- Email: [email protected]
Clinical outcomes in breast cancer (BC) patients (pts) with intermediate Oncotype DX Recurrence Score (RS) results
15th St.Gallen International Breast Cancer Conference / The Breast 32S1 (2017) S78–S132
P228 T cell landscape in triple negative breast cancer patients A. Poissonnier, M. Le Gallo, F. Godey, P. Legembre*. CLCC Eugene Marquis – INSERM U1242, Rennes, France Aims: To characterize the immune landscape in triple negative breast cancers (TNBCs) and identify immune subsets whose infiltrate is associated with a good/bad prognosis for these women. Methods: Prospective and retrospective analyses have been performed. At the diagnosis, TNBCs are dissociated after surgery and the immune infiltrate is evaluated using multiparameter flow cytometry. In parallel, TCGA breast cancer cohort has been interrogated to decipher whether certain immune subsets were associated to a clinical outcome. Results: We identified a CD4+ T-cell subset in 22.4% of TNBC patients and found that some markers of this T-cell population were associated with an excellent prognosis. Conclusions: We identified T-cell subset in TNBC patients that can be used to exclude the patients from clinical trials because they do not relapse. Disclosure of Interest: No significant relationships. P229 Clinical outcomes in breast cancer (BC) patients ( pts) with intermediate Oncotype DX Recurrence Score (RS) results L. Leitzin*, N. Sikorsky, N. Popovich-Hadari, M. Leviov. Lin Medical Center, Department of Oncology, Haifa, Israel Aims: The benefit of adjuvant chemotherapy (CT) in estrogen receptor (ER)+ human epidermal growth factor receptor 2 (HER2)negative endocrine therapy-treated BC pts with intermediate RS is unclear. We analyzed clinical outcomes in intermediate RS pts with the aim of identifying clinicopathological prognostic factors in this population. Methods: This retrospective study included all pts with N0-N2 ER+ HER-2-negative BC who were treated at Lin Medical Center and were RS-tested between 4/2006 and 12/2010. We compared clinicopathological characteristics, RS, and treatments received in the subgroups of pts with and without distant recurrence. Results: The cohort included 103 pts (102 females). After a median (range) follow-up of 6.6 (3.6–10.2) years, 88 pts (85%) were alive without evidence of disease, 4 (4%) were alive with distant metastasis, 8 (8%) died due to metastatic BC, and 3 (3%) died due to other cases. We compared the 91 pts without distant recurrence to the 12 pts with distant recurrence. Age distribution was: median (range), 58 (28–84) vs 65 (33–75) years; proportion of pts <50, 23% vs 17%, respectively. Nodal status distribution was: N0, 73% and 75%; N1mi, 10% and 8%; N1, 15% and 17%; N2, 2% and 0%, respectively. Tumor size >2 cm: 19% vs 83%; median (range) tumor diameter, 1.5 (0.4–6.0) vs 2.5 (1.0–4.0) cm, respectively. In the non-recurring group 85% had invasive ductal carcinoma (IDC), 13% invasive lobular carcinoma (ILC), 1% colloid, and 1% mucinous. In the pts who recurred, 83% had IDC and 17% ILC. In the non-recurring cohort, 13%, 61%, and 15% had grade 1, 2, and 3, respectively (11% had unknown grade). In the pts who recurred, none had grade 1, 58% had grade 2, and 25% had grade 3 (17% had unknown grade). In the non-recurring group, median (range) RS was 23 (18–30); in the pts who recurred, 23.5 (21–29). Of the non-recurring group, 27% received adjuvant CT. CT-treated pts, had median (range) RS of 26 (19–30). Of the pts who recurred, 50% received adjuvant CT. Their median (range) RS result was 28 (23–29). Also, 2 pts with RS results 24 and 19 were offered but refused CT, of whom 1 pt (RS: 24) recurred. Conclusions: RS ≥ 19 was the threshold for CT use; however, all recurring pts had RS ≥ 21. No clinicopathological differences were observed between the pts who recurred vs those who did not, except for tumor diameter and grade. Disclosure of Interest: No significant relationships.
S99
P230 Clinical validation of the genomic grade: a retrospective study based on 3 independent populations Abstract withdrawn. P231 Serial changes of expression of tumor associated circulating transcripts in breast cancer patients who received neoadjuvant chemotherapy S.M. Lim1 *, H.S. Park1, J.Y. Kim1, S. Park1, H.J. Han2, Y.A. Choi2, J.D. Lee2,3, G.M. Kim4, J.H. Sohn4, S.I. Kim1. 1Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea, 2Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea, 3Department of Human Biology and Genomics, Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, South Korea, 4Department of Oncology, Yonsei University College of Medicine, Seoul, South Korea Aims: Reverse transcription polymerase chain reaction (RT-PCR) based detection of tumor associated circulating transcripts (TACT) is a frequently used method for the identification of circulating tumor cells (CTCs). The purpose of the present study was to evaluate the correlation between serial changes of expression of TACTs and clinicopathological features in patients with breast cancer who received neoadjuvant chemotherapy. Methods: We prospectively enrolled 508 breast cancer patients: Among them, 91 patients received neoadjuvant chemotherapy. In this study, RT-PCR assay was used to analyze the mRNA expression of five CTC-specific markers including EpCAM, CK19, HER2, Ki67, and hTERT. We have investigated the difference of pCR rate according to TACT expression in serial time points during neoadjuvant chemotherapy. Results: Of the 91 breast cancer patients who received neoadjuvant chemotherapy, 33 (36.2%) were positively for TACT. In the TACT positive group, HER2 positive ratio was more than in the negative group (39.4% vs. 17.2%; p = 0.014). According to baseline TACT expression that was measured before neoadjuvant chemotherapy, the TACT positive group showed higher pCR rate than the TACT negative group (36.4% vs. 15.5%; p = 0.037). The pCR rate was higher in the initial TACT positive group than in the negative group during on the prior to neoadjuvant chemotherapy and post neoadjuvant chemotherapy ( p = 0.012). Conclusions: Based on these results, in the initial TACT positive group, the pCR rate for neoadjuvant chemotherapy was higher than in the initial TACT negative group. Monitoring the presence or absence of TACT before and after neoadjuvant chemotherapy could be a surrogate for treatment response to neoadjuvant chemotherapy. Disclosure of Interest: No significant relationships. P232 The cardiac echo and MRI methods in diagnostics of the cardiotoxic risk factors S. Malov*. Vishnevsky Institute of Surgery, Moscow, Russian Federation Aims: Chemotherapy is widespread method for breast cancer treatment. Thus more and more dates reported that cardiotoxic side effect has lead for treatment change or even exclusion of that treatment. Our research considers MRI and echocardiography as the optimal complex for detection of individual risk factors of cardiotoxicity. Methods: Echocardiograms and MRI were evaluated for detection of the subclinical deviations in cardiac morphology at baseline, 3 months and 1 year after initial cycle of chemotherapy (anthracyclines and trastuzumab) in 20 patients. Speckle tracking of function included peak longitudinal strain and strain rate. For MRI late gadolinium enhancement was investigated. Two groups were compared in cardiotoxicity effects: the group of cardiac
P228 T cell landscape in triple negative breast cancer patients A. Poissonnier, M. Le Gallo, F. Godey, P. Legembre*. CLCC Eugene Marquis – INSERM U1242, Rennes, France Aims: To characterize the immune landscape in triple negative breast cancers (TNBCs) and identify immune subsets whose infiltrate is associated with a good/bad prognosis for these women. Methods: Prospective and retrospective analyses have been performed. At the diagnosis, TNBCs are dissociated after surgery and the immune infiltrate is evaluated using multiparameter flow cytometry. In parallel, TCGA breast cancer cohort has been interrogated to decipher whether certain immune subsets were associated to a clinical outcome. Results: We identified a CD4+ T-cell subset in 22.4% of TNBC patients and found that some markers of this T-cell population were associated with an excellent prognosis. Conclusions: We identified T-cell subset in TNBC patients that can be used to exclude the patients from clinical trials because they do not relapse. Disclosure of Interest: No significant relationships. P229 Clinical outcomes in breast cancer (BC) patients ( pts) with intermediate Oncotype DX Recurrence Score (RS) results L. Leitzin*, N. Sikorsky, N. Popovich-Hadari, M. Leviov. Lin Medical Center, Department of Oncology, Haifa, Israel Aims: The benefit of adjuvant chemotherapy (CT) in estrogen receptor (ER)+ human epidermal growth factor receptor 2 (HER2)negative endocrine therapy-treated BC pts with intermediate RS is unclear. We analyzed clinical outcomes in intermediate RS pts with the aim of identifying clinicopathological prognostic factors in this population. Methods: This retrospective study included all pts with N0-N2 ER+ HER-2-negative BC who were treated at Lin Medical Center and were RS-tested between 4/2006 and 12/2010. We compared clinicopathological characteristics, RS, and treatments received in the subgroups of pts with and without distant recurrence. Results: The cohort included 103 pts (102 females). After a median (range) follow-up of 6.6 (3.6–10.2) years, 88 pts (85%) were alive without evidence of disease, 4 (4%) were alive with distant metastasis, 8 (8%) died due to metastatic BC, and 3 (3%) died due to other cases. We compared the 91 pts without distant recurrence to the 12 pts with distant recurrence. Age distribution was: median (range), 58 (28–84) vs 65 (33–75) years; proportion of pts <50, 23% vs 17%, respectively. Nodal status distribution was: N0, 73% and 75%; N1mi, 10% and 8%; N1, 15% and 17%; N2, 2% and 0%, respectively. Tumor size >2 cm: 19% vs 83%; median (range) tumor diameter, 1.5 (0.4–6.0) vs 2.5 (1.0–4.0) cm, respectively. In the non-recurring group 85% had invasive ductal carcinoma (IDC), 13% invasive lobular carcinoma (ILC), 1% colloid, and 1% mucinous. In the pts who recurred, 83% had IDC and 17% ILC. In the non-recurring cohort, 13%, 61%, and 15% had grade 1, 2, and 3, respectively (11% had unknown grade). In the pts who recurred, none had grade 1, 58% had grade 2, and 25% had grade 3 (17% had unknown grade). In the non-recurring group, median (range) RS was 23 (18–30); in the pts who recurred, 23.5 (21–29). Of the non-recurring group, 27% received adjuvant CT. CT-treated pts, had median (range) RS of 26 (19–30). Of the pts who recurred, 50% received adjuvant CT. Their median (range) RS result was 28 (23–29). Also, 2 pts with RS results 24 and 19 were offered but refused CT, of whom 1 pt (RS: 24) recurred. Conclusions: RS ≥ 19 was the threshold for CT use; however, all recurring pts had RS ≥ 21. No clinicopathological differences were observed between the pts who recurred vs those who did not, except for tumor diameter and grade. Disclosure of Interest: No significant relationships.
S99
P230 Clinical validation of the genomic grade: a retrospective study based on 3 independent populations Abstract withdrawn. P231 Serial changes of expression of tumor associated circulating transcripts in breast cancer patients who received neoadjuvant chemotherapy S.M. Lim1 *, H.S. Park1, J.Y. Kim1, S. Park1, H.J. Han2, Y.A. Choi2, J.D. Lee2,3, G.M. Kim4, J.H. Sohn4, S.I. Kim1. 1Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea, 2Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, South Korea, 3Department of Human Biology and Genomics, Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul, South Korea, 4Department of Oncology, Yonsei University College of Medicine, Seoul, South Korea Aims: Reverse transcription polymerase chain reaction (RT-PCR) based detection of tumor associated circulating transcripts (TACT) is a frequently used method for the identification of circulating tumor cells (CTCs). The purpose of the present study was to evaluate the correlation between serial changes of expression of TACTs and clinicopathological features in patients with breast cancer who received neoadjuvant chemotherapy. Methods: We prospectively enrolled 508 breast cancer patients: Among them, 91 patients received neoadjuvant chemotherapy. In this study, RT-PCR assay was used to analyze the mRNA expression of five CTC-specific markers including EpCAM, CK19, HER2, Ki67, and hTERT. We have investigated the difference of pCR rate according to TACT expression in serial time points during neoadjuvant chemotherapy. Results: Of the 91 breast cancer patients who received neoadjuvant chemotherapy, 33 (36.2%) were positively for TACT. In the TACT positive group, HER2 positive ratio was more than in the negative group (39.4% vs. 17.2%; p = 0.014). According to baseline TACT expression that was measured before neoadjuvant chemotherapy, the TACT positive group showed higher pCR rate than the TACT negative group (36.4% vs. 15.5%; p = 0.037). The pCR rate was higher in the initial TACT positive group than in the negative group during on the prior to neoadjuvant chemotherapy and post neoadjuvant chemotherapy ( p = 0.012). Conclusions: Based on these results, in the initial TACT positive group, the pCR rate for neoadjuvant chemotherapy was higher than in the initial TACT negative group. Monitoring the presence or absence of TACT before and after neoadjuvant chemotherapy could be a surrogate for treatment response to neoadjuvant chemotherapy. Disclosure of Interest: No significant relationships. P232 The cardiac echo and MRI methods in diagnostics of the cardiotoxic risk factors S. Malov*. Vishnevsky Institute of Surgery, Moscow, Russian Federation Aims: Chemotherapy is widespread method for breast cancer treatment. Thus more and more dates reported that cardiotoxic side effect has lead for treatment change or even exclusion of that treatment. Our research considers MRI and echocardiography as the optimal complex for detection of individual risk factors of cardiotoxicity. Methods: Echocardiograms and MRI were evaluated for detection of the subclinical deviations in cardiac morphology at baseline, 3 months and 1 year after initial cycle of chemotherapy (anthracyclines and trastuzumab) in 20 patients. Speckle tracking of function included peak longitudinal strain and strain rate. For MRI late gadolinium enhancement was investigated. Two groups were compared in cardiotoxicity effects: the group of cardiac