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Prognostic Significance of Molecular Profile in Non-metastatic Invasive Breast Cancer: A Multicentre Study from India

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Purpose

To give the molecular profiling and its association with DFS among women with early breast cancer (EBC) and locally advanced breast cancer (LABC).

Methods

This cohort study used secondary data from six tertiary cancer hospitals in south India. DFS was calculated from the date of treatment completion to local or distant relapse, death, or last follow-up or date of censoring (31 December 2018) whichever was earlier. Adjusted hazard ratios (HRs) and 95% CIs were calculated using Cox regression analysis.

Results

Of 837 women, 288 (34.4%) had EBC and 549 (65.6%) had LABC. The mean age was 52.1 years (SD 10.4). Luminal A was the most frequent molecular subtype (36.7%) followed by triple-negative (25.4%), Her2/neu-enriched (14.9%) and luminal B Her2/neu-positive subtypes (13.1%). Three-year DFS was 92% among EBC and 76% among LABC. Among EBC group, molecular profile was not associated with DFS. On adjusted analysis among LABC group, when compared to luminal A, triple-negative [aHR 3.95 (95% CI 1.78, 7.88)] and Her2-enriched [aHR 2.6 (95% CI 1.21, 5.61)] were associated with relapse.

Conclusion

Certain molecular subtypes predicted survival in LABC group. However, early diagnosis and treatment appear to nullify this effect on survival.

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Acknowledgements

This research was conducted through the Structured Operational Research and Training Initiative (SORT IT), a global partnership led by the Special Program for Research and Training in Tropical Diseases at the World Health Organization (WHO/TDR). The training model is based on a course developed jointly by the International Union Against Tuberculosis and Lung Disease (The Union) and Medécins sans Frontières (MSF/Doctors Without Borders). The specific SORT IT programme which resulted in this publication was jointly developed and implemented by: Fenivi Research Solutions Private Limited, Chennai, India; The Union South-East Asia Office, New Delhi, India; and the Center for Operational Research, The Union, Paris, France. Mentorship and the coordination/facilitation of this particular SORT IT programme were provided through Fenivi Research Solutions Private Limited, Chennai, India; The Union South-East Asia Office, New Delhi, India; the Center for Operational Research, The Union, Paris, France; Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India; All India Institute of Medical Sciences (AIIMS), Nagpur, India; and Velammal Medical College Hospital and Research Institute, Madurai, India. The specific SORT IT programme which resulted in this publication was based on the data shared by the members of Collaborative Medical Oncology Group (CMOG), India.

Author information

Author notes

  1. Shashidhar V. Karpurmath and Arun Seshachalam have contributed equally to this work.

Authors and Affiliations

  1. Department of Medical Oncology, Meenakshi Mission Hospital and Research Centre, Lake Area, Melur Road, Madurai, 625107, India

    Krishnakumar Rathnam, Kosanam S. Kirushnakumar, R. Vijayabhaskar, P. Anandaselvakumar & S. V. Saju

  2. Fenivi Research Solutions, Chennai, India

    K. Niraimathi

  3. International Union Against Tuberculosis and Lung Disease (The Union), Paris, France

    Hemant Deepak Shewade

  4. The Union South-East Asia, New Delhi, India

    Hemant Deepak Shewade

  5. Karuna Trust, Bengaluru, India

    Hemant Deepak Shewade

  6. Department of Medical Oncology, Apollo Hospital, Bengaluru, India

    Chenappa N. Patil

  7. Department of Medical Oncology, Columbia Asia Hospital, Bengaluru, India

    Neelesh Reddy

  8. Madras Cancer Care Foundation, Chennai, India

    Ramanan Ganapathy & Murugesan Janarthinakani

  9. Department of Medical Oncology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, India

    Manjunath Nandennavar & Shashidhar V. Karpurmath

  10. Department of Medical Oncology, Dr GVN Cancer Institute, Tiruchirappalli, India

    Arun Seshachalam

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  1. Krishnakumar Rathnam
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Correspondence to Krishnakumar Rathnam.

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Appendix: Chemotherapy Treatment Regimens

Appendix: Chemotherapy Treatment Regimens

  1. 1.

    FAC—fluorouracil/doxorubicin/cyclophosphamide × 6 cycles

  2. 2.

    FEC—fluorouracil/epirubicin/cyclophosphamide × 6 cycles

  3. 3.

    AC—doxorubicin/cyclophosphamide × 4 cycles

  4. 4.

    EC—epirubicin/cyclophosphamide × 4 cycles

  5. 5.

    AC—T-doxorubicin/cyclophosphamide × 4 cycles—docetaxel × 4 cycles

  6. 6.

    AC—P-doxorubicin/cyclophosphamide × 4 cycles—paclitaxel × 4 cycles

  7. 7.

    AC—WP-doxorubicin/cyclophosphamide × 4 cycles—paclitaxel × weekly 12 cycles

  8. 8.

    EC—T-epirubicin/cyclophosphamide × 4 cycles—docetaxel × 4 cycles

  9. 9.

    EC—P-epirubicin/cyclophosphamide × 4 cycles—paclitaxel × 4 cycles

  10. 10.

    EC—WP-epirubicin/cyclophosphamide × 4 cycles—paclitaxel × weekly 12 cycles

  11. 11.

    TC—docetaxel/cyclophosphamide × 4–6 cycles

  12. 12.

    CMF—fluorouracil/methotrexate/cyclophosphamide × 6 cycles

  13. 13.

    TCH—docetaxel/carboplatin/herceptin × 6 cycles

Chemotherapy dosing was uniformly followed at treating institutions done as per recent updated National Comprehensive Cancer Network (NCCN) guidelines existing at particular treatment time frames.

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Rathnam, K., Niraimathi, K., Shewade, H.D. et al. Prognostic Significance of Molecular Profile in Non-metastatic Invasive Breast Cancer: A Multicentre Study from India. Indian J Gynecol Oncolog 18, 36 (2020). https://doi.org/10.1007/s40944-020-0381-3

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  • DOI: https://doi.org/10.1007/s40944-020-0381-3

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