Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer: a multicentre pooled analysis of 5161 patients

作者：Christina Yau, Christina Yau, Marie Osdoit, Marieke van der Noordaa, Sonal Shad, Jane Wei, Diane de Croze, Anne-Sophie Hamy, Marick Laé, Fabien Reyal, Gabe S Sonke, Tessa G Steenbruggen, Maartje van Seijen, Jelle Wesseling, Miguel Martín, Maria del Monte-Millán, Sara López-Tarruella, Kathi Adamson, Kathy S. Albain, Adam L. Asare, Smita M. Asare, Ron Balassanian, Heather Beckwith, Scott M. Berry, Donald A. Berry, Judy C. Boughey, Meredith B. Buxton, Yunn-Yi Chen, Beiyun Chen, A. Jo Chien, Stephen Y. Chui, Amy S. Clark, Julia L. Clennell, Brian Datnow, Angela M. DeMichele, Xiuzhen Duan, Kirsten K. Edmiston, Anthony D. Elias, Erin D. Ellis, Laura L. Esserman, David M. Euhus, Oluwole Fadare, Fang Fan, Michael D Feldman, Andres Forero-Torres, Barbara B. Haley, Hyo S. Han, Shuko Harada, Patricia Haugen, Teresa Helsten, Gillian L. Hirst, Nola M. Hylton, Claudine Isaacs, Kathleen Kemmer, Qamar J. Khan, Laila Khazai, Molly E. Klein, Gregor Krings, Julie E. Lang, Lauren G. LeBeau, Brian Leyland-Jones, Minetta C. Liu, Shelly Lo, Janice Lu, Anthony Magliocco, Jeffrey B. Matthews, Michelle E. Melisko, Paulette Mhawech-Fauceglia, Stacy L. Moulder, Rashmi K. Murthy, Rita Nanda, Donald W. Northfelt, Idris T. Ocal, Olufunmilayo Olopade, Stefan Pambuccian, Melissa Paoloni, John W. Park, Barbara A. Parker, Jane Perlmutter, Garry Peterson, Lajos Pusztai, Mara Rendi, Hope S. Rugo, Sunati Sahoo, Sharon Sams, Ashish Sanil, Husain Sattar, Richard B. Schwab, Ruby Singhrao, Katherine Steeg, Erica Stringer-Reasor, W. Fraser Symmans, Ossama Tawfik, Debasish Tripathy, Megan L. Troxell, Laura J. van't Veer, Sara J. Venters, Tuyethoa Vinh, Rebecca K. Viscusi, Anne M. Wallace, Shi Wei, Amy Wilson, Christina Yau, Christina Yau, Douglas Yee, Jay C. Zeck, Judy C Boughey, Matthew P Goetz, Tanya Hoskin, Rebekah Gould, Vicente Valero, Stephen B Edge, Jean E Abraham, John M S Bartlett, Carlos Caldas, Janet Dunn, Helena Earl, Larry Hayward, Louise Hiller, Elena Provenzano, Stephen-John Sammut, Jeremy S Thomas, David Cameron, Ashley Graham, Peter Hall, Lorna Mackintosh, Fang Fan, Andrew K Godwin, Kelsey Schwensen, Priyanka Sharma, Angela M DeMichele, Kimberly Cole, Lajos Pusztai, Mi-Ok Kim, Laura J van 't Veer, Laura J Esserman, W Fraser Symmans · 发表于：The Lancet Oncology · 年份：2021 · DOI：10.1016/s1470-2045(21)00589-1 · 被引用次数：464 · 研究领域：Breast Cancer Treatment Studies、Cancer Treatment and Pharmacology、Breast Lesions and Carcinomas

BACKGROUND: Previous studies have independently validated the prognostic relevance of residual cancer burden (RCB) after neoadjuvant chemotherapy. We used results from several independent cohorts in a pooled patient-level analysis to evaluate the relationship of RCB with long-term prognosis across different phenotypic subtypes of breast cancer, to assess generalisability in a broad range of practice settings. METHODS: In this pooled analysis, 12 institutes and trials in Europe and the USA were identified by personal communications with site investigators. We obtained participant-level RCB results, and data on clinical and pathological stage, tumour subtype and grade, and treatment and follow-up in November, 2019, from patients (aged ≥18 years) with primary stage I-III breast cancer treated with neoadjuvant chemotherapy followed by surgery. We assessed the association between the continuous RCB score and the primary study outcome, event-free survival, using mixed-effects Cox models with the incorporation of random RCB and cohort effects to account for between-study heterogeneity, and stratification to account for differences in baseline hazard across cancer subtypes defined by hormone receptor status and HER2 status. The association was further evaluated within each breast cancer subtype in multivariable analyses incorporating random RCB and cohort effects and adjustments for age and pretreatment clinical T category, nodal status, and tumour grade. Kaplan-Meier estimates of ev...