Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

Dominique J.P. Van Uden (Corresponding Author), Marissa Corine van Maaren, Peter Bult, Luc J.A. Strobbe, Johannes J.M. van der Hoeven, C.F.J.M. Blanken-Peeters, Sabine Siesling, Johannes H.W. de Wilt

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Abstract

Purpose To analyze the influence of hormone receptors (HR) and Human Epidermal growth factor Receptor-2 (HER2)-based molecular subtypes in stage III inflammatory breast cancer (IBC) on tumor characteristics, treatment, pathologic response to neoadjuvant chemotherapy (NACT), and overall survival (OS). Methods Patients with stage III IBC, diagnosed in the Netherlands between 2006 and 2015, were classified into four breast cancer subtypes: HR+/HER2− , HR+/HER2+ , HR−/HER2+ , and HR−/HER2− . Patient-, tumor- and treatment-related characteristics were compared. In case of NACT, pathologic complete response (pCR) was compared between subgroups. OS of the subtypes was compared using Kaplan–Meier curves and the log-rank test. Results 1061 patients with stage III IBC were grouped into subtypes: HR+/HER2− (N = 453, 42.7%), HR−/HER2− (N = 258, 24.3%), HR−/HER2+ (N = 180,17.0%), and HR+/HER2+ (N = 170,16.0%). In total, 679 patients (85.0%) received NACT. In HR−/HER2+ tumors, pCR rate was highest (43%, (p < 0.001). In case of pCR, an improved survival was observed for all subtypes, especially for HR+/HER2+ and HR−/HER2+ tumor subtypes. Trimodality therapy (NACT, surgery, radiotherapy) improved 5-year OS as opposed to patients not receiving this regimen: HR+/HER2− (74.9 vs. 46.1%), HR+/HER2+ (80.4 vs. 52.6%), HR−/HER2+ (76.4 vs. 29.7%), HR−/HER2− (47.6 vs. 27.8%). Conclusions In stage III IBC, breast cancer subtypes based on the HR and HER2 receptor are important prognostic factors of response to NACT and OS. Patients with HR−/HER2− IBC were less likely to achieve pCR and had the worst OS, irrespective of receiving most optimal treatment regimen to date (trimodality therapy).
Original languageEnglish
Pages (from-to)217-226
JournalBreast cancer research and treatment
Volume176
Issue number1
Early online date10 Apr 2019
DOIs
Publication statusPublished - 1 Jul 2019

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Inflammatory Breast Neoplasms
Hormones
Breast Neoplasms
Survival
Drug Therapy
human ERBB2 protein
Neoplasms

Keywords

  • UT-Hybrid-D

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Van Uden, D. J. P., van Maaren, M. C., Bult, P., Strobbe, L. J. A., van der Hoeven, J. J. M., Blanken-Peeters, C. F. J. M., ... de Wilt, J. H. W. (2019). Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer. Breast cancer research and treatment, 176(1), 217-226. https://doi.org/10.1007/s10549-019-05219-7
Van Uden, Dominique J.P. ; van Maaren, Marissa Corine ; Bult, Peter ; Strobbe, Luc J.A. ; van der Hoeven, Johannes J.M. ; Blanken-Peeters, C.F.J.M. ; Siesling, Sabine ; de Wilt, Johannes H.W. / Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer. In: Breast cancer research and treatment. 2019 ; Vol. 176, No. 1. pp. 217-226.
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abstract = "Purpose To analyze the influence of hormone receptors (HR) and Human Epidermal growth factor Receptor-2 (HER2)-based molecular subtypes in stage III inflammatory breast cancer (IBC) on tumor characteristics, treatment, pathologic response to neoadjuvant chemotherapy (NACT), and overall survival (OS). Methods Patients with stage III IBC, diagnosed in the Netherlands between 2006 and 2015, were classified into four breast cancer subtypes: HR+/HER2− , HR+/HER2+ , HR−/HER2+ , and HR−/HER2− . Patient-, tumor- and treatment-related characteristics were compared. In case of NACT, pathologic complete response (pCR) was compared between subgroups. OS of the subtypes was compared using Kaplan–Meier curves and the log-rank test. Results 1061 patients with stage III IBC were grouped into subtypes: HR+/HER2− (N = 453, 42.7{\%}), HR−/HER2− (N = 258, 24.3{\%}), HR−/HER2+ (N = 180,17.0{\%}), and HR+/HER2+ (N = 170,16.0{\%}). In total, 679 patients (85.0{\%}) received NACT. In HR−/HER2+ tumors, pCR rate was highest (43{\%}, (p < 0.001). In case of pCR, an improved survival was observed for all subtypes, especially for HR+/HER2+ and HR−/HER2+ tumor subtypes. Trimodality therapy (NACT, surgery, radiotherapy) improved 5-year OS as opposed to patients not receiving this regimen: HR+/HER2− (74.9 vs. 46.1{\%}), HR+/HER2+ (80.4 vs. 52.6{\%}), HR−/HER2+ (76.4 vs. 29.7{\%}), HR−/HER2− (47.6 vs. 27.8{\%}). Conclusions In stage III IBC, breast cancer subtypes based on the HR and HER2 receptor are important prognostic factors of response to NACT and OS. Patients with HR−/HER2− IBC were less likely to achieve pCR and had the worst OS, irrespective of receiving most optimal treatment regimen to date (trimodality therapy).",
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Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer. / Van Uden, Dominique J.P. (Corresponding Author); van Maaren, Marissa Corine; Bult, Peter; Strobbe, Luc J.A.; van der Hoeven, Johannes J.M.; Blanken-Peeters, C.F.J.M.; Siesling, Sabine ; de Wilt, Johannes H.W.

In: Breast cancer research and treatment, Vol. 176, No. 1, 01.07.2019, p. 217-226.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Pathologic complete response and overall survival in breast cancer subtypes in stage III inflammatory breast cancer

AU - Van Uden, Dominique J.P.

AU - van Maaren, Marissa Corine

AU - Bult, Peter

AU - Strobbe, Luc J.A.

AU - van der Hoeven, Johannes J.M.

AU - Blanken-Peeters, C.F.J.M.

AU - Siesling, Sabine

AU - de Wilt, Johannes H.W.

N1 - Springer deal

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Purpose To analyze the influence of hormone receptors (HR) and Human Epidermal growth factor Receptor-2 (HER2)-based molecular subtypes in stage III inflammatory breast cancer (IBC) on tumor characteristics, treatment, pathologic response to neoadjuvant chemotherapy (NACT), and overall survival (OS). Methods Patients with stage III IBC, diagnosed in the Netherlands between 2006 and 2015, were classified into four breast cancer subtypes: HR+/HER2− , HR+/HER2+ , HR−/HER2+ , and HR−/HER2− . Patient-, tumor- and treatment-related characteristics were compared. In case of NACT, pathologic complete response (pCR) was compared between subgroups. OS of the subtypes was compared using Kaplan–Meier curves and the log-rank test. Results 1061 patients with stage III IBC were grouped into subtypes: HR+/HER2− (N = 453, 42.7%), HR−/HER2− (N = 258, 24.3%), HR−/HER2+ (N = 180,17.0%), and HR+/HER2+ (N = 170,16.0%). In total, 679 patients (85.0%) received NACT. In HR−/HER2+ tumors, pCR rate was highest (43%, (p < 0.001). In case of pCR, an improved survival was observed for all subtypes, especially for HR+/HER2+ and HR−/HER2+ tumor subtypes. Trimodality therapy (NACT, surgery, radiotherapy) improved 5-year OS as opposed to patients not receiving this regimen: HR+/HER2− (74.9 vs. 46.1%), HR+/HER2+ (80.4 vs. 52.6%), HR−/HER2+ (76.4 vs. 29.7%), HR−/HER2− (47.6 vs. 27.8%). Conclusions In stage III IBC, breast cancer subtypes based on the HR and HER2 receptor are important prognostic factors of response to NACT and OS. Patients with HR−/HER2− IBC were less likely to achieve pCR and had the worst OS, irrespective of receiving most optimal treatment regimen to date (trimodality therapy).

AB - Purpose To analyze the influence of hormone receptors (HR) and Human Epidermal growth factor Receptor-2 (HER2)-based molecular subtypes in stage III inflammatory breast cancer (IBC) on tumor characteristics, treatment, pathologic response to neoadjuvant chemotherapy (NACT), and overall survival (OS). Methods Patients with stage III IBC, diagnosed in the Netherlands between 2006 and 2015, were classified into four breast cancer subtypes: HR+/HER2− , HR+/HER2+ , HR−/HER2+ , and HR−/HER2− . Patient-, tumor- and treatment-related characteristics were compared. In case of NACT, pathologic complete response (pCR) was compared between subgroups. OS of the subtypes was compared using Kaplan–Meier curves and the log-rank test. Results 1061 patients with stage III IBC were grouped into subtypes: HR+/HER2− (N = 453, 42.7%), HR−/HER2− (N = 258, 24.3%), HR−/HER2+ (N = 180,17.0%), and HR+/HER2+ (N = 170,16.0%). In total, 679 patients (85.0%) received NACT. In HR−/HER2+ tumors, pCR rate was highest (43%, (p < 0.001). In case of pCR, an improved survival was observed for all subtypes, especially for HR+/HER2+ and HR−/HER2+ tumor subtypes. Trimodality therapy (NACT, surgery, radiotherapy) improved 5-year OS as opposed to patients not receiving this regimen: HR+/HER2− (74.9 vs. 46.1%), HR+/HER2+ (80.4 vs. 52.6%), HR−/HER2+ (76.4 vs. 29.7%), HR−/HER2− (47.6 vs. 27.8%). Conclusions In stage III IBC, breast cancer subtypes based on the HR and HER2 receptor are important prognostic factors of response to NACT and OS. Patients with HR−/HER2− IBC were less likely to achieve pCR and had the worst OS, irrespective of receiving most optimal treatment regimen to date (trimodality therapy).

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SN - 0167-6806

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