![]() ![]() Additionally, we tested whether different intrinsic subtypes using the same cut-off year at 2010 have any impact on OS, DFS and pCR rates. In the present study, we addressed the question, whether there is a prognostic difference in breast cancer patients treated with neoadjuvant chemotherapy prior to or after 2010 due to relevant changes in treatment strategies such as the use of platinum containing regimens. Based on annual and bi-annual consensus definitions, the treatment guidelines for the different intrinsic subtypes have been adapted several times during the past decades 8. Gallen consensus recommendations, tumors were classified into four different molecular subtypes: triple negative, HER2+, Luminal A und Luminal B like (HER2+ or enriched and HER2− 8. The distinct biological subtypes response differently to systemic and local treatments and differ in their epidemiological risk factors 8. Depending on the intrinsic breast-cancer subtypes, the incidence and prognostic impact of pCR can 2 vary. pCR is defined as no invasive residual tumor (in some guidelines also including the complete absence of in situ carcinoma) in breast and lymph nodes after neoadjuvant 2. ![]() Patients with pathologic complete response (pCR) after neoadjuvant chemotherapy have been shown to have improved disease-free survival (DFS) and overall survival (OS) 2, 5, 7. Due to increased risk for metastasis of the HER2-receptor positive and triple negative subtypes, patients may also benefit from early treatment of possible distant micro-metastasis with neoadjuvant 5, 6. In a large meta-analysis of the Early Breast Cancer Trialists Collaborative Group, several studies could confirm a similar mortality following adjuvant and neoadjuvant therapy 4. Obtaining a complete pathological response has been clearly shown to improve overall survival (OS) 2. In more recent years, neoadjuvant chemotherapy has been increasingly used for operable (early) breast cancer because of the several advantages like improved rates of breast-conserving therapy, minimizing the need for axillary lymph node dissection and collecting information on chemosensitivity in-vivo including the possibility to switch therapy if the response is inadequate 2, 3. Since the early years of the 1970s, neoadjuvant chemotherapy has been used to downstage locally advanced cancer to make it operable 1. Clinico-pathological factors and distinct therapy regiments especially in triple negative and HER2+ subtypes have prognostic impact on pCR, OS and DFS after neoadjuvant chemotherapy. Nodal stage and intrinsic subtypes (pre- and postoperative) significantly correlated with OS ( p 30%), clinical metastatic stage and pathological tumor stage had prognostic impact on OS ( p < 0.001, p = 0.0001, p = 0.002). 57 (17%) patients died recurrences occurred in 103 of 342 (30%) patients. Two subgroups were separated using an arbitrary cut-off year at 2009/2010, due to 2010 when platinum containing regimens were first administered. Overall survival (OS) was correlated with preoperative clinical stage, postoperative pathological stage, treatment modalities and tumor biology before and after chemotherapy. 342 female breast cancer stage I-IV patients receiving neoadjuvant chemotherapy between 20 were analyzed. This retrospective study addresses the question how biomarker profiles and treatment modalities in the neoadjuvant chemotherapy setting have changed during the past 15 years and what prognostic impact these changes implicate. ![]() Response rates to systemic and local treatments as well as the interaction with epidemiological risk factors have been validated in clinical trials and translational studies. Distinct intrinsic subtypes and surrogate biomarker profiles play a major role for therapeutic decisions. Breast cancer is a biologically diverse disease with treatment modalities selected based on tumor stage and tumor biology. ![]()
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