Predictive factors of pathologic complete response of HER2-positive breast cancer after preoperative chemotherapy with trastuzumab: development of a specific predictor and study of its utilities using decision curve analysis
العنوان: | Predictive factors of pathologic complete response of HER2-positive breast cancer after preoperative chemotherapy with trastuzumab: development of a specific predictor and study of its utilities using decision curve analysis |
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المؤلفون: | Charles Coutant, V. Lorgis, Marion Cortet, Clémentine Jankowski, P. Fumoleau, Bruno Coudert, Séverine Guiu, Isabelle Desmoulins, Roman Rouzier, Laurent Arnould, Céline Charon-Barra, Fabien Reyal |
المساهمون: | Université de Bourgogne (UB), Département d'oncologie médicale [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Institut du Cancer de Montpellier (ICM), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), UNICANCER, Département de Biologie et pathologie des tumeurs [Centre Georges-François Leclerc] |
المصدر: | Breast Cancer Research and Treatment Breast Cancer Research and Treatment, Springer Verlag, 2017, 161 (1), pp.73-81. ⟨10.1007/s10549-016-4040-4⟩ |
بيانات النشر: | Springer Science and Business Media LLC, 2016. |
سنة النشر: | 2016 |
مصطلحات موضوعية: | Oncology, Cancer Research, Receptor, ErbB-2, [SDV]Life Sciences [q-bio], Institut Gustave Roussy, Breast cancer, Antineoplastic Agents, Immunological, 0302 clinical medicine, Trastuzumab, Preoperative chemotherapy, 030212 general & internal medicine, skin and connective tissue diseases, 10. No inequality, Middle Aged, Prognosis, Combined Modality Therapy, Neoadjuvant Therapy, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Female, Predictive factors, medicine.drug, Adult, medicine.medical_specialty, Clinical Decision-Making, Breast Neoplasms, Neoadjuvant chemotherapy, Decision Support Techniques, 03 medical and health sciences, HER2, Internal medicine, Preoperative Care, Biomarkers, Tumor, medicine, Humans, neoplasms, Pathological, Neoplasm Staging, Retrospective Studies, business.industry, Reproducibility of Results, Cancer, Nomogram, medicine.disease, ROC Curve, business |
الوصف: | International audience; PURPOSE:The aim of this study was to assess the Institut Gustave Roussy/M.D. Anderson Cancer Center (IGR/MDACC) nomogram in predicting pathologic complete response (pCR) to preoperative chemotherapy in a cohort of human epidermal growth factor receptor 2 (HER2)-positive tumors treated with preoperative chemotherapy with trastuzumab. We then combine clinical and pathological variables associated with pCR into a new nomogram specific to HER2-positive tumors treated by preoperative chemotherapy with trastuzumab.PATIENTS AND METHODS:Data from 270 patients with HER2-positive tumors treated with preoperative chemotherapy with trastuzumab at the Institut Curie and at the Georges François Leclerc Cancer Center were used to assess the IGR/MDACC nomogram and to subsequently develop a new nomogram for pCR based on multivariate logistic regression. Model performance was quantified in terms of calibration and discrimination. We studied the utility of the new nomogram using decision curve analysis.RESULTS:The IGR/MDACC nomogram was not accurate for the prediction of pCR in HER2-positive tumors treated by preoperative chemotherapy with trastuzumab, with poor discrimination (AUC = 0.54, 95% CI 0.51-0.58) and poor calibration (p = 0.01). After uni- and multivariate analysis, a new pCR nomogram was built based on T stage (TNM), hormone receptor status, and Ki67 (%). The model had good discrimination with an area under the curve (AUC) at 0.74 (95% CI 0.70-0.79) and adequate calibration (p = 0.93). By decision curve analysis, the model was shown to be relevant between thresholds of 0.3 and 0.7.CONCLUSION:To the best of our knowledge, ours is the first nomogram to predict pCR in HER2-positive tumors treated by preoperative chemotherapy with trastuzumab. To ensure generalizability, this model needs to be externally validated. |
تدمد: | 1573-7217 0167-6806 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cc462ca3a8247d37b8b80d54360e911a https://doi.org/10.1007/s10549-016-4040-4 |
حقوق: | CLOSED |
رقم الأكسشن: | edsair.doi.dedup.....cc462ca3a8247d37b8b80d54360e911a |
قاعدة البيانات: | OpenAIRE |
تدمد: | 15737217 01676806 |
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