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  11. Pathologic Complete Response (pcr) Rates For Patients With Hr+/her2- High-risk, Early-stage Breast Cancer (ebc) By Clinical And Molecular Features In The Phase Ii I-spy2 Clinical Trial.

Pathologic complete response (pCR) rates for patients with HR+/HER2- high-risk, early-stage breast cancer (EBC) by clinical and molecular features in the phase II I-SPY2 clinical trial.

L A Huppert1, D Wolf2, C Yau3

  • 1Department of Medicine, University of California San Francisco, San Francisco, USA.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|October 30, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Molecular biomarkers like MammaPrint High2, BluePrint Basal-type, and ImPrint-positive predict better pathologic complete response (pCR) in hormone receptor-positive, HER2-negative early-stage breast cancer. These findings help personalize neoadjuvant chemotherapy treatments.

Area of Science:

  • Oncology
  • Genomics
Keywords:
MammaPrintbasalintrinsic subtypeluminal

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  • Clinical Trials

    • Background:

    • Hormone receptor-positive (HR+), human epidermal growth factor receptor 2 (HER2)-negative early-stage breast cancer (EBC) is a complex disease.
    • Identifying robust clinical and molecular biomarkers is crucial for tailoring optimal treatment strategies.
    • Current biomarkers do not fully capture the heterogeneity within this EBC subtype.

    Purpose of the Study:

    • To analyze the association between various clinical and molecular features and treatment response in HR+/HER2- EBC.
    • To evaluate the predictive value of MammaPrint (MP), BluePrint (BP), and ImPrint signatures for pathologic complete response (pCR) and distant recurrence-free survival (DRFS).
    • To understand the heterogeneity of HR+/HER2- EBC and its impact on neoadjuvant therapy outcomes.

    Main Methods:

    • Analysis of 379 patients with HR+/HER2- EBC from eight neoadjuvant arms of the I-SPY2 trial.
    • Assessment of pCR and DRFS rates based on clinical factors (age, stage, histology) and molecular markers (ER/PR status, MammaPrint, BluePrint, ImPrint).
    • Quantification of biomarker overlap and their correlation with treatment outcomes.

    Main Results:

    • pCR rates varied significantly across patient subgroups, with higher rates observed in Stage II disease, ductal histology, lower ER positivity (≤66%), MP-High2, BP-Basal-type, and ImPrint-positive disease.
    • MP-High2 and BP-Basal-type signatures were associated with higher pCR rates (31% and 34%, respectively) compared to MP-High1 and BP-Luminal-type (11% and 10%).
    • Patients achieving pCR had favorable outcomes regardless of initial characteristics; however, among non-pCR patients, MP-High2 and BP-Basal-type were linked to more frequent DRFS events.

    Conclusions:

    • MP-High2, BP-Basal-type, and ImPrint-positive signatures identify overlapping subsets of high-risk HR+/HER2- EBC patients likely to respond better to neoadjuvant therapy.
    • These molecular signatures provide valuable insights into treatment selection for specific patient populations.
    • The I-SPY2.2 trial is integrating these biomarkers to refine treatment strategies for HR+/HER2- EBC.
    molecular subtype
    neoadjuvant therapy