title: Effect of neoadjuvant anthracycline-taxane-based chemotherapy in different biological breast cancer phenotypes: overall results from the GeparTrio study.
abstract: In order to explore the effect of neoadjuvant chemotherapy (NACT) on clinical mid-course and pathological complete response (pCR) at surgery in different biological breast cancer subtypes. The GeparTrio study included 2,072 patients with operable or locally advanced breast cancer. After two cycles with docetaxel, doxorubicin and cyclophosphamide (TAC) patients were randomized according to their clinical response. Clinical and biological factors were assessed for predicting clinically mid-course response and pCR at surgery. The overall pCR rate, defined as no invasive residuals in breast and axilla, was 20.5%. The highest pCR rate of 57% was observed in patients below 40 years of age with triple negative or grade 3 tumors. Independent factors for mid-course response and pCR were: young age, non-T4 tumors, high grade, and hormone receptor status, the strongest single predictive factor. Within the biological subtypes, grading was an independent factor to predict pCR for luminal tumors, clinical tumor stage for the HER2 like tumors and age for the triple negative ones. Grading gave independent information for mid-course response within the triple negative group. No factor predicted mid-course response within the other groups. Grading and age can identify subgroups within the luminal and triple negative patients who have an increased benefit from NACT.
authors.affiliation: Brustzentrum Kantonsspital St Gallen, St Gallen, Switzerland.
authors.forename: Jens
authors.initials: J
authors.lastname: Huober
authors.forename: Gunter
authors.initials: G
authors.lastname: von Minckwitz
authors.forename: Carsten
authors.initials: C
authors.lastname: Denkert
authors.forename: Hans
authors.initials: H
authors.lastname: Tesch
authors.forename: Erich
authors.initials: E
authors.lastname: Weiss
authors.forename: Dirk Michael
authors.initials: DM
authors.lastname: Zahm
authors.forename: Antje
authors.initials: A
authors.lastname: Belau
authors.forename: Fariba
authors.initials: F
authors.lastname: Khandan
authors.forename: Maik
authors.initials: M
authors.lastname: Hauschild
authors.forename: Christoph
authors.initials: C
authors.lastname: Thomssen
authors.forename: Bernhard
authors.initials: B
authors.lastname: Högel
authors.forename: Silvia
authors.initials: S
authors.lastname: Darb-Esfahani
authors.forename: Keyur
authors.initials: K
authors.lastname: Mehta
authors.forename: Sibylle
authors.initials: S
authors.lastname: Loibl
mesh_terms: D000328:Adult; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D003520:Cyclophosphamide / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D005858:Germany; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018579:Patient Selection; D010641:Phenotype; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D043823:Taxoids / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D014408:Biomarkers, Tumor; D000069287:Capecitabine; D003520:Cyclophosphamide; D003841:Deoxycytidine; D000077143:Docetaxel; D004317:Doxorubicin; D005472:Fluorouracil; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D043823:Taxoids; D014747:Vinblastine; D000077235:Vinorelbine; C508053:ERBB2 protein, human