جستجوی مقالات مرتبط با کلیدواژه « pathologic complete response » در نشریات گروه « پزشکی »

 Neoadjuvant chemotherapy (NCT) has become an increasingly popular approach in management of breast cancer (BC). This study was conducted to evaluate the pathologic response and 36-month recurrence and survival rates of patients with human epidermal growth factor receptor 2 (HER2)-negative BC treated with different NCT regimens.

 A total of 163 female patients with HER2-negative BC who received NCT during 2017-2020 were identified from the Clinical Breast Cancer Registry of Iran and entered the study. The prescribed NCT regimens included 4 cycles of doxorubicin plus cyclophosphamide, 4 cycles of doxorubicin plus cyclophosphamide followed by 4 cycles of paclitaxel, 4 cycles of doxorubicin plus cyclophosphamide followed by 4 cycles of docetaxel or 6 cycles of doxorubicin plus cyclophosphamide plus docetaxel (TAC).

 Thirty-two patients (19.6%) experienced pathologic complete response (pCR). TAC regimen, triple negative-BC and ki67>10% were significantly associated with increased pCR. The recurrence, overall survival (OS) and disease-free survival (DFS) rate at 36 months for all patients were 16.6%, 84.7% and 79.8%, respectively. Type of neoadjuvant regimen as well as age, hormone receptor status, Ki67, grade, clinical stage, type of surgery and pathologic response to chemotherapy did not significantly influence the survival and recurrence; however, TAC results in improved recurrence, OS and DFS rates.

 This study provides further evidence that NCT is a viable treatment option for patients with HER2-negative BC. The TAC regimen resulted in a significantly higher pCR rate compared to other regimens, but did not result in a significant improvement in recurrence, OS and DFS and rates.

Neoadjuvant chemotherapy (NAC) is less effective for luminal human epidermal growth factor receptor 2 (HER2) negative breast cancer (BC) patients and generally shows a low pathological complete response (pCR) after NAC compared to HER2 positive and triple negative breast cancer (TNBC). This studyaimed to determine the factors associated with histopathologic response following NAC in luminal (HER2 negative) BC.

This is a cross-sectional study conducted on 255 estrogen (ER) positive and HER2 negative BC patients after NAC between January 2018 and July 2023. Demographic and clinicopathological characteristics of the patients were collected for the statistical analysis.Chi-Square tests were used in the qualitative comparisons between study groups. Receiver Operating Characteristic (ROC) analysis was used for the diagnostic performance of Ki-67 expression and ER in determining the pCR rates. Using the Youden index, optimum cut points were determined. Also, multivariate logistic regression analysis was applied to determine the independent variables associated with the dependent variable (pCR).

After NAC, pCR was achieved in the breast in 35 (14%) patients, in the axilla in 44 (17%) patients, and in both the breast and axilla in 18 (7%) patients. Ki-67 expression was the only common variable associated with the breast, axilla and both the breast and axilla pCR. The most appropriate Ki-67 expression cut-off value for determining the breast and axilla complete response was found to be 40%. ER positivity level was only associated with pCR in the breast and the cut-off value was found to be 85%.

The results of this study raise the possibility of patients with luminal (HER2 negative) BC with Ki-67 expression higher than 40% benefiting from chemotherapy, as they showed increased pCR rates.

Neoadjuvant chemotherapy (NAC) is an integral part of breast cancer treatment. Determination of the factors that can distinguish patients who will have best response to NAC is invaluable. In this study, we aimed to elucidate the factors influencing patient response to NAC.

We retrospectively collected data of female patients with non-metastatic breast cancer that had received NAC followed by surgery, admitted to Imam Khomeini hospital between 2015–2019. We investigated the association between various tumor and patients’ characteristics with pathologic complete response (PCR).

Overall data of 205 female patients were collected. PCR was observed in 27.6% of cases. PCR rate in luminal A, luminal B, HER2 enriched, and TNB tumors was reported in 11.1%, 30.2%, 35.7%, and 36.4% of patients respectively ( P = 0.27). In patients with luminal B tumors, PCR was more prevalent in patients with positive HER2 only (P = 0.006). In our study factors which was significantly associated with PCR were: tumor grade, progesterone receptor (PR) status, and HER2 status. In the multiple regression model, positive PR in the tumor lowered the odds of pathologic response 3.6 times (P = 0.004).

In our study, tumor grade, PR status, and HER2 status was associated with response to NAC. PCR was more prevalent in non-luminal tumors; however, PCR rate in luminal B patients-especially those with HER2 positive status- was slightly less than non-luminals.