Pathologic Response to Neoadjuvant Sequential Chemoradiation Therapy in Locally Advanced Breast Cancer: Preliminary, Translational Results from the French Neo-APBI-01 Trial - Archive ouverte HAL
Article Dans Une Revue Cancers Année : 2023

Pathologic Response to Neoadjuvant Sequential Chemoradiation Therapy in Locally Advanced Breast Cancer: Preliminary, Translational Results from the French Neo-APBI-01 Trial

Nhu Hanh To
Isabelle Gabelle-Flandin
  • Fonction : Auteur
Thi My Hanh Luong
  • Fonction : Auteur
Gokoulakrichenane Loganadane
  • Fonction : Auteur
Nabila Ouidir
  • Fonction : Auteur
Chahrazed Boukhobza
  • Fonction : Auteur
Noémie Grellier
  • Fonction : Auteur
Camille Verry
  • Fonction : Auteur
Allan Thiolat
  • Fonction : Auteur
José Cohen
  • Fonction : Auteur
Yazid Belkacemi

Résumé

Background: Radiation therapy (RT), a novel approach to boost the anticancer immune response, has been progressively evaluated in the neoadjuvant setting in breast cancer (BC). Purpose: We aimed to evaluate immunity-related indicators of response to neoadjuvant chemoradiation therapy (NACRT) in BC for better treatment personalization. Patients and Methods: We analyzed data of the first 42 patients included in the randomized phase 2 Neo-APBI-01 trial comparing standard neoadjuvant chemotherapy (NACT) and NACRT regimen in locally advanced triple-negative (TN) and luminal B (LB) subtype BC. Clinicopathological parameters, blood counts and the derived parameters, total tumor-infiltrating lymphocytes (TILs) and their subpopulation, as well as TP53 mutation status, were assessed as predictors of response. Results: Twenty-one patients were equally assigned to each group. The pathologic complete response (pCR) was 33% and 38% in the NACT and NACRT groups, respectively, with a dose-response effect. Only one LB tumor reached pCR after NACRT. Numerous parameters associated with response were identified, which differed according to the assigned treatment. In the NACRT group, baseline hemoglobin of ≥13 g/dL and body mass index of <26 were strongly associated with pCR. Higher baseline neutrophils-to-lymphocytes ratio, total TILs, and T-effector cell counts were favorable for pCR. Conclusion: This preliminary analysis identified LB and low-TIL tumors as poor responders to the NACRT protocol, which delivered RT after several cycles of chemotherapy. These findings will allow for amending the selection of patients for the trial and help better design future trials of NACRT in BC.

Domaines

Cancer

Dates et versions

hal-04209898 , version 1 (18-09-2023)

Identifiants

Citer

Nhu Hanh To, Isabelle Gabelle-Flandin, Thi My Hanh Luong, Gokoulakrichenane Loganadane, Nabila Ouidir, et al.. Pathologic Response to Neoadjuvant Sequential Chemoradiation Therapy in Locally Advanced Breast Cancer: Preliminary, Translational Results from the French Neo-APBI-01 Trial. Cancers, 2023, 15 (7), pp.2030. ⟨10.3390/cancers15072030⟩. ⟨hal-04209898⟩
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