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Early ultrasound evaluation identifies excellent responders to neoadjuvant systemic therapy among patients with triple‐negative breast cancer
- Source :
- Cancer
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- BACKGROUND Heterogeneity exists in the response of triple-negative breast cancer (TNBC) to standard anthracycline (AC)/taxane-based neoadjuvant systemic therapy (NAST), with 40% to 50% of patients having a pathologic complete response (pCR) to therapy. Early assessment of the imaging response during NAST may identify a subset of TNBCs that are likely to have a pCR upon completion of treatment. The authors aimed to evaluate the performance of early ultrasound (US) after 2 cycles of neoadjuvant NAST in identifying excellent responders to NAST among patients with TNBC. METHODS Two hundred fifteen patients with TNBC were enrolled in the ongoing ARTEMIS (A Robust TNBC Evaluation Framework to Improve Survival) clinical trial. The patients were divided into a discovery cohort (n = 107) and a validation cohort (n = 108). A receiver operating characteristic analysis with 95% confidence intervals (CIs) and a multivariate logistic regression analysis were performed to model the probability of a pCR on the basis of the tumor volume reduction (TVR) percentage by US from the baseline to after 2 cycles of AC. RESULTS Overall, 39.3% of the patients (42 of 107) achieved a pCR. A positive predictive value (PPV) analysis identified a cutoff point of 80% TVR after 2 cycles; the pCR rate was 77% (17 of 22) in patients with a TVR ≥ 80%, and the area under the curve (AUC) was 0.84 (95% CI, 0.77-0.92; P < .0001). In the validation cohort, the pCR rate was 44%. The PPV for pCR with a TVR ≥ 80% after 2 cycles was 76% (95% CI, 55%-91%), and the AUC was 0.79 (95% CI, 0.70-0.87; P < .0001). CONCLUSIONS The TVR percentage by US evaluation after 2 cycles of NAST may be a cost-effective early imaging biomarker for a pCR to AC/taxane-based NAST.
- Subjects :
- Oncology
Cancer Research
medicine.medical_specialty
Anthracycline
Triple Negative Breast Neoplasms
Article
03 medical and health sciences
0302 clinical medicine
Breast cancer
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Anthracyclines
030212 general & internal medicine
Triple-negative breast cancer
Ultrasonography
Taxane
business.industry
Area under the curve
medicine.disease
Neoadjuvant Therapy
Confidence interval
Tumor Burden
Clinical trial
Treatment Outcome
030220 oncology & carcinogenesis
Cohort
Female
Taxoids
business
Subjects
Details
- ISSN :
- 10970142 and 0008543X
- Volume :
- 127
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....43b248fd85f93cc33db8890223ada0e8