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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Tuesday, September 3, 2024
The increased mortality rate observed in patients with locally advanced breast cancer from Latin America has motivated researchers to investigate the underlying cause and to provide strategies to combat this trend, according to a study published in JCO Global Oncology. Breast-conservation therapy and neoadjuvant treatment may be imperative to improving outcomes in this patient population, suggested Javier Retamales, MD, of Grupo Oncologico Cooperativo Chileno de Investigacion, Santiago, and colleagues.
A total of nearly 1,500 patients with locally advanced breast cancer were enrolled in the Molecular Profiling of Breast Cancer Study. Patients were recruited from Latin American countries including Argentina, Brazil, Chile, Mexico, and Uruguay. Completing the 5-year follow-up period were 711 patients assigned to undergo primary surgery and 480 patients given neoadjuvant chemotherapy. They were closely monitored for 5 years to assess clinical outcomes.
The study authors identified an independent association between overall survival and residual cancer burden (RCB). Worse survival outcomes were demonstrated for patients with RCB-III (hazard ratio [HR] = 8.19) and RCB-II (HR = 3.69) compared with patients who exhibited a pathologic complete response. In addition, patients who underwent mastectomy were found to have a worse overall survival than were patients who received breast-conserving therapy (HR = 2.97). Furthermore, an increased extent of pathologic complete responses (48.9%) was observed in patients who had hormone receptor–negative, HER2-positive disease. Moreover, the authors identified variability among trastuzumab therapy compliance, ranging from 33.3% to 88.7%.
“Despite encountering limitations, including variability in access to key treatments, this study represents a significant step forward in understanding the real-world implementation of oncologic procedures in diverse health-care environments,” the investigators concluded.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
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