Analysis of the effectiveness of various neoadjuvant chemotherapy regimens in patients with T1-3N1-3M0 I–IIIC stage locally advanced breast cancer

Roman S. Pesotsky; Песоцкий Роман Сергеевич; V. F. Semiglazov; Семиглазов В. Ф.; P. V. Krivorotko; Криворотько П. В.; T. T. Tabagua; Табагуа Т. Т.; K. Yu Zernov; Зернов К. Ю.; A. S. Emelyanov; Емельянов А. С.; S. S. Yerechshenko; Ерещенко С. С.; N. Amirov; Амиров Н.; V. V. Mortada; Мортада В. В.; D. G. Ulrikh; Ульрих Д. Г.; V. E. Levchenko; Левченко В. Е.; K. Yu. Rychagov; Рычагов К. Ю.; K. Y. Zirov; Зиров К. Ю.; V. N. Evseev; Евсеев В. Н.

doi:10.18565/pharmateca.2023.6-7.94-100

Analysis of the effectiveness of various neoadjuvant chemotherapy regimens in patients with T1-3N1-3M0 I–IIIC stage locally advanced breast cancer

Autores: Pesotsky R.S.¹, Semiglazov V.F.¹^,2, Krivorotko P.V.¹, Tabagua T.T.¹, Zernov K.Y.¹, Emelyanov A.S.¹, Yerechshenko S.S.¹, Amirov N.¹, Mortada V.V.¹, Ulrikh D.G.¹, Levchenko V.E.³, Rychagov K.Y.¹, Zirov K.Y.⁴, Evseev V.N.⁵
Afiliações:
1. N.N. Petrov National Medical Research Center of Oncology
2. North-Western State Medical University named after I.I. Mechnikov
3. City Clinical Oncological Dispensary
4. Russian Biotechnological University (ROSBIOTECH)
5. MEDSI LLC
Edição: Volume 30, Nº 6/7 (2023)
Páginas: 94-100
Seção: Original articles
URL: https://journals.eco-vector.com/2073-4034/article/view/562819
DOI: https://doi.org/10.18565/pharmateca.2023.6-7.94-100
ID: 562819

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Background. Determining the most effective drug therapy regimens is one of the top priorities in the individualization of the treatment of patients with breast cancer (BC). When studying neoadjuvant systemic therapy (NST) in many domestic and foreign studies, the achievement of pathological complete response (pCR), an important prognostic factor, is use as the surrogate primary end point. According to the literature, the achievement of pCR after NST in breast cancer varies from 30 to 70%. Patients who do not achieve pCR require post-neoadjuvant treatment.

Objective. Determination of the correlation between the schemes of NST and the degree of tumor response based on the results of postoperative pathological findings on the RCB scale.

Methods. We analyzed the data of 455 patients aged 18–65 years with T1-3N1-3M0 I–IIIC stage locally advanced breast cancer, who underwent NST. This study included patients treated at the N.N. Petrova National Medical Research Center of Oncology from 2015 to 2021.

Results. Data analysis revealed the most effective combinations of drugs expressed in the degree of pathomorphological response according to the RCB scale.

Conclusion. Neoadjuvant chemotherapy regimens that allow achieving a pathological complete response in triple-negative and HER2-positive breast cancer have been defined. An assessment of adverse factors that affect the effectiveness of organ-preserving treatment and correlate with a deterioration in overall survival was performed.

Palavras-chave

breast cancer, neoadjuvant systemic therapy, chemotherapy, complete pathomorphological regression

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Sobre autores

Roman Pesotsky

N.N. Petrov National Medical Research Center of Oncology

Autor responsável pela correspondência
Email: shipmeback@gmail.com
ORCID ID: 0000-0002-2573-2211

Oncologist, Department of Breast Tumors

Rússia, St. Petersburg

Bibliografia

Mathew J., et al. Neoadjuvant chemotherapy for locally advanced breast cancer: A review of the literature and future directions. Eur J Surg Oncol. (EJSO). 2009;2(35):113–22. doi: 10.1016/j.ejso.2008.03.015.
Burstein H.J., et al. Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer 2021. Ann Oncol. 2021;10(32):1216–35. doi: 10.1016/j.annonc.2021.06.023.
Golshan M., et al. Impact of Neoadjuvant Chemotherapy in Stage II–III Triple Negative Breast Cancer on Eligibility for Breast-conserving Surgery and Breast Conservation Rates. Ann Surg. 2015;3(262):434–39.
Specht J., Gralow J. R. Neoadjuvant chemotherapy for locally advanced breast cancer. Seminars in radiation oncology. WB Saunders, 2009. Vol. 19. №. 4. С. 222-228.
Golshan M., et al. Impact of neoadjuvant therapy on eligibility for and frequency of breast conservation in stage II–III HER2-positive breast cancer: surgical results of CALGB 40601 (Alliance). Breast Cancer Res Treat. 2016;2(160):297–304. doi: 10.1007/s10549-016-4006-6.
Leal F. et al. Neoadjuvant endocrine therapy for resectable breast cancer: A systematic review and meta-analysis. Breast. 2015;4(24):406–12. doi: 10.1016/j.breast.2015.03.004.
Golshan M., et al. Breast Conservation After Neoadjuvant Chemotherapy for Triple-Negative Breast Cancer. JAMA Surg. 2020;3(155):e195410. doi: 10.1001/jamasurg.2019.5410.
Semiglazov V.F., et al. Primary (neoadjuvant) chemotherapy and radiotherapy compared with primary radiotherapy alone in stage IIb-IIIa breast cancer. Ann Oncol. 1994;7(5):591–95. doi: 10.1093/oxfordjournals.annonc.a058929.
Semiglazov V.F., et al. The relative efficacy of neoadjuvant endocrine therapy vs chemotherapy in postmenopausal women with ER- positive breast cancer. J Clin Oncol. 2004;22(Suppl. 14):519–19.
Pelizzari G., et al. Post-neoadjuvant strategies in breast cancer: From risk assessment to treatment escalation. Cancer Treat Rev. 2019;72:7–14. doi: 10.1016/j.ctrv.2018.10.014.
Каприн А.Д. и др. Комбинированное и комплексное лечение больных раком молочной железы. Клинические рекомендации. Ассоциация онкологов России. 2021. [Kaprin A.D. and other Combined and complex treatment of patients with breast cancer. Clinical guidelines. Association of Oncologists of Russia. 2021. (In Russ.)].
Гиголаева Л.П. и др. Оценка эффективности неоадъювантной химиотерапии у больных с местно-распространенным BRCA-ассоциированным раком молочной железы. Злокачественные опухоли. 2018;8 (Спецвыпуск 1):29–36. [Gigolaeva L.P. Evaluation of the effectiveness of neoadjuvant chemotherapy in patients with locally advanced BRCA-associated breast cancer. Zlokachestvennye opukholi=Malignant tumors. 2018;8(Special Issue 1):29–36. (In Russ.)].
Meijnen P., Oldenburg H.S., Loo C.E. Risk of invasion and axillary lymph node metastasis in ductal carcinoma in situ diagnosed by core-needle biopsy. Br J Surg. 2007;8(94):952–56. doi: 10.1002/bjs.5735.
Denkert C., et al. Tumour-infiltrating lymphocytes and prognosis in different subtypes of breast cancer: a pooled analysis of 3771 patients treated with neoadjuvant therapy. Lancet. Oncol. 2018;1(19):40–50. doi: 10.1016/S1470-2045(17)30904-X.
Loi S., et al. Tumor infiltrating lymphocytes are prognostic in triple negative breast cancer and predictive for trastuzumab benefit in early breast cancer: results from the FinHER trial. Ann Oncol. 2014;8(25):1544–50. doi: 10.1093/annonc/mdu112.