Universität zu Köln

Marme, Frederik, Solbach, Christine, Michel, Laura, Schneeweiss, Andreas, Blohmer, Jens-Uwe ORCID: 0000-0002-7969-250X, Huober, Jens, Fasching, Peter A., Jackisch, Christian, Nekljudova, Valentina, Link, Theresa, Rhiem, Kerstin, Rey, Julia, Denkert, Carsten, Hanusch, Claus, Tesch, Hans, Lederer, Bianca, Loibl, Sibylle and Untch, Michael (2021). Utility of the CPS plus EG scoring system in triple-negative breast cancer treated with neoadjuvant chemotherapy. Eur. J. Cancer, 153. S. 203 - 213. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0852

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Abstract

Background: Pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) is associated with superior survival. This association is strongest in triple negative breast cancer (TNBC). The CPS + EG system, based on pre-treatment clinical (CS) and post-treatment pathological stage (PS), oestrogen-receptor status (E) and grade (G), leads to a refined estimate of prognosis after NACT in all-comers and hormone receptor-positive/ human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Here, we investigate if CPS + EG scoring provides a superior estimate of prognosis in TNBC to select patients for postneoadjuvant therapy. Methods: We calculated the CPS + EG score for 1795 patients with TNBC from 8 prospective German trials. Five-year disease-free survival (DFS) and overall survival estimates were calculated using the Kaplan-Meier method. Results: In TNBC, patients with pCR (ypT0/is ypN0, n = 822, 45.8%) had a 5-year DFS of 86%, whereas patients with residual American Joint Committee on Cancer stage I disease (n = 383; 21.3%) had a 5-year DFS of 77.5%.CPS + EG led to superior prognostic information compared with that provided by the clinical stage, but it was inferior to the prognostic information provided by the pathological stage (c-index statistics, p < 0.001). CPS + EG did not discriminate prognosis within the two best prognostic groups (score 1 and 2; n = 362; 37.2%). In contrast, pCR status added prognostic information beyond CPS + EG. Patients with a CPS + EG score of 3 had a 5-year DFS rate of 64% overall, but those with pCR had a 5-year DFS rate of 84%, and those without pCR had a 5-year DFS rate of only 49.7%. Conclusions: In TNBC, CPS + EG scoring provided inferior prognostic information compared with the pathological stage and was unable to identify patients without pCR and with a sufficiently good prognosis, who could avoid postneoadjuvant therapy. pCR remains the strongest and most clinically useful prognostic factor after NACT. Other biologic factors beyond pCR are needed in TNBC. 2021 Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Marme, Frederik UNSPECIFIED UNSPECIFIED UNSPECIFIED Solbach, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Michel, Laura UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneeweiss, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Blohmer, Jens-Uwe UNSPECIFIED orcid.org/0000-0002-7969-250X UNSPECIFIED Huober, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Fasching, Peter A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jackisch, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Nekljudova, Valentina UNSPECIFIED UNSPECIFIED UNSPECIFIED Link, Theresa UNSPECIFIED UNSPECIFIED UNSPECIFIED Rhiem, Kerstin UNSPECIFIED UNSPECIFIED UNSPECIFIED Rey, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Denkert, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hanusch, Claus UNSPECIFIED UNSPECIFIED UNSPECIFIED Tesch, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Lederer, Bianca UNSPECIFIED UNSPECIFIED UNSPECIFIED Loibl, Sibylle UNSPECIFIED UNSPECIFIED UNSPECIFIED Untch, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-603592
DOI:	10.1016/j.ejca.2021.05.027
Journal or Publication Title:	Eur. J. Cancer
Volume:	153
Page Range:	S. 203 - 213
Date:	2021
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-0852
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PATHOLOGICAL COMPLETE RESPONSE; TAXANE-BASED CHEMOTHERAPY; STAGING SYSTEM; DOSE-DENSE; SURVIVAL; CYCLOPHOSPHAMIDE; CAPECITABINE; TRASTUZUMAB; BURDEN; BEVACIZUMAB Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60359