137005-151

Locoregional recurrence (LRR) after neoadjuvant chemotherapy (NAC): Pooled-analysis results from the collaborative trials in neoadjuvant breast cancer (CTNeoBC).

Category: 
Local/Regional Therapy
Session Type and Session Title: 
Oral Abstract Session A: Local/Regional Therapy, Survivorship, and Health Policy
General Poster Session A: Local/Regional Therapy, Survivorship, and Health Policy
Abstract Number: 
61
Citation: 
J Clin Oncol 32, 2014 (suppl 26; abstr 61)
Author(s): 
Eleftherios P. Mamounas, Patricia Cortazar, Lijun Zhang, Gunter Von Minckwitz, Keyur Mehta, David A. Cameron, Herve R. Bonnefoi, Luca Gianni, Pinuccia Valagussa, Norman Wolmark, Sibylle Loibl, Jan Bogaerts, Sandra M. Swain, Rajeshwari Sridhara, Joseph P. Costantino, Priya Rastogi, Charles E. Geyer, Holger Eidtmann, Bernd Gerber, Michael Untch; National Surgical Adjuvant Breast and Bowel Project and the UF Health Cancer Center - Orlando Health, Orlando, FL; U.S. Food and Drug Administration, Silver Spring, MD; German Breast Group/University Frankfurt, Neu-Isenburg, Germany; German Breast Group, Neu-Isenburg, Germany; University of Edinburgh, Edinburgh, United Kingdom; Institut Bergonie Cancer Center, Bordeaux, France; San Raffaele Scientific Institute, Milan, Italy; Fondazione Michelangelo, Milan, Italy; National Surgical Adjuvant Breast and Bowel Project; The Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; German Breast Group/Sana Klinikum Offenbach, Neu-Isenburg, Germany; European Organisation for Research and Treatment of Cancer, Brussels, Belgium; MedStar Washington Hospital Center, Washington, DC; Biostatistical Center, National Surgical Adjuvant Breast and Bowel Project and Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; University of Pittsburgh Medical Center, Pittsburgh, PA; Massey Cancer Center, Virginia Commonwealth University School of Medicine & NRG Oncology, Richmond, VA; University Kiel, Kiel, Germany; University Rostock, Rostock, Germany; Helios Klinikum Berlin-Buch, Berlin, Germany

Abstract Disclosures

Abstract: 

Background: There is limited information on LRR rates in pts treated with NAC. Methods: 12 large NAC BC trials (11,955 pts) with pCR information and long-term F/U for LRR, EFS and OS were included. Primary aims were to assess LRR rates by pCR, tumor subtype, surgery type and other clinico-pathologic factors. Main definition of pCR was ypT0/is ypN0. Results: Median F/U: 5.4 years. Median age: 49, T2 tumors: 61%, Inflammatory BC: 4%; Clinically(+) nodes: 47%. Overall LRR: 6.8% (95% CI: 6.3, 7.2). LRR was 5.5% with pCR (ypT0/isypN0) vs. 7.1% without. After lumpectomy, LRR rates were similar with pCR (6.0%) vs. without (6.3%). After mastectomy, LRR rates were lower with pCR (3.8%) vs. without (8.1%), irrespective of XRT use. In HR(+)/HER2(-) BC, LRR rates were low with pCR (1.9%) or without (3.3%) with similarly low LRR rates in grade 1/2 tumors (pCR: 2%, no-pCR: 2.6%). In HR(+)/HER2(-)/grade 3 BC LRR rates were lower with pCR (1%) vs. without (5.3%). In HER2(+) BC LRR rates were similar with pCR (5.1%) or without (7.3%), mainly seen in HER2(+)/HR(+) BC (5.7% vs. 5.5%). In contrast, in HER2(+)/HR(-) BC LRR rates were lower with pCR (4.9%) vs. without (9.8%). Also, in HR(-) /HER2(-) BC LRR rates were lower with pCR (4.9%) vs. without (8.6%). LRR varied with path nodal status and TNM stage at surgery: node(-): 5.6% vs. node(+) 8.9%; stage 0: 5.3%; stage 1: 5.2%; stage 2: 7.3%; stage 3: 10.1%. Conclusions: LRR rates after NAC are low and vary by pCR status, tumor subtype, type of surgery, stage and path nodal status. This information may have clinical implications on selecting appropriate candidates for XRT.


Group
LRR rates (%)
Absolute diff. in LRR rates (%) (95% CI)
pCR No pCR
pCR Definition
ypT0/is ypN0
ypT0 ypN0


5.5
4.5


7.1
7.2


1.6 (0.5, 2.6)
2.7 (1.5, 3.8)
Lumpectomy 6.0 6.3 0.3 (-1.0,1.6)
Mastectomy
XRT
No XRT

3.8
1.7
5.3

8.1
6.5
9.2

4.3 (2.4, 6.2)
4.7 (1.6, 7.7)
3.8 (0.8, 6.8)
BC Subtype
HR(+)/HER2(-)
Grade I/2
Grade 3
HER2(+)
HR(+)
HR(-)
HR(-)/HER2(-)

1.9
2.0
1.0
5.1
5.7
4.9
4.9

3.3
2.6
5.3
7.3
5.5
9.8
8.6

1.4 (-0.4,3.2)
0.5 (-1.9,2.9)
4.3 (1.6,7.0)
2.2 (-0.1,4.4)
-0.2 (-3.5,3.1)
4.9 (1.4,8.4)
3.7 (0.8, 6.6)

Note: information on surgery type, XRT, HR, HER2 not available in all pts.