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The use of neoadjuvant platinum-based chemotherapy in locally advanced breast cancer that is triple negative: retrospective analysis of 144 patients

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Abstract

Triple-negative breast cancers comprise about 20 % of breast cancers. They have poor prognosis and have no standard therapy. The aim of this study was to evaluate pathologic complete response (pCR), progression-free survival (PFS), and overall survival (OS) in patients with TNBC treated with neoadjuvant platinum-based chemotherapy. This is a retrospective study of one hundred and forty-four women with TNBC treated with neoadjuvant platinum-containing chemotherapy for locally advanced breast cancer at the University of Miami between January 1, 1999, and January 1, 2011. The medical record was reviewed to obtain data on clinical characteristics, including ethnicity, race, age, clinical stage, treatment regimen, and vital status. This study was approved by the University of Miami IRB. All patients had locally advanced breast cancer with at least one of the following features at presentation: T3, T4, N2, and N3. The mean tumor size by palpation was 9.4 cm. The clinical T-stage at presentation was 1.4 % T1, 8.3 % T2, 52.8 % T3, and 37.5 % T4 (19.4 % T4d). The nodal status by physical exam at presentation was 23 % N0, 37.5 % N1, 34 % N2, and 5.5 % N3. pCR in breast and axilla was seen in 31 %. PFS and OS were 55 and 59 %, respectively, at 7 years. Cisplatin offered a survival advantage over carboplatin in both PFS (P = 0.007) and OS (P = 0.018). Node positivity was the most important predictor of survival. Cisplatin/docetaxel neoadjuvant therapy was well tolerated and an effective therapy in locally advanced TNB.

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References

  1. EBCTCG (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717

    Article  Google Scholar 

  2. Perou CM, Sorlie T, Elsen MB et al (2000) Molecular portraits of human breast tumors. Nature 406:747–752

    Article  PubMed  CAS  Google Scholar 

  3. Sorlie T, Perou CM, Tibshirani R et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 98:10869–10874

    Article  PubMed  CAS  Google Scholar 

  4. Fulford LG, Easton DF, Reis-Filho JS et al (2008) Specific morphologic features predictive for the basal phenotype in grade 3 invasive ductal carcinoma of the breast. Histopathology 49:22–34

    Article  Google Scholar 

  5. Rahka E, Reis-Filho J, Ellis I (2008) Basal-like breast cancer: a critical review. J Clin Oncol 26(15):2568–2581

    Article  Google Scholar 

  6. Banerjee S, Reis-Filho JS, Ashley S et al (2006) Basal-like breast carcinomas: clinical outcome and response to chemotherapy. J Clin Pathol 59:729–735

    Article  PubMed  CAS  Google Scholar 

  7. Van de Rijn M, Perou CM, Tibshirani R et al (2002) Expression of cytokeratins 17 and 5 identifies a group of breast carcinomas with poor clinical outcome. Am J Pathol 161:1991–1996

    Article  PubMed  Google Scholar 

  8. Abd El-Rehim DM, Pinder SE, Paish CE et al (2004) Expression of luminal and basal cytokeratins in human breast carcinoma. J Pathol 203:661–671

    Article  PubMed  Google Scholar 

  9. Livasy CA, Karaca G, Nanda R et al (2006) Phenotypic evaluation of the basal-like subtype of invasive breast carcinoma. Mod Pathol 19:264–271

    Article  PubMed  CAS  Google Scholar 

  10. Nielsen TO, Hsu FD, Jensen K et al (2004) Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res 10:5367–5537

    Article  PubMed  CAS  Google Scholar 

  11. Carey L, Winer E, Viale G et al (2010) Triple-negative breast cancer: disease entitiy or title of convenience. Nat Rev Clin Oncol 7:683–692

    Article  PubMed  Google Scholar 

  12. Dent R, Trudeau M, Pritchard K et al (2007) Triple negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 13(15):4429–4434

    Article  PubMed  Google Scholar 

  13. Gluz O, Liedtke C, Gottschalk N et al (2009) Triple-negative breast cancer—current status and future directions. Ann Oncol 20(12):1913–1927

    Article  PubMed  CAS  Google Scholar 

  14. Schneider B, Winer E, Foulkes W et al (2008) Triple-negative breast cancer: risk factors to potential targets. Clin Cancer Res 14(24):8010–8018

    Article  PubMed  CAS  Google Scholar 

  15. Carey L, Perou C, Livasy C et al (2006) Race, breast cancer subtypes, and survival in the Carolina breast cancer study. JAMA 295(21):2492–2502

    Article  PubMed  CAS  Google Scholar 

  16. Nanda Rita (2011) “Targeting” triple-negative breast cancer: the lessons learned from BRCA1-associated breast cancers. Semin Oncol 38(2):254–262

    Article  PubMed  CAS  Google Scholar 

  17. Miyoshi Y, Murase K, Oh K (2008) Basal-like subtype and BRCA1 dysfunction in breast cancer. Int J Clin Oncol 13:395–400

    Article  PubMed  CAS  Google Scholar 

  18. Quinn J, Kennedy RD, Mullan P et al (2003) BRCA1 functions as a differential modulator of chemotherapy-induced apoptosis. Cancer Res 63:6221–6228

    PubMed  CAS  Google Scholar 

  19. Shafee N, Smith C, Wie S et al (2008) Cancer stem cells contribute to cisplatin resistance in BRCA1/p53-mediated mouse mammary tumors. Cancer Res 68(9):3243–3250

    Article  PubMed  CAS  Google Scholar 

  20. Bhattacharyya A, Ear U, Kollers B et al (2000) The breast cancer susceptibility gene BRCA1 is required for subnuclear assembly of Rad51 and survival following treatment with the DNA cross-linking agent cisplatin. J Biol Chem 275(31):23899–23903

    Article  PubMed  CAS  Google Scholar 

  21. Kennedy RD, Quinn J, Mullan PB et al (2004) The role of BRCA1 in the cellular response to chemotherapy. JNCI 96(22):1659–1669

    Article  PubMed  CAS  Google Scholar 

  22. Farmer H, McCabe N, Lord C et al (2005) Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy. Nature 434:917–920

    Article  PubMed  CAS  Google Scholar 

  23. Foulkes W (2006) BRAC1 and BRCA2: chemosensitivity, treatment outcomes and prognosis. Fam Cancer 5:135–142

    Article  PubMed  CAS  Google Scholar 

  24. Gray R (1988) A class of K-sample tests for comparing the cumulative incidence of competing risk. Ann Stat 16:1141–1154

    Article  Google Scholar 

  25. Fine JP, Gray R (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94:496–509

    Article  Google Scholar 

  26. Parmar MKB, Machin D (1995) Survival analysis: a practical approach. Wiley, Cambridge

    Google Scholar 

  27. Fisher B, Brown A, Mamounas E et al (1997) Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol 15:2483–2493

    PubMed  CAS  Google Scholar 

  28. Kuerer HM, Newman LA, Smith TL et al (1999) Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol 17:460–469

    PubMed  CAS  Google Scholar 

  29. Morrell L, Lee Y, Hurley J et al (1998) A Phase II trial of neoadjuvant methotrexate, vinblastine, doxorubicin and cisplatin in the treatment of patients with locally advanced breast cancer. Cancer 82:503–511

    Article  PubMed  CAS  Google Scholar 

  30. Carey L, Dees C, Sawyer L et al (2007) The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res 13(8):2329–2334

    Article  PubMed  CAS  Google Scholar 

  31. Liedtke C, Mazouni C, Hess K et al (2008) Response to neoadjuvant therapy and long-term survival in patients with triple negative breast cancer. J Clin Oncol 26(8):1275–1281

    Article  PubMed  Google Scholar 

  32. Dawood S, Briglio K, Kau S et al (2009) Triple negative breast cancer: the effect of race on response to primary systemic treatment and survival outcomes. J Clin Oncol 27(2):220–226

    Article  PubMed  CAS  Google Scholar 

  33. Falo C, Moreno A, Varela M et al (2007) HER-2/neu status and response to CMF: retrospective study in a series of operable breast cancer treated with primary CMF. J Cancer Res Clin Oncol 133:423–429

    Article  PubMed  CAS  Google Scholar 

  34. Egawa C, Miyoshi Y, Takamura Y et al (2001) Decreased expression of BRCA2 mRNA predicts favorable response to docetaxel in breast cancer. Int J Cancer 95:255–259

    Article  PubMed  CAS  Google Scholar 

  35. Frasci G, Comella P, Rinaldo M et al (2009) Preoperative weekly cisplatin–epirubicin–paclitaxel with G-CSF support in triple negative large operable breast cancer. Ann Oncol 20:1185–1192

    Article  PubMed  CAS  Google Scholar 

  36. Sirohi B, Arnedos M, Popat S et al (2008) Platinum based chemotherapy in triple-negative breast cancer. Ann Oncol 19:1847–1852

    Article  PubMed  CAS  Google Scholar 

  37. Yerulshalmi R, Hayes MM, Gelmon K et al (2009) A phase II trial of a neoadjuvant platinum regimen for locally advanced breast cancer: pathologic response, long-term follow-up, and clinical correlation with biomarkers. Clin Breast Cancer 9(3):166–171

    Article  Google Scholar 

  38. Byrski T, Huzarski T, Dent R et al (2008) Response to neoadjuvant therapy with cisplatin an BRCA1 positive breast cancer. Breast Cancer Res Treat 115(2):359–363

    Article  PubMed  Google Scholar 

  39. Silver D, Richardson AL, Ecklung A et al (2010) Efficacy of neoadjuvant cisplatin in triple negative breast cancer. J Clin Oncol 28(7):1145–1153

    Article  PubMed  CAS  Google Scholar 

  40. Rosell R, Gatzemeier U, Betticher DC et al (2002) Phase III randomized trial comparing paclitaxel/carboplatin with paclitaxel/cisplatin in patients with advanced non-small cell lung cancer: a cooperative multinational trial. Ann Oncol 13:1539–1549

    Article  PubMed  CAS  Google Scholar 

  41. Ardizzoni A, Boni L, Tiseo M et al (2007) Cisplatin versus carboplatin-based chemotherapy in first-line treatment of advanced non-small cell lung cancer: an individual patient data meta-analysis. J Natl Cancer Inst 99(11):847–857

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This research was conducted in accordance with the Declaration of Helsinki and Good Clinical Practice and was approved by the Institutional Review Board of the University of Miami.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, 1475 NW 12th Avenue, D8-4, Miami, FL, 33136, USA

    Judith Hurley

  2. Division of Biostatistics, Department of Epidemiology and Public Health, and Division of Biostatistics, Biostatistics and Bioinformatics Core, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA

    Isildinha M. Reis

  3. Daughtry Family Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA

    Steven E. Rodgers

  4. Department of Pathology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA

    Carmen Gomez-Fernandez

  5. Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA

    Jean Wright

  6. Department of Medicine, UPMC Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA

    Jose Pablo Leone

  7. Department of Anesthesiology, University of Texas Health Science Center, San Antonio, TX, USA

    Rene Larrieu

  8. Division of Hematology/Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford University, Stanford, CA, USA

    Mark D. Pegram

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  1. Judith Hurley
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Correspondence to Judith Hurley.

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Hurley, J., Reis, I.M., Rodgers, S.E. et al. The use of neoadjuvant platinum-based chemotherapy in locally advanced breast cancer that is triple negative: retrospective analysis of 144 patients. Breast Cancer Res Treat 138, 783–794 (2013). https://doi.org/10.1007/s10549-013-2497-y

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  • DOI: https://doi.org/10.1007/s10549-013-2497-y

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