Pathological Response in the Breast and Axillary Lymph Nodes after Neoadjuvant Systemic Treatment in Patients with Initially Node-Positive Breast Cancer Correlates with Disease Free Survival: An Exploratory Analysis of the GeparOcto Trial

Gerber B, Schneeweiss A, Möbus V, Golatta M, Tesch H, Krug D, Hanusch C, Denkert C, Lübbe K, Heil J, Huober J, Ataseven B, Klare P, Hahn M, Untch M, Kast K, Jackisch C, Thomalla J, Seither F, Blohmer JU, Rhiem K, Fasching P, Nekljudova V, Loibl S, Kühn T (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Book Volume: 14

Article Number: 521

Journal Issue: 3

DOI: 10.3390/cancers14030521

Abstract

Background: The conversion of initially histologically confirmed axillary lymph node-positive (pN+) to ypN0 after neoadjuvant systemic treatment (NAST) is an important prognostic factor in breast cancer (BC) patients and may influence surgical de-escalation strategies. We aimed to determine pCR rates in lymph nodes (pCR-LN), the breast (pCR-B), and both (tpCR) in women who present with pN+ BC, to assess predictors for response and the impact of pCR-LN, pCR-B, and tpCR on invasive disease-free survival (iDFS). Methods: Retrospective, exploratory analysis of 242 patients with pN+ at diagnosis from the multicentric, randomized GeparOcto trial. Results: Of 242 patients with initially pN+ disease, 134 (55.4%) had a pCR-LN, and 109 (45.0%) a pCR-B. Of the 109 pCR-B patients, 9 (8.3%) patients had involved LN, and 100 (41.3%) patients had tpCR. Those with involved LN still had a bad prognosis. As expected, pCR-B and intrinsic subtypes (TNBC and HER2+) were identified as independent predictors of pCR-LN. pCR-LN (ypN0; hazard ratio 0.42; 95%, CI 0.23–0.75; p = 0.0028 for iDFS) was the strongest independent prognostic factor. Conclusions: In initially pN+ patients undergoing NAST, the conversion to ypN0 is of high prognostic value. Surgical axillary staging after NAST is still essential in these patients to offer tailored treatment.

Authors with CRIS profile

Involved external institutions

Universität Rostock Germany (DE) Deutsches Krebsforschungszentrum (DKFZ) Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Ruprecht-Karls-Universität Heidelberg Germany (DE) Agaplesion Markus Krankenhaus Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Rotkreuzklinikum München Germany (DE) Philipps-Universität Marburg Germany (DE) Universitätsklinikum Ulm Germany (DE) Klinikum der Universität München Germany (DE) Eberhard Karls Universität Tübingen Germany (DE) HELIOS Kliniken Germany (DE) Universitätsklinikum Köln Germany (DE) Sana Klinikum Offenbach Germany (DE) Praxis für Hämatologie und Onkologie Koblenz Germany (DE) GBG Forschungs GmbH (German Breast Group) Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Städtische Kliniken Esslingen Germany (DE)

How to cite

APA:

Gerber, B., Schneeweiss, A., Möbus, V., Golatta, M., Tesch, H., Krug, D.,... Kühn, T. (2022). Pathological Response in the Breast and Axillary Lymph Nodes after Neoadjuvant Systemic Treatment in Patients with Initially Node-Positive Breast Cancer Correlates with Disease Free Survival: An Exploratory Analysis of the GeparOcto Trial. Cancers, 14(3). https://doi.org/10.3390/cancers14030521

MLA:

Gerber, Bernd, et al. "Pathological Response in the Breast and Axillary Lymph Nodes after Neoadjuvant Systemic Treatment in Patients with Initially Node-Positive Breast Cancer Correlates with Disease Free Survival: An Exploratory Analysis of the GeparOcto Trial." Cancers 14.3 (2022).

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