Change in the hormone receptor status following administration of neoadjuvant chemotherapy and its impact on the long-term outcome in patients with primary breast cancer

Abstract

BACKGROUND: To evaluate the impact of change in the hormone receptor (HR) status (HR status conversion) on the long-term outcomes of breast cancer patients treated with neoadjuvant chemotherapy (NAC). METHODS: We investigated 368 patients for the HR status of their lesions before and after NAC. On the basis of the HR status and the use/non-use of endocrine therapy (ET), the patients were categorised into four groups: Group A, 184 ET-administered patients with HR-positive both before and after NAC; Group B, 47 ET-administered patients with HR status conversion; Group C, 12 ET-naive patients with HR status conversion; Group D, 125 patients with HR-negative both before and after NAC. RESULTS: Disease-free survival in Group B was similar to that in Group A (hazard ratio, 1.16; P ¼ 0.652), but that in Group C was significantly lesser than that in Group A (hazard ratio, 6.88; Po0.001). A similar pattern of results was obtained for overall survival. CONCLUSION: Our results indicate that the HR status of tumours is a predictive factor for disease-free and overall survival and that ET appears to be suitable for patients with HR status conversion. Therefore, both the CNB and surgical specimens should be monitored for HR status.

Neoadjuvant Chemotherapy Exerts Selection Pressure Towards Luminal Phenotype Breast Cancer

“…Cytotoxic, endocrine and biological agents may specifically target and kill sensitive BC subpopulations, leaving behind the resistant ones. This hypothesis was sustained by some studies, showing higher frequency of BC phenotype change in NAC-treated patients than in naïve controls [14,15]. The present work shows that most cases undergoing phenotype changes presented with advanced stage (pT3-4, pN+, cM+).…”

Receptor Status Change From Primary to Residual Breast Cancer After Neoadjuvant Chemotherapy and Analysis of Survival Outcomes

“…8 Few studies have investigated the association between biomarker status alterations and long-term outcomes, finding inconsistent results. [9][10][11] Furthermore, little is known about the relationship between alterations in receptor status after NCT and long-term survival outcomes. 12 The objectives of this study were to assess the frequency of ER, PR, and HER2 status changes and changes in breast cancer subtypes after NCT and to determine whether these changes were correlated with long-term survival outcomes.…”

Serial Changes in Expression of Proteins in Response to Neoadjuvant Chemotherapy in Breast Cancer

“…after neoadjuvant chemotherapy was reported in several studies (112)(113)(114). In general, studies that reported a good concordance of hormone receptor status before and after neoadjuvant chemotherapy had a relatively smaller number of patients compared to the studies that found significant changes.…”