Long-term evaluation of neoadjuvant chemotherapy for breast cancer and influencing factors
HU Chen1, JIA Zhilong2, WEI Xiaochen1, ZHU Liqin1
1.Department of Pharmacy,Tianjin First Central Hospital, Tianjin 300192, China; 2.Medical and Research Department,Medical Center of the Chinese People’s Armed Police Force,Tianjin 300162,China
Abstract：Objective To explore the influencing factors of the curative effect and prognosis of patients with breast cancer who have undergone neoadjuvant chemotherapy.Methods The clinicopathologic data on 190 locally advanced breast cancer patients receiving neoadjuvant chemotherapy was retrospectively collected and the factors that influenced pathologic complete response and prognosis of patients after neoadjuvant chemotherapy were analyzed.Results Among the 190 patients, 22 cases (11.58%) had pathological complete response after neoadjuvant chemotherapy. Univariate analysis showed that the expression level of ki-67, chemotherapy regimen and Luminal typing were correlated with PCR (P<0.05). Multivariate analysis showed that the expression level of ki-67 was an independent factor influencing the pathological complete response after neoadjuvant chemotherapy (P<0.05). The overall 10-year survival rate was 56.3%. Multivariate analysis showed that PCR was an independent factor affecting the survival rate of breast cancer patients after neoadjuvant chemotherapy (P<0.05).Conclusions Ki-67 is an independent factor that affects pathological complete response after neoadjuvant chemotherapy for breast cancer while PCR is an independent factor influencing the prognosis of breast cancer patients after neoadjuvant chemotherapy.
Mcshane L M, Altman D G, Sauerbrei W, et al. Reporting Recommendations for Tumor Marker Prognostic Studies (REMARK)[J]. J Natl Cancer Inst,2005,97(16):1180-1184.
[2]
沈镇宙,邵志敏. 乳腺肿瘤学[M].上海:上海科学技术出版社,2005.4:271.
[3]
Rabanal C, Ruiz R, Neciosup S, et al. Metronomic chemotherapy for non-metastatic triple negative breast cancer: selection is the key[J]. World J Clin Oncol,2017,8(6):437-446.
[4]
Elies A, Riviere S, Pouget N, et al. The role of neoadjuvant chemotherapy in ovarian cancer[J]. Expert Rev Anticancer Ther,2018,18(6):555-566.
[5]
Yalcin B. Overview on locally advanced breast cancer: defining, epidemiology, and overview on neoadjuvant therapy[J]. Exp Oncol,2013,35(4):250-252.
[6]
Chen X S, Wu J Y, Huang O, et al. Molecular subtype can predict the response and outcome of Chinese locally advanced breast cancer patients treated with preoperative therapy[J]. Oncol Rep,2010,23(5):1213-1220.
[7]
Bernard A, William B,John B,et al.Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials[J]. Lancet Oncol,2018,19(1):27-39.
[8]
Abubakar M, Orr N, Daley F, et al. Prognostic value of automated KI67 scoring in breast cancer: a centralised evaluation of 8088 patients from 10 study groups[J]. Breast Cancer Res,2016,18(1):104.
[9]
Ellis M J, Suman V J, Hoog J, et al. Ki67 proliferation index as a tool for chemotherapy decisions during and after neoadjuvant aromatase inhibitor treatment of breast cancer: results from the American College of Surgeons Oncology Group Z1031 Trial (Alliance)[J]. J Clin Oncol,2017,35(10):1061-1069.
[10]
Ei B H, Zribi A, Laabidi S, et al. Ki-67: role in diagnosis, prognosis and follow-up after treatment of breast cancers[J]. Tunis Med,2015,93(12):737-741.
[11]
Luporsi E, Andre F, Spyratos F, et al. Ki-67: level of evidence and methodological considerations for its role in the clinical management of breast cancer: analytical and critical review[J]. Breast Cancer Res Treat,2012,132(3):895-915.
[12]
Darwito D, Dharmana E, Riwanto I, et al. Effects of omega-3 supplementation on Ki-67 and VEGF expression levels and clinical outcomes of locally advanced breast cancer patients treated with neoadjuvant CAF chemotherapy: a randomized controlled trial report[J]. Asian Pac J Cancer Prev,2019,20(3):911-916.
[13]
Tokuda E, Horimoto Y, Arakawa A, et al. Differences in Ki67 expressions between pre- and post-neoadjuvant chemotherapy specimens might predict early recurrence of breast cancer[J]. Hum Pathol,2017,63:40-45.
Luangdilok S, Samarnthai N, Korphaisarn K. Association between pathological complete response and outcome following neoadjuvant chemotherapy in locally advanced breast cancer patients[J]. J Breast Cancer,2014,17(4):376-385.
[17]
Wu K, Yang Q, Liu Y, et al. Meta-analysis on the association between pathologic complete response and triple-negative breast cancer after neoadjuvant chemotherapy[J]. World J Surg Oncol,2014,12:95.
[18]
Chaudhary L N, Wilkinson K H, Kong A. Triple-negative breast cancer: who should receive neoadjuvant chemotherapy?[J]. Surg Oncol Clin N Am,2018,27(1):141-153.
[19]
Perou C M, Sorlie T, Eisen M B, et al. Molecular portraits of human breast tumours[J]. Nature,2000,406(6797):747-752.
[20]
Cazzaniga M E, Pinotti G, Montagna E, et al. Metronomic chemotherapy for advanced breast cancer patients in the real world practice: final results of the VICTOR-6 study[J]. Breast,2019,48:7-16.
2020, Vol. 31 
