Biomarkers Predicting Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer.
OBJECTIVE
Recent studies have shown strong correlation of pathologic complete response (pCR) to neoadjuvant chemotherapy with survival and prognosis in breast cancers.


METHODS
Clinical data from 237 breast cancer patients who received neoadjuvant chemotherapy between 2012 and 2014 were reviewed. Correlations were sought between pCR and estrogen receptor (ER), progesterone receptor (PR), and HER2 status; Nottingham and nuclear grades; tumor tubule formation; mitotic score; Ki67 index; and tumoral and stromal lymphocytic infiltration (TLI and SLI, respectively).


RESULTS
Of the 237 cases, 104 (43.9%) achieved pCR. The HER2+ and triple negative breast cancer (TNBC) subtypes had higher pCR rates compared with the luminal subtype (ER+ or PR+ and HER2-). ER and PR negativity, HER2 positivity, Nottingham grade 3, increased TLI and SLI, high mitotic count and Ki67 score correlated significantly with pCR in the overall cohort. TLI and SLI correlated significantly with pCR in the HER2+ and TNBC subtypes in multivariate analysis, whereas no biomarkers correlated with pCR in the luminal subtype.


CONCLUSIONS
In addition to the pathologic parameters and biomarkers already routinely assessed, evaluation of TLI and SLI may help to better select patients with HER2+ and TNBC for neoadjuvant chemotherapy.
From the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA xli40@emory.edu rituaneja@gmail.com.
Xiaoxian Bill
XB
Li
From the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA.
Uma
U
Krishnamurti
Department of Biology, Georgia State University, Atlanta.
Shristi
S
Bhattarai
Department of Biology, Georgia State University, Atlanta.
Sergey
S
Klimov
From the Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA.
Michelle D
MD
Reid
Department of Medicine, University of Wisconsin, Madison.
Ruth
R
O'Regan
Department of Biology, Georgia State University, Atlanta.
Ritu
R
Aneja
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult
D014408:Biomarkers, Tumor
Biomarker; Breast cancer; Neoadjuvant therapy; Pathologic complete response; TIL; Tumor infiltrating lymphocytes; pCR