but no significant statistical correlations were found.Frequency of Bcl-2 expression does not differ between TNBC and non-TNBC, but different prognostic factors correlate with Bcl-2 in the two cases.
Triple-negative breast cancer
Triple negative
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Purpose: Triple negative breast cancer (estrogen receptor-negative, progesterone receptor-negative, and HER2/neu negative) is associated with high risk of recurrence and poor prognosis. We investigated the characteristics and prognosis of triple negative early-stage breast cancer. Methods: We reviewed the records of 821 early-stage breast cancer patients treated at our hospital from 1995 to 2005. We studied the differences between a triple negative group compared with a non-triple negative group. Results: Of 821 early-stage breast cancer patients, 200 (24.4%) were classified as triple negative. Large tumors (＞2 cm) in the triple negative group were significantly more than those in the non-triple negative group (P=0.042). Histologic and nuclear grade of the triple negative group were significantly higher than those of the non-triple negative group (P＜0.001). The median follow-up time is 50 months (1∼135). There have been 50 local recurrences, 98 distant metastases, and 65 deaths. There were high rates of local recurrence in the triple negative group but no difference in 5-year disease free survival rates (P=0.178). The 5-year overall survival rate showed 85% in the triple negative group but 92.8% in the non-triple negative group (P=0.008). The relative risk for overall survival was 1.93 times higher in the triple negative group. Conclusion: Triple negative breast cancer patients in early stages have poor pathologic findings and prognoses. Careful treatment and follow-up are important and further investigation is necessary for triple negative breast cancer.
Triple-negative breast cancer
Triple negative
Triple test
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Triple-negative breast cancer
Triple negative
Triple test
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Triple-negative breast cancer
Triple junction
Triple negative
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