RESPONSE TO NEOADJUVANT THERAPY AND LONG-TERM OUTCOME IN PATIENTS WITH TRIPLE NEGATIVE BREAST CANCER

Abstract

Background. Triple negative breast cancer (TNBC) is defined by thelack of estrogen receptors (ER), progesterone receptors (PR) and humanepidermal growth factor receptor 2 (HER-2) expression. In this study weinvestigated response to neoadjuvant chemotherapy in TNBC patients and itsimpact on disease free (DFS) and overall survival (OS).Patients and methods. We identified 134 patients with stage I-III TNBCtreated at Riga East University Hospital between 2009-2012. 48 patients withTNBC received neoadjuvant chemotherapy. Correlation of clinical andpathological parameters with pathologic complete response (pCR) rate,disease-free and overall survival measurements and organ specific relapserates were analysed.Results. 48 patients with stage IIB-IIIC TNBC were included, 17 patientsreceived anthracycline based, 31 patients anthracycline and taxane basedneoadjuvant chemotherapy. 8 patients (16%) had pCR, 38 patients hadincomplete response, 2 patients had disease progression during neoadjuvantchemotherapy. pCR correlates with primary tumor size, but not with otherclinical and pathological factors. At a median follow-up of 30 months, 100%patients who reached pCR were disease-free versus 55% in those withoutpCR (p=0.017). Overall survival was 100% in patients who had pCR versus50% in those without pCR (p=0.020). 2 patients are alive after diseaserecurrence, 20 patients died. The most common sites of disease recurrencewere brain, lung and liver.Conclusions. Patients with TNBC who have a pCR in the breast and axillarynodes have a significantly improved disease-free and overall survival ratecompared with patients with residual disease after neoadjuvantchemotherapy.