title: Impact of immunohistochemistry-based molecular subtype on chemosensitivity and survival in Hispanic breast cancer patients following neoadjuvant chemotherapy.
abstract: BACKGROUND
  Neoadjuvant chemotherapy (NAC) is the standard treatment for patients with locally advanced breast cancer, showing improvement in disease-free survival (DFS) and overall survival (OS) rates in patients achieving pathological complete response (pCR). The relationship between immunohistochemistry-based molecular subtyping (IMS), chemo sensitivity and survival is currently a matter of interest. We explore this relationship in a Hispanic cohort of breast cancer patients treated with NAC.
  
  
  METHODS
  A retrospective survival analysis was performed on Colombian females with breast cancer treated at Instituto de Cancerología-Clinica Las Américas between January 2009 and December 2011. Patients were classified according to immunohistochemistry-based subtyping into the following five groups: Luminal A, Luminal B, Luminal B/HER 2+, HER2-enriched, and triple-negative breast cancer. Demographic characteristics, recurrence pattern, and survival rate were reviewed by bivariate and multivariate analysis.
  
  
  RESULTS
  A total of 328 patients fulfilled the study's inclusion parameters and the distribution of subtypes were as follows: Luminal A: 73 (22.3%), Luminal B/HER2-: 110 (33.5%), Luminal B/HER2+: 75 (22.9%), HER2-enriched: 30 (9.1%), and triple-negative: 40 (12.2%). The median follow-up was 41 months (interquartile range: 31-52). Pathological response to NAC was as follows: complete pathological response (pCR) in 28 (8.5%) patients, partial 247 (75.3%); stable disease 47 (14.3%), and progression 6 (1.8%) patients. The presence of pCR had a significant DFS and OS in the entire group (p = 0.01) but subtypes had different DFS in Luminal B (p = 0.01) and triple negative (p = 0.02) and also OS in Luminal B (p = 0.01) and triple negative (p = 0.01).
  
  
  CONCLUSIONS
  pCR is associated with an improved overall survival and disease-free survival rates in this group of Hispanics patients. Advanced stages, Luminal B subtypes, triple-negative tumours and non-pCR showed lower DFS.
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; School of Medicine, Universidad de Antioquia, Medellín, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Rodolfo
authors: R
authors: Gómez
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Carlos Andrés
authors: CA
authors: Ossa
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: María Elvira
authors: ME
authors: Montoya
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Carolina
authors: C
authors: Echeverri
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Gonzalo
authors: G
authors: Ángel
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Johana
authors: J
authors: Ascuntar
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; School of Medicine, Universidad de Antioquia, Medellín, Colombia.
authors: Mauricio
authors: M
authors: Borrero
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Mónica
authors: M
authors: Gil
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Sabrina
authors: S
authors: Herrera
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Eduardo
authors: E
authors: Gutiérrez
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Fernando
authors: F
authors: Herazo
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Alejo
authors: A
authors: Jiménez
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; School of Medicine, Universidad de Antioquia, Medellín, Colombia.
authors: Jorge
authors: J
authors: Madrid
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Pedro Alejandro
authors: PA
authors: Reyes
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia.
authors: Lina
authors: L
authors: Zuluaga
authors: Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; Cancer Research Group, Instituto de Cancerología-Clínica Las Américas, Medellín 05001000, Colombia ; School of Medicine, Clinical Epidemiology Academic Group (GRAEPIC), Universidad de Antioquia, Medellín, Colombia.
authors: Héctor
authors: H
authors: García
keywords: Colombia; Hispanics; breast cancer; intrinsic subtypes; molecular subtypes; neoadjuvant therapy; pathological complete response