TY - JOUR
T1 - Early assessment with magnetic resonance imaging for prediction of pathologic response to neoadjuvant chemotherapy in triple-negative breast cancer
T2 - Results from the phase III BrighTNess trial
AU - Golshan, Mehra
AU - Wong, Stephanie M.
AU - Loibl, Sibylle
AU - Huober, Jens Bodo
AU - O'Shaughnessy, Joyce
AU - Rugo, Hope S.
AU - Wolmark, Norman
AU - Ansell, Peter
AU - Maag, David
AU - Sullivan, Danielle M.
AU - Metzger-Filho, Otto
AU - Von Minckwitz, Gunter
AU - Geyer, Charles E.
AU - Sikov, William M.
AU - Untch, Michael
N1 - Funding Information:
AbbVie and Breast Cancer Research Foundation. This study was funded by AbbVie Pharmaceuticals . The funders of the study were involved in the study design and data analysis of this report.
Funding Information:
AbbVie and Breast Cancer Research Foundation. This study was funded by AbbVie Pharmaceuticals. The funders of the study were involved in the study design and data analysis of this report.The following co-authors received funding from AbbVie: Mehra Golshan, Sibylle Loibl, Jens Bodo Huober, Joyce O'Shaughnessy, Hope S. Rugo, Norman Wolmark (institution only), Peter Ansell, David Maag, Danielle M. Sullivan, Otto Metzger-Filho, Gunter Von Minckwitz, Charles E. Geyer, Jr., William M. Sikov, Michael Untch.Jens Bodo Huober reports honoraria and is on advisory boards for Celgene, Roche, Novartis, Hexal, Pfizer, AstraZeneca, Lilly, Amgen, Eisai, MSD, and Abbvie; research grants from Celgene and Novartis; and travel grants from Roche, Novartis, Celgene, Pfizer and Daiichi-Sankyo.
Publisher Copyright:
© 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2020/2
Y1 - 2020/2
N2 - INTRODUCTION: The ability of breast magnetic resonance imaging (MRI) to predict pathologic complete response (pCR) to neoadjuvant systemic therapy (NST) varies across biological subtypes. We sought to determine how well breast MRI findings following initial treatment on the phase III BrighTNess trial correlated with pCR in patients with triple negative breast cancer (TNBC).METHODS: Baseline and mid-treatment imaging and pathologic response data were available in 519 patients with stage II-III TNBC who underwent NST as per protocol. MRI complete response (mCR) was defined as disappearance of all target lesion(s) and MRI partial response (mPR) as a ≥50% reduction in the largest tumor diameter.RESULTS: Overall, mCR was demonstrated in 116 patients (22%), whereas 166 (32%) had mPR and 237 (46%) had stable/progressive disease (SD/PD). The positive predictive value (PPV), negative predictive value, and overall accuracy of the mid-treatment MRI for pCR were 78%, 56%, and 61%, respectively; accuracy did not differ significantly between gBRCA mutation carriers and non-carriers (52% vs. 63%, p = 0.10). When compared to patients with SD/PD, those with mPR or mCR were 3.35-fold (95% CI 2.07-5.41) more likely to have pCR at surgery. MRI response during NST was significantly associated with eligibility for breast-conserving surgery following completion of treatment (93.1% for mCR vs. 81.6% for SD/PD, p < 0.001).CONCLUSIONS: Complete response on mid-treatment MRI in the BrighTNess trial had a PPV of 78% for demonstration of pCR after completion of NST in TNBC. However, a substantial proportion of patients with mPR or SD/PD also achieved a pCR.CLINICAL TRIAL REGISTRATION: NCT02032277.
AB - INTRODUCTION: The ability of breast magnetic resonance imaging (MRI) to predict pathologic complete response (pCR) to neoadjuvant systemic therapy (NST) varies across biological subtypes. We sought to determine how well breast MRI findings following initial treatment on the phase III BrighTNess trial correlated with pCR in patients with triple negative breast cancer (TNBC).METHODS: Baseline and mid-treatment imaging and pathologic response data were available in 519 patients with stage II-III TNBC who underwent NST as per protocol. MRI complete response (mCR) was defined as disappearance of all target lesion(s) and MRI partial response (mPR) as a ≥50% reduction in the largest tumor diameter.RESULTS: Overall, mCR was demonstrated in 116 patients (22%), whereas 166 (32%) had mPR and 237 (46%) had stable/progressive disease (SD/PD). The positive predictive value (PPV), negative predictive value, and overall accuracy of the mid-treatment MRI for pCR were 78%, 56%, and 61%, respectively; accuracy did not differ significantly between gBRCA mutation carriers and non-carriers (52% vs. 63%, p = 0.10). When compared to patients with SD/PD, those with mPR or mCR were 3.35-fold (95% CI 2.07-5.41) more likely to have pCR at surgery. MRI response during NST was significantly associated with eligibility for breast-conserving surgery following completion of treatment (93.1% for mCR vs. 81.6% for SD/PD, p < 0.001).CONCLUSIONS: Complete response on mid-treatment MRI in the BrighTNess trial had a PPV of 78% for demonstration of pCR after completion of NST in TNBC. However, a substantial proportion of patients with mPR or SD/PD also achieved a pCR.CLINICAL TRIAL REGISTRATION: NCT02032277.
KW - Breast neoplasms
KW - MRI
KW - Neoadjuvant chemotherapy
KW - PARP inhibitor
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Double-Blind Method
KW - Humans
KW - Middle Aged
KW - Magnetic Resonance Imaging/methods
KW - Adult
KW - Neoadjuvant Therapy
KW - Aged
KW - Chemotherapy, Adjuvant
KW - Triple Negative Breast Neoplasms/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85073067006&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073067006&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2019.10.002
DO - 10.1016/j.ejso.2019.10.002
M3 - Article
C2 - 31606288
AN - SCOPUS:85073067006
SN - 0748-7983
VL - 46
SP - 223
EP - 228
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 2
ER -