TY - JOUR
T1 - Clinical outcomes after 1 versus 2-3 lines of neoadjuvant therapy in stage III inflammatory breast cancer
AU - Nakhlis, Faina
AU - Niman, Samuel M.
AU - Ueno, Naoto T.
AU - Troll, Elizabeth
AU - Ryan, Sean
AU - Yeh, Eren
AU - Warren, Laura
AU - Bellon, Jennifer
AU - Harrison, Beth
AU - Iwase, Toshiaki
AU - Carisa Le-Petross, H. T.
AU - Saleem, Sadia
AU - Teshome, Mediget
AU - Whitman, Gary J.
AU - Woodward, Wendy A.
AU - Overmoyer, Beth
AU - Tolaney, Sara M.
AU - Regan, Meredith
AU - Lynce, Filipa
AU - Layman, Rachel M.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023.
PY - 2024/4
Y1 - 2024/4
N2 - Purpose: Many stage III inflammatory breast cancer (IBC) patients experience a sufficient response to first-line (1L) neoadjuvant chemotherapy (NAC) to allow surgery, while some require additional NAC. We evaluated the pathologic complete response (pCR), breast cancer-free survival (BCFS) and overall survival (OS) among patients requiring 1 vs. 2-3 lines (L) of NAC prior to surgery. Methods: Stage III IBC patients from 2 institutions who received 1L or 2-3L of NAC prior to surgery were identified. Hormone receptor and HER2 status, grade, and pCR were evaluated. BCFS and OS were evaluated by the Kaplan–Meier method. Multivariable Cox models were utilized to estimate the hazard ratio (HR). Results: 808 eligible patients (1997–2020) were identified (median age 51 years, median follow-up 69 months). 733 (91%) had 1L and 75 (9%) had 2-3L of NAC. Grade III, triple-negative and HER2-positive disease were more prevalent in 2-3L patients. 178 (24%) 1L and 14 (19%) 2-3L patients had pCR. 376 1L patients and 41 2-3L patients had recurrences. The 5-year BCFS was worse for the 2-3L group (33 vs. 46%, HR = 1.37; 95% CI 0.99–1.91). However, in 192 patients with a pCR, BCFS was similar (76 vs. 83% in 1L vs. 2-3L, respectively). There were 308 deaths (276 among 1L and 32 among 2-3L patients). The 5-year OS in 1L vs. 2-3L was 60 vs. 53% (HR = 1.32, 95% CI 0.91–1.93). Conclusions: Among stage III IBC patients, pCR rates were similar, irrespective of the NAC lines number, and BCFS and OS were comparable with pCR after 1L and 2-3L.
AB - Purpose: Many stage III inflammatory breast cancer (IBC) patients experience a sufficient response to first-line (1L) neoadjuvant chemotherapy (NAC) to allow surgery, while some require additional NAC. We evaluated the pathologic complete response (pCR), breast cancer-free survival (BCFS) and overall survival (OS) among patients requiring 1 vs. 2-3 lines (L) of NAC prior to surgery. Methods: Stage III IBC patients from 2 institutions who received 1L or 2-3L of NAC prior to surgery were identified. Hormone receptor and HER2 status, grade, and pCR were evaluated. BCFS and OS were evaluated by the Kaplan–Meier method. Multivariable Cox models were utilized to estimate the hazard ratio (HR). Results: 808 eligible patients (1997–2020) were identified (median age 51 years, median follow-up 69 months). 733 (91%) had 1L and 75 (9%) had 2-3L of NAC. Grade III, triple-negative and HER2-positive disease were more prevalent in 2-3L patients. 178 (24%) 1L and 14 (19%) 2-3L patients had pCR. 376 1L patients and 41 2-3L patients had recurrences. The 5-year BCFS was worse for the 2-3L group (33 vs. 46%, HR = 1.37; 95% CI 0.99–1.91). However, in 192 patients with a pCR, BCFS was similar (76 vs. 83% in 1L vs. 2-3L, respectively). There were 308 deaths (276 among 1L and 32 among 2-3L patients). The 5-year OS in 1L vs. 2-3L was 60 vs. 53% (HR = 1.32, 95% CI 0.91–1.93). Conclusions: Among stage III IBC patients, pCR rates were similar, irrespective of the NAC lines number, and BCFS and OS were comparable with pCR after 1L and 2-3L.
KW - Inflammatory breast cancer
KW - Neoadjuvant chemotherapy
KW - Pathologic complete response
KW - Resectability
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U2 - 10.1007/s10549-023-07195-5
DO - 10.1007/s10549-023-07195-5
M3 - Article
C2 - 38155272
AN - SCOPUS:85180665832
SN - 0167-6806
VL - 204
SP - 289
EP - 297
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 2
ER -