Treatment Strategies for Residual Disease following Neoadjuvant Chemotherapy in Patients with Early-Stage Breast Cancer

Abdel‐Razeq, Hikmat; Khalil, Hanan; Assi, Hazem; Dargham, Tarek Bou

doi:10.3390/curroncol29080458

Cited by 11 publications

(8 citation statements)

References 94 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As reported in the literature [43], considering only those patients with a good response to NA, there is no significant difference between CBS and RBS in terms of LR-DFS (70% vs. 75.9%-p = 0.420), DDFS (67.8% vs. 29.7%-p = 0.112), and OS (69.8% vs. 59.8%-p = 0.311). Therefore, RBS intervention remains indicated in patients with poor or no response or progression during NA because they have a high risk of distant recurrence and mortality.…”

Section: Discussionmentioning

confidence: 52%

Conservative Surgery in cT4 Breast Cancer: Single-Center Experience in the Neoadjuvant Setting

Franco

Leone

Fabi

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: The diffusion of screening programs has resulted in a decrease of cT4 breast cancer diagnosis. The standard care for cT4 was neoadjuvant chemotherapy (NA), surgery, and locoregional or adjuvant systemic therapies. NA allows two outcomes: 1. improve survival rates, and 2. de-escalation of surgery. This de-escalation has allowed the introduction of conservative breast surgery (CBS). We evaluate the possibility of submitting cT4 patients to CBS instead of radical breast surgery (RBS) by assessing the risk of locoregional disease-free survival, (LR-DFS) distant disease-free survival (DDFS), and overall survival (OS). Methods: This monocentric, retrospective study evaluated cT4 patients submitted to NA and surgery between January 2014 and July 2021. The study population included patients undergoing CBS or RBS without immediate reconstruction. Survival curves were obtained using the Kaplan-Meyer method and compared using a Log Rank test. Results: At a follow-up of 43.7 months, LR-DFS was 70% and 75.9%, respectively, in CBS and RBS (p = 0.420). DDFS was 67.8% and 29.7%, respectively, (p = 0.122). OS was 69.8% and 59.8%, respectively, (p = 0.311). Conclusions: In patients with major or complete response to NA, CBS can be considered a safe alternative to RBS in the treatment of cT4a-d stage. In patients with poor response to NA, RBS remained the best surgical choice.

show abstract

Section: Discussionmentioning

confidence: 52%

Conservative Surgery in cT4 Breast Cancer: Single-Center Experience in the Neoadjuvant Setting

Franco

Leone

Fabi

et al. 2023

Cancers

View full text Add to dashboard Cite

show abstract

“…In addition, performing pCR predictions may create opportunities for patients who have considerable residual disease after conventional NAC treatment to become candidates for clinical trials of innovative drugs. For those patients with tumor residuals after NAC, the systematic management of post-NAC therapy is also required [ 58 ]. The better selection of patients for more appropriate treatment based on biomarkers, both in NAC and in post-NAC treatment, is an Issue that will need to be explored over time.…”

Section: Discussionmentioning

confidence: 99%

Development and Assessment of a Novel Core Biopsy-Based Prediction Model for Pathological Complete Response to Neoadjuvant Chemotherapy in Women with Breast Cancer

Lan

Chen

et al. 2023

IJERPH

View full text Add to dashboard Cite

Purpose: Pathological complete response (pCR), the goal of NAC, is considered a surrogate for favorable outcomes in breast cancer (BC) patients administrated neoadjuvant chemotherapy (NAC). This study aimed to develop and assess a novel nomogram model for predicting the probability of pCR based on the core biopsy. Methods: This was a retrospective study involving 920 BC patients administered NAC between January 2012 and December 2018. The patients were divided into a primary cohort (769 patients from January 2012 to December 2017) and a validation cohort (151 patients from January 2017 to December 2018). After converting continuous variables to categorical variables, variables entering the model were sequentially identified via univariate analysis, a multicollinearity test, and binary logistic regression analysis, and then, a nomogram model was developed. The performance of the model was assessed concerning its discrimination, accuracy, and clinical utility. Results: The optimal predictive threshold for estrogen receptor (ER), Ki67, and p53 were 22.5%, 32.5%, and 37.5%, respectively (all p < 0.001). Five variables were selected to develop the model: clinical T staging (cT), clinical nodal (cN) status, ER status, Ki67 status, and p53 status (all p ≤ 0.001). The nomogram showed good discrimination with the area under the curve (AUC) of 0.804 and 0.774 for the primary and validation cohorts, respectively, and good calibration. Decision curve analysis (DCA) showed that the model had practical clinical value. Conclusions: This study constructed a novel nomogram model based on cT, cN, ER status, Ki67 status, and p53 status, which could be applied to personalize the prediction of pCR in BC patients treated with NAC.

show abstract

“…Almost all chemotherapy drugs are available at major public hospitals, as well as in the private sector. Similarly, anti-HER2 drugs, including trastuzumab, pertuzumab [43], lapatinib [44], and ado-trastuzumab emtansine (T-DM1) [45], are widely available. However, almost all antibody drug conjugates (ADCs)-a class of targeted medications that combine monoclonal antibodies with cytotoxic payloads via a linker, including sacituzumab govitecan [46], trastuzumab duocarmazine [47], and trastuzumab deruxtecan (T-DXd) [48,49]-are not available at public hospitals or at KHCC.…”

Section: Medical Therapymentioning

confidence: 99%

Challenges and Opportunities in Breast Cancer Care in Low-Resourced Countries, Jordan as An Example

Abdel-Razeq,

Mansour

2024

Cancers

Self Cite

View full text Add to dashboard Cite

Jordan is a relatively small country with a rapidly growing population and a challenged economy. Breast cancer is the most diagnosed cancer among women worldwide and also in Jordan. Though the age-standardized rate (ASR) of breast cancer incidence is still lower than that in Western societies, the number of newly diagnosed cases continues to increase, involving younger women, and new cases are usually detected at more advanced stages. Improvements in breast cancer care across the health care continuum, including early detection, prevention, treatment, and survivorship and palliative care, have become very visible, but may not match the magnitude of the problem. More organized, goal-oriented work is urgently needed to downstage the disease and improve awareness of, access to, and participation in early detection programs. The cost of recently introduced anti-cancer therapies poses a great challenge, but the impact of these therapies on treatment outcomes, including overall survival, is becoming very noticeable. Though the concept of a multidisciplinary approach to breast cancer treatment is often used at most health care facilities, its implementation in real practice varies significantly. The availability of breast reconstruction procedures, survivorship programs, germline genetic testing, counselling, and palliative care is improving, but these are not widely practiced. In this manuscript, we review the status of breast cancer in Jordan and highlight some of the existing challenges and opportunities.

show abstract

Treatment Strategies for Residual Disease following Neoadjuvant Chemotherapy in Patients with Early-Stage Breast Cancer

Cited by 11 publications

References 94 publications

Conservative Surgery in cT4 Breast Cancer: Single-Center Experience in the Neoadjuvant Setting

Conservative Surgery in cT4 Breast Cancer: Single-Center Experience in the Neoadjuvant Setting

Development and Assessment of a Novel Core Biopsy-Based Prediction Model for Pathological Complete Response to Neoadjuvant Chemotherapy in Women with Breast Cancer

Challenges and Opportunities in Breast Cancer Care in Low-Resourced Countries, Jordan as An Example

Contact Info

Product

Resources

About