Treatment of residual breast cancer


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Abstract

Background. Patients with residual tumors after neoadjuvant systemic therapy (NST) are at greater risk of relapse compared with those who have achieved complete pathomorphological tumor regression (pCR). Objective: to improve treatment outcomes for residual breast cancer after neoadjuvant systemic therapy. Methods. The study included information on 339 patients with breast cancer (BC) who received NST at the N.N. Petrov National Research Center of Oncology. Results. Residual tumor was detected in 212 (62.5%) patients. The presence of a residual tumor worsens the 3-year survival rate for all BC subtypes, especially with a triple negative phenotype (TNBC; 48.8 versus 91.8%; p=0.01). In TNBC, the risk of disease recurrence is 2 higher than that in patients with HER2-positive and luminal B BC subtypes (51.2 versus 23.9 and 25.6%; p=0.02). In patients with TNBC with a residual tumor after NST (anthracyclines and taxanes), the administration of adjuvant therapy with capecitabine improves the relapse-free survival rate. Conclusion. Further progress in the treatment of the most aggressive types of breast cancer (triply negative and HER2-positive phenotypes) is associated with immunotherapy. Randomized clinical trials are evaluating the contribution of anti-PD-L1 immunotherapy (atesolizumab) in combination with chemotherapy (TNBC) or targeted therapy (HER2+) in the treatment of patients with metastatic or locally advanced breast cancer.

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About the authors

S. S Ereschenko

N.N. Petrov National Medical Research Center for Oncology

St. Petersburg, Russia

V. F Semiglazov

N.N. Petrov National Medical Research Center for Oncology

Email: vsemiglazov@mail.ru
Dr. Sci. (Med.), Corr. Member of RAS, Professor, Head of the Scientific Department, Chief Researcher at the Scientific Department of Breast Tumors 68, Leningradskaya str., Pesochny settlement, St. Petersburg 197758, Russian Federation

P. V Krivorotko

N.N. Petrov National Medical Research Center for Oncology

St. Petersburg, Russia

G. A Dashyan

N.N. Petrov National Medical Research Center for Oncology

St. Petersburg, Russia

V. O Smirnova

N.N. Petrov National Medical Research Center for Oncology

St. Petersburg, Russia

A. V Komyakhov

N.N. Petrov National Medical Research Center for Oncology

St. Petersburg, Russia

L. P Gigolaeva

N.N. Petrov National Medical Research Center for Oncology

St. Petersburg, Russia

E. K Zhiltsova

N.N. Petrov National Medical Research Center for Oncology

St. Petersburg, Russia

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