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Nomogram to predict pathologic complete response in HER2-positive breast cancer treated with neoadjuvant systemic therapy.


ABSTRACT:

Background

Pathologic complete response (pCR) is associated with improved survival outcomes in patients with HER2-positive primary breast cancer. We developed a nomogram to predict the probability of pCR rates by using oestrogen receptor (ER) expression, progesterone receptor (PR) expression and HER2/CEP17 ratio as continuous variables.

Methods

We retrospectively reviewed patients with stages I-III HER2-positive invasive breast cancer who had definitive surgery in 1999-2015 and received neoadjuvant systemic therapy (NST). Multivariate logistic regression models were applied to assess the effect of variables on pCR. A nomogram was built to estimate the probability of pCR. The discriminative ability was estimated by the concordance index (C-index). The accuracy was assessed graphically with a calibration curve.

Results

A total of 793 patients were included in the analysis. Low ER expression (P<0.001), high HER2/CEP12 ratio (P=0.03), and non-inflammatory breast cancer subtype (P=0.003) were associated with increased pCR rates. Regimens containing trastuzumab or trastuzumab and pertuzumab were associated with higher pCR rates than cytotoxic agents alone (P<0.001 and P<0.001, respectively). The C-index was 0.69. The calibration curve showed good agreement.

Conclusions

Our nomogram predicted the pCR rate after NST among patients with HER2-positive primary breast cancer using clinicopathologic factors.

SUBMITTER: Fujii T 

PROVIDER: S-EPMC5318977 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Nomogram to predict pathologic complete response in HER2-positive breast cancer treated with neoadjuvant systemic therapy.

Fujii Takeo T   Kogawa Takahiro T   Wu Jimin J   Sahin Aysegul A AA   Liu Dian D DD   Chavez-MacGregor Mariana M   Giordano Sharon H SH   Raghavendra Akshara A   Murthy Rushmy K RK   Tripathy Debu D   Shen Yu Y   Yamal Jose-Miguel JM   Ueno Naoto T NT  

British journal of cancer 20170112 4


<h4>Background</h4>Pathologic complete response (pCR) is associated with improved survival outcomes in patients with HER2-positive primary breast cancer. We developed a nomogram to predict the probability of pCR rates by using oestrogen receptor (ER) expression, progesterone receptor (PR) expression and HER2/CEP17 ratio as continuous variables.<h4>Methods</h4>We retrospectively reviewed patients with stages I-III HER2-positive invasive breast cancer who had definitive surgery in 1999-2015 and re  ...[more]

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