Meta-analysis confirms achieving pathological complete response after neoadjuvant chemotherapy predicts favourable prognosis for breast cancer patients

TY - JOUR

T1 - Meta-analysis confirms achieving pathological complete response after neoadjuvant chemotherapy predicts favourable prognosis for breast cancer patients

AU - Kong, Xiangnan

AU - Moran, Meena S.

AU - Zhang, Ning

AU - Haffty, Bruce

AU - Yang, Qifeng

N1 - Funding Information: This Project is supported by Programme for New Century Excellent Talents in University , Key Project of Chinese Ministry of Education (No. 108080 ), National Natural Science Foundation of China (Nos. 30772133 , 81072150 ) and Independent Innovation Foundation of Shandong University (IIFSDU, No. 2009JQ007 ) to Prof. Q. Yang.

PY - 2011/9

Y1 - 2011/9

N2 - Neoadjuvant chemotherapy (NAC) has become a widely accepted method of sequencing systemic therapy for breast cancer treatment. While 'response to chemotherapy' in the neoadjuvant setting has been utilised to predict prognosis, the published data are inconsistent. The present meta-analysis was conducted to determine whether the pathologic response to NAC predicts for outcomes. Papers were selected from the PubMed database based on defined inclusion and exclusion criteria. Parameters such as number/percentage of patients having pCR and outcome statistics (i.e. overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS)) were collected. The analysis included 16 studies with 3776 patients. The summary odds ratio (OR) estimating the association of OS with pCR was 3.44 (95% confidence interval [95%CI]: 2.45-4.84), with similar findings for DFS (OR = 3.41, 95%CI: 2.54-4.58) and RFS (OR = 2.45, 95%CI: 1.59-3.80). No obvious statistical heterogeneity was detected. Funnel plots and Egger's tests did not reveal publication bias. This meta-analysis confirms that pathologic response is a prognostic indicator for RFS, DFS and OS and suggests that patients achieving pCR after NAC have favourable outcomes.

AB - Neoadjuvant chemotherapy (NAC) has become a widely accepted method of sequencing systemic therapy for breast cancer treatment. While 'response to chemotherapy' in the neoadjuvant setting has been utilised to predict prognosis, the published data are inconsistent. The present meta-analysis was conducted to determine whether the pathologic response to NAC predicts for outcomes. Papers were selected from the PubMed database based on defined inclusion and exclusion criteria. Parameters such as number/percentage of patients having pCR and outcome statistics (i.e. overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS)) were collected. The analysis included 16 studies with 3776 patients. The summary odds ratio (OR) estimating the association of OS with pCR was 3.44 (95% confidence interval [95%CI]: 2.45-4.84), with similar findings for DFS (OR = 3.41, 95%CI: 2.54-4.58) and RFS (OR = 2.45, 95%CI: 1.59-3.80). No obvious statistical heterogeneity was detected. Funnel plots and Egger's tests did not reveal publication bias. This meta-analysis confirms that pathologic response is a prognostic indicator for RFS, DFS and OS and suggests that patients achieving pCR after NAC have favourable outcomes.

KW - Breast cancer

KW - Meta-analysis

KW - Neoadjuvant chemotherapy

KW - Pathological complete response

KW - Prognosis

KW - Prognostic indicator

UR - https://www.scopus.com/pages/publications/80052546951

UR - https://www.scopus.com/pages/publications/80052546951#tab=citedBy

U2 - 10.1016/j.ejca.2011.06.014

DO - 10.1016/j.ejca.2011.06.014

M3 - Article

C2 - 21737257

SN - 0959-8049

VL - 47

SP - 2084

EP - 2090

JO - European Journal of Cancer

JF - European Journal of Cancer

IS - 14

ER -