What factors predict poor prognosis in high-risk TNBC?

  • Kennedy WR & al.
  • J Natl Compr Canc Netw
  • 1 Mar 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Risk factors for distant metastasis in high-risk triple-negative breast cancer (TNBC) are positive lymph nodes and lymphovascular space invasion (LVSI).
  • High-risk is defined as failing to achieve pathologic complete response (pCR) after treatment with neoadjuvant chemotherapy (NAC).

Why this matters

  • Results suggest a way to stratify patients with high-risk TNBC in relation to their prognosis and to design future clinical trials.

Study design

  • Retrospective cohort study (153 consecutive patients) of high-risk TNBC at a single-center (treated with NAC, surgery, and radiation therapy).
  • Funding: None disclosed.

Key results

  • Median follow-up was 4.04 (range, 0.51-13.97) years.
  • 29.4% of the cohort achieved pCR after NAC; the remainder did not.
  • Comparing 5-year freedom from distant metastasis between patients without pCR (55%) vs with pCR (98%), the following 2 risk factors independently predicted distant metastatic disease:
    • Positive lymph nodes: HR, 3.08 (P=.001).
    • LVSI: HR, 1.91 (P=.030).

Limitations

  • Retrospective, observational design.
  • Small cohort.