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William J. Gradishar, MD, FACP, FASCO


New Metric May Help to Predict Long-Term Survival in Triple-Negative Breast Cancer

By: Victoria Kuhr, BA
Posted: Friday, July 29, 2022

Lajos Pusztai, MD, PhD, of Yale School of Medicine, New Haven, Connecticut, and colleagues reported that a new metric—known as the treatment efficacy score—may help to predict long-term survival in patients with triple-negative breast cancer. Additionally, treatment efficacy scores appeared to better correlate with event-free and distant recurrence–free survival than pathologic complete response (pCR) rate difference in trial arms of this type of breast cancer. These findings were published in Annals of Oncology.

“Treatment efficacy score could serve as a better early surrogate to predict trial-arm level survival than difference in pathologic complete response rates,” said the study authors.

The study authors created treatment efficacy scores to compare the efficacy of neoadjuvant chemotherapy in randomized trial arms in preoperative breast cancer trials. The treatment efficacy score describes the effectiveness of a cancer drug in shrinking cancer in a group of patients across the whole spectrum of tumor shrinkage. The treatment efficacy score reflects the area between the weighted cumulative distribution functions of residual breast cancer values from two trial arms. The higher the treatment efficacy score, the greater the shift to lower residual breast cancer values in the experimental arm.

A total of 947 arms from the I-SPY2 trial (72 durvalumab plus olaparib arms and 282 corresponding controls) and 11 other experimental arms and control cohorts were used as validation sets to assess the performance of these scores. In the validation set, the scores identified arms with a higher pCR rate—the traditional measure of success. Additionally, the scores more accurately identified regimens as less effective in improving recurrence-free survival when treatment did not reduce the frequency of high residual breast cancer values. The correlation between treatment efficacy scores and survival was reported to be higher than the correlation between pCR rate difference and survival. The highest treatment efficacy score in triple-negative breast cancer was in two immunotherapy arms: pembrolizumab and durvalumab plus olaparib.

Disclosure: For full disclosures of the study authors, visit

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