AACR 2023: Prognostic Value of New Model in Patients With Breast Cancer Treated With Neoadjuvant Therapy

By: Susan Reckling, MA
Posted: Monday, April 17, 2023

German researchers have created a new prognostic model for breast cancer—called the Altona regression model—for use in those treated with preoperative neoadjuvant chemotherapy. According to Dr. med. Anne-Sophie Wegscheider, of Pathologie Hamburg-West, Germany, and colleagues, their novel model “showed significantly better prognostic value concerning progression-free survival for patients with breast cancer after neoadjuvant therapy and surgery, compared with two well-known regression gradings.” These findings were presented at the American Association for Cancer Research (AACR) Annual Meeting 2023 (Abstract 1019/29).

The investigators focused on hematoxylin and eosin–stained, whole-slide images from 518 patients, who were treated in Hamburg between 2001 and 2019 with current therapy standards. They analyzed different variables of regressive changes in the breast cancer cells before therapy. The size of the residual tumor and the tumor bed was measured, with attention paid to lymph node metastasis and residual intraductal carcinoma in situ. Also examined by the research team were cell density and cell shape of the residual tumor, heterogeneity of residual tumor cells spreading within the tumor bed and size of the biggest cell clusters, and changes in the stroma and inflammation within the tumor bed.

Based on their univariate observation findings, the factors that had an impact on progression-free survival were heterogeneity, cell density and cell shape of residual tumor cells, stroma changes, presence of lymph node metastases, and largest diameter and largest cluster of residual tumor. The investigators stratified patients into low-, intermediate-, and high-risk groups for an event (local recurrence, metastasis, or death).

The incremental AUC was 0.607 for the novel model, compared with 0.350 for the Sinn et al model (which focuses on mRNA signatures) and 0.380 for the MD Anderson residual cancer burden (RCB) calculator (which combines pathologic findings in the primary tumor bed and the regional lymph nodes). As previously mentioned, the researchers reported their model yielded significantly better prognostic value regarding progression-free survival for this patient group than these other two models.

Disclosure: The study authors reported no conflicts of interest.

AACR Annual Meeting 2023

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