Chemotherapy response and survival of inflammatory breast cancer by hormone receptor- and HER2-defined molecular subtypes approximation: an analysis from the National Cancer Database

Jieqiong Liu, Kai Chen, Wen Jiang, Kai Mao, Shunrong Li, Min Ji Kim, Qiang Liu, Lisa K. Jacobs

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: To study the impact of hormone receptor (HR)- and human epidermal growth factor receptor 2 (HER2)-defined subtypes on survival of inflammatory breast cancer (IBC), and to determine whether sensitivity to neoadjuvant chemotherapy (NAC) varies with subtypes in a large IBC population. Methods: We analyzed 593 IBCs with known HR/HER2 statuses between 2010 and 2011 from National Cancer Database. We compared pathologic complete response (pCR) rates among four molecular subtypes by Chi-square test. Overall survival (OS) was compared among four subtypes and patients with or without pCR using log-rank test. Multivariate Cox model was performed to identify the impact of molecular subtype and other prognostic factors on OS. Results: Of the 593 patients included, 231 (39.0 %) patients had HR+/HER2− tumors, 98 (16.5 %) had HR+/HER2+ disease, 112 (18.9 %) were HR-/HER2 + patients, and 152 (25.6 %) had triple-negative subtype. The pCR rates differed significantly by subtype (P < 0.001): HR−/HER2+ showed the highest, and HR+/HER2− exhibited the lowest. Multivariate analysis showed that triple-negative and HR+/HER2− IBCs had significantly worse survival compared with HR+/HER2+ or HR−/HER2+ subtype (P < 0.01 for all comparisons). Additional factors associated with worse OS included more comorbidities, lack or incomplete surgical resection, absence of radiotherapy, lack of hormone therapy, and more advanced stage. Conclusions: IBC is an aggressive heterogeneous disease with distinct molecular subtypes associated with differential outcomes and sensitivities to NAC. Unlike in noninflammatory breast cancer, in IBC HR + disease was not associated with favorable prognosis. Triple-negative and HR+/HER2− subtypes are independent predictors for suboptimal OS in IBC.

Original languageEnglish (US)
Pages (from-to)161-168
Number of pages8
JournalJournal of Cancer Research and Clinical Oncology
Volume143
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

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Inflammatory Breast Neoplasms
Databases
Hormones
Drug Therapy
Survival
Neoplasms
human ERBB2 protein
Chi-Square Distribution
Proportional Hazards Models

Keywords

  • Chemotherapy response
  • Inflammatory breast cancer
  • Molecular subtype
  • National Cancer Database
  • Overall survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Chemotherapy response and survival of inflammatory breast cancer by hormone receptor- and HER2-defined molecular subtypes approximation : an analysis from the National Cancer Database. / Liu, Jieqiong; Chen, Kai; Jiang, Wen; Mao, Kai; Li, Shunrong; Kim, Min Ji; Liu, Qiang; Jacobs, Lisa K.

In: Journal of Cancer Research and Clinical Oncology, Vol. 143, No. 1, 01.01.2017, p. 161-168.

Research output: Contribution to journalArticle

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title = "Chemotherapy response and survival of inflammatory breast cancer by hormone receptor- and HER2-defined molecular subtypes approximation: an analysis from the National Cancer Database",
abstract = "Purpose: To study the impact of hormone receptor (HR)- and human epidermal growth factor receptor 2 (HER2)-defined subtypes on survival of inflammatory breast cancer (IBC), and to determine whether sensitivity to neoadjuvant chemotherapy (NAC) varies with subtypes in a large IBC population. Methods: We analyzed 593 IBCs with known HR/HER2 statuses between 2010 and 2011 from National Cancer Database. We compared pathologic complete response (pCR) rates among four molecular subtypes by Chi-square test. Overall survival (OS) was compared among four subtypes and patients with or without pCR using log-rank test. Multivariate Cox model was performed to identify the impact of molecular subtype and other prognostic factors on OS. Results: Of the 593 patients included, 231 (39.0 {\%}) patients had HR+/HER2− tumors, 98 (16.5 {\%}) had HR+/HER2+ disease, 112 (18.9 {\%}) were HR-/HER2 + patients, and 152 (25.6 {\%}) had triple-negative subtype. The pCR rates differed significantly by subtype (P < 0.001): HR−/HER2+ showed the highest, and HR+/HER2− exhibited the lowest. Multivariate analysis showed that triple-negative and HR+/HER2− IBCs had significantly worse survival compared with HR+/HER2+ or HR−/HER2+ subtype (P < 0.01 for all comparisons). Additional factors associated with worse OS included more comorbidities, lack or incomplete surgical resection, absence of radiotherapy, lack of hormone therapy, and more advanced stage. Conclusions: IBC is an aggressive heterogeneous disease with distinct molecular subtypes associated with differential outcomes and sensitivities to NAC. Unlike in noninflammatory breast cancer, in IBC HR + disease was not associated with favorable prognosis. Triple-negative and HR+/HER2− subtypes are independent predictors for suboptimal OS in IBC.",
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AU - Liu, Jieqiong

AU - Chen, Kai

AU - Jiang, Wen

AU - Mao, Kai

AU - Li, Shunrong

AU - Kim, Min Ji

AU - Liu, Qiang

AU - Jacobs, Lisa K.

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N2 - Purpose: To study the impact of hormone receptor (HR)- and human epidermal growth factor receptor 2 (HER2)-defined subtypes on survival of inflammatory breast cancer (IBC), and to determine whether sensitivity to neoadjuvant chemotherapy (NAC) varies with subtypes in a large IBC population. Methods: We analyzed 593 IBCs with known HR/HER2 statuses between 2010 and 2011 from National Cancer Database. We compared pathologic complete response (pCR) rates among four molecular subtypes by Chi-square test. Overall survival (OS) was compared among four subtypes and patients with or without pCR using log-rank test. Multivariate Cox model was performed to identify the impact of molecular subtype and other prognostic factors on OS. Results: Of the 593 patients included, 231 (39.0 %) patients had HR+/HER2− tumors, 98 (16.5 %) had HR+/HER2+ disease, 112 (18.9 %) were HR-/HER2 + patients, and 152 (25.6 %) had triple-negative subtype. The pCR rates differed significantly by subtype (P < 0.001): HR−/HER2+ showed the highest, and HR+/HER2− exhibited the lowest. Multivariate analysis showed that triple-negative and HR+/HER2− IBCs had significantly worse survival compared with HR+/HER2+ or HR−/HER2+ subtype (P < 0.01 for all comparisons). Additional factors associated with worse OS included more comorbidities, lack or incomplete surgical resection, absence of radiotherapy, lack of hormone therapy, and more advanced stage. Conclusions: IBC is an aggressive heterogeneous disease with distinct molecular subtypes associated with differential outcomes and sensitivities to NAC. Unlike in noninflammatory breast cancer, in IBC HR + disease was not associated with favorable prognosis. Triple-negative and HR+/HER2− subtypes are independent predictors for suboptimal OS in IBC.

AB - Purpose: To study the impact of hormone receptor (HR)- and human epidermal growth factor receptor 2 (HER2)-defined subtypes on survival of inflammatory breast cancer (IBC), and to determine whether sensitivity to neoadjuvant chemotherapy (NAC) varies with subtypes in a large IBC population. Methods: We analyzed 593 IBCs with known HR/HER2 statuses between 2010 and 2011 from National Cancer Database. We compared pathologic complete response (pCR) rates among four molecular subtypes by Chi-square test. Overall survival (OS) was compared among four subtypes and patients with or without pCR using log-rank test. Multivariate Cox model was performed to identify the impact of molecular subtype and other prognostic factors on OS. Results: Of the 593 patients included, 231 (39.0 %) patients had HR+/HER2− tumors, 98 (16.5 %) had HR+/HER2+ disease, 112 (18.9 %) were HR-/HER2 + patients, and 152 (25.6 %) had triple-negative subtype. The pCR rates differed significantly by subtype (P < 0.001): HR−/HER2+ showed the highest, and HR+/HER2− exhibited the lowest. Multivariate analysis showed that triple-negative and HR+/HER2− IBCs had significantly worse survival compared with HR+/HER2+ or HR−/HER2+ subtype (P < 0.01 for all comparisons). Additional factors associated with worse OS included more comorbidities, lack or incomplete surgical resection, absence of radiotherapy, lack of hormone therapy, and more advanced stage. Conclusions: IBC is an aggressive heterogeneous disease with distinct molecular subtypes associated with differential outcomes and sensitivities to NAC. Unlike in noninflammatory breast cancer, in IBC HR + disease was not associated with favorable prognosis. Triple-negative and HR+/HER2− subtypes are independent predictors for suboptimal OS in IBC.

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KW - Overall survival

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