Abstract P1-14-13: Increased Pathologic Complete Response Rate and Reduced Tumour RNA Levels Upon Treatment of Locally Advanced Breast Cancer with Neoadjuvant Concurrent Chemotherapy and Radiation
Notice bibliographique
Résumé
Abstract Introduction: Patients with locally advanced breast cancer (LABC) have a 5-year survival rate of 50% using standard treatment that includes neo-adjuvant chemotherapy, surgery and adjuvant radiation. Given this poor prognosis, we proposed use of an adjuvant regimen in the neoadjuvant setting, involving radiation with docetaxel for radiosensitization. Pathological complete response (pCR) at surgery (the best surrogate for overall survival) was the primary end-point of this single-arm prospective Phase II trial. Given that dose-dependent reductions in tumour RNA integrity mid-treatment were correlated with post-treatment pCRs in similar patients in the NCIC-CTG-MA.22 clinical trial (Breast Cancer Research and Treatment 119:347–56), we also assessed whether changes in tumour RNA integrity and concentration could be observed following this regimen. Methodology: Thirty-two patients with stage III non-metastatic LABC were enrolled at a single institution from 2009–2011. They were treated with neoadjuvant 5-Fluoro-uracil, Epirubicin, and Cyclophosphamide (FEC) q3 weekly for 4 cycles followed by weekly Docetaxel (35 mg/m2) concurrently with regional radiation (45 Gy with 16 Gy boost in 25 & 5 fractions) for the first 6 of 9 weeks (D/R). Serial 14 gauge tumour core biopsies were taken from the patients pre-, mid- and post-treatment and 1 mm3 samples used to assess RNA quantity and quality using an Agilent 2100 Bioanalyzer. This was followed by a modified radical mastectomy. Results: Treatment-related toxicities included grade 3 resolving pneumonitis (6 patients), grade 3 dermatitis (6 patients) and one treatment-related death. The pCR rate was 23%–about twice the provincial rate for LABC. At a mean 21 months follow-up, the relapse-free survival was 100% in the pCR cohort and 65% among partial responders (PRs). While biopsies were not normalized for mass, little difference in RNA concentration was observed between pre-treatment and post-FEC tumour biopsies (means of 50 ± 15 nanograms/microliter and 50 ± 12 nanograms/microliter, respectively). In contrast, the mean tumour RNA concentration was reduced to 10 ± 2.1 nanograms/microliter post-D/R. While the post-treatment biopsies often yielded insufficient RNA for assignment of tumour RNA integrity (RIN) values, treatment response appeared to be associated with low tumour RNA integrity, since patients with disease progression or stable disease had higher RIN values than patients exhibiting PRs or pCRs. Conclusions: This is the first study to use a full chemotherapy regimen with radiation in the neo-adjuvant setting for LABC. Although not without toxicity, the regimen appeared to significantly improve the pCR rate for this high-risk group, resulting in a much-improved outcome even at short-term follow-up. In addition, the FEC→D/R regimen produced reductions in tumour RNA concentration, and treatment response appeared to be associated with reduced RNA integrity. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-14-13.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».