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• W2973155199 abstract "There are limited studies evaluating the outcomes in breast cancer patients receiving neoadjuvant endocrine therapy (NET). The purpose of this study is to evaluate outcomes and identify predictors of progression-free survival (PFS) and overall survival (OS) in patients receiving NET. This is a retrospective, IRB approved study of ER+ HER2- breast cancer patients treated with NET from 2000-2018 at a university hospital and an associated safety net hospital. Patient demographics, disease characteristics, treatment regimens, and clinical outcomes were collected through patient record review. Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Predictors of PFS and OS were evaluated using univariable and multivariable Cox’s regression modeling. A total of 201 patients were reviewed and 151 with disease diagnosed between 2000 and 2017 had surgery and complete data for analysis. Median age of diagnosis was 61 years and median FU was 45.1 months (range: 2.7 to 177.1). The population consisted of mostly postmenopausal (98%) women, of those 35 (23.2%) were black (including 4 Hispanics), 104 (68.9%) Hispanic white, 9 (6%) non-Hispanic white and 3 (2%) Asian. By clinical staging, 1.3% were stage I, 52.3% stage II, 44.4% stage III and 2% stage IV. Median tumor size was 5 cm. Following NET, 53 patients (35.1%) underwent lumpectomy and 98 (64.9%) underwent mastectomy. Ninety-six patients (63.6%) received adjuvant chemotherapy. Radiotherapy was delivered to 104 patients (68.9%). Sixty-one patients (40.4%) had ≥ 50% tumor size reduction at time of surgery. Pathological complete response was observed in 4 patients (2.6%). PFS and OS in the overall group was favorable, at 75.3% (95%CI: 65.8, 82.5%) and 89.6% (95%CI: 80.3, 94.7%) at 60 months, respectively. In univariable analysis race/ethnicity, clinical tumor stage III-IV, 4+ positive lymph nodes, 50% tumor size reduction were significant predictors for PFS (p<0.05) and only race/ethnicity was significant predictors for OS (p<0.05). On multivariable analysis only tumor size reduction was a predictor for PFS (p<0.05) and there was a trend for black race to have worse OS (p=0.078). This is the largest retrospective study of neoadjuvant hormonal therapy in an underserved population. NET is well tolerated, easy to deliver, and less costly in a safety net hospital system. Our study demonstrated overall excellent outcomes using NET in a multi-racial/ethnic ER+ HER2- breast cancer population. Our results indicate that there may be a difference in response to endocrine therapy based on race, and this deserves further characterization. A better understanding of the tumor response to NET may allow us to further individualize treatment regimens, such as adding radiation or systemic therapy, to improve PFS in the poor responders. Prospective trials are needed." @default.
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• W2973155199 date "2019-09-01" @default.
• W2973155199 modified "2023-09-27" @default.
• W2973155199 title "Neoadjuvant Hormonal Therapy Outcomes in a Multi-Racial/Ethnic Breast Cancer Population" @default.
• W2973155199 doi "https://doi.org/10.1016/j.ijrobp.2019.06.630" @default.
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