Clinical Research Papers:
Pathological complete response as a surrogate for relapse-free survival in patients with triple negative breast cancer after neoadjuvant chemotherapy
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JunJie Li1,2,*, Sheng Chen1,2,*, CanMing Chen1,2, GenHong Di1,2, GuangYu Liu1,2, Jiong Wu1,2 and ZhiMin Shao1,2
1 Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China
* These authors have contributed equally to this work
ZhiMin Shao, email:
Keywords: breast cancer; neoadjuvant; pathological complete response; triple negative
Received: December 03, 2015 Accepted: March 31, 2016 Published: May 14, 2016
We retrospective analyzed triple negative breast cancer (TNBC) patients who received either taxane-based or anthracycline-based neoadjuvant chemotherapy, evaluated whether pathological complete response (pCR) is a surrogate endpoint for relapse free survival (RFS) in TNBC and explored which subgroup of patients benefits more from superior treatment regimen. 186 patients received taxane-based (Group A) or anthracycline-based (Group B) neoadjuvant chemotherapy, median follow-up was 48.1 months. 42 patients received total pCR (ypT0/is ypN0), 34 in Group A and 8 in Group B, p < 0.001. Patients who achieved pCR had an increased RFS when compared with non-pCR patients, p = 0.043. Patients in Group A had a better RFS, p = 0.025, after adjusting for tumor size and clinical lymph node status before neoadjuvant therapy. Only patients sensitive to neoadjuvant chemotherapy exhibited RFS benefit from taxane-based treatment, and those who were treatment insensitive had similar RFS between both groups. Our analysis showed Taxane-based regimen had higher pCR rate and could predict improved RFS in TNBC, and the prognostic value was greater in treatment sensitive patients. This retrospective analysis supports the use of pCR as a surrogate endpoint for RFS in TNBC.
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