Details der Publikation - Benefit of adjuvant chemotherapy in patients with special histology subtypes of triple-negative breast cancer: a systematic review

Benefit of adjuvant chemotherapy in patients with special histology subtypes of triple-negative breast cancer: a systematic review

Purpose Breast cancer (BC) is a leading cause of morbidity, disability, and mortality in women, worldwide; triple-negative BC (TNBC) is a subtype traditionally associated with poorer prognosis. TNBC special histology subtypes present distinct clinical and molecular features and sensitivity to antineoplastic treatments. However, no consensus has been defined on the best adjuvant therapy. The aim of the review is to study the evidence from literature to inform the choice of adjuvant treatments in this setting. Methods We systematically searched literature assessing the benefit of adjuvant chemotherapy in patients with TNBC special histotypes (PROSPERO: CRD42020153818). Results We screened 6404 records (15 included). All the studies estimated the benefit of different chemotherapy regimens, in retrospective cohorts (median size: 69 patients (range min–max: 17–5142); median follow-up: 51 months (range: 21–268); mostly in Europe and USA). In patients with early-stage adenoid cystic TNBC, a marginal role of chemotherapy was reported. Similar for apocrine TNBC. Medullary tumors exhibited an intrinsic good prognosis with a limited role of chemotherapy, suggested to be modulated by the presence of tumor-infiltrating lymphocytes. A significant impact of chemotherapy on the overall survival was estimated in patients with metaplastic TNBC. Limitations were related to the retrospective design of all the studies and heterogeneous treatments received by the patients. Conclusions There is potential opportunity to consider treatment de-escalation and less intense therapies in some patients with early, special histology-type TNBC. International efforts are indispensable to validate prospective clinical decision models..

Medienart:	E-Artikel

Erscheinungsjahr:	2021
Erschienen:	2021

Enthalten in:	Zur Gesamtaufnahme - volume:187
Enthalten in:	Breast cancer research and treatment - 187(2021), 2 vom: 27. Mai, Seite 323-337

Sprache:	Englisch

Beteiligte Personen:	Trapani, D. [VerfasserIn] Giugliano, F. [VerfasserIn] Uliano, J. [VerfasserIn] Zia, V. A. A. [VerfasserIn] Marra, A. [VerfasserIn] Viale, G. [VerfasserIn] Ferraro, E. [VerfasserIn] Esposito, A. [VerfasserIn] Criscitiello, C. [VerfasserIn] D’amico, P. [VerfasserIn] Curigliano, G. [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

BKL:	44.92$jGynäkologie
Themen:	Adjuvant treatment intensity customization Escalation and de-escalation Special histology Triple-negative breast cancer WHO classification

Anmerkungen:	© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021

doi:	10.1007/s10549-021-06259-8

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	OLC2125969505

Internformat


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520			\|a Purpose Breast cancer (BC) is a leading cause of morbidity, disability, and mortality in women, worldwide; triple-negative BC (TNBC) is a subtype traditionally associated with poorer prognosis. TNBC special histology subtypes present distinct clinical and molecular features and sensitivity to antineoplastic treatments. However, no consensus has been defined on the best adjuvant therapy. The aim of the review is to study the evidence from literature to inform the choice of adjuvant treatments in this setting. Methods We systematically searched literature assessing the benefit of adjuvant chemotherapy in patients with TNBC special histotypes (PROSPERO: CRD42020153818). Results We screened 6404 records (15 included). All the studies estimated the benefit of different chemotherapy regimens, in retrospective cohorts (median size: 69 patients (range min–max: 17–5142); median follow-up: 51 months (range: 21–268); mostly in Europe and USA). In patients with early-stage adenoid cystic TNBC, a marginal role of chemotherapy was reported. Similar for apocrine TNBC. Medullary tumors exhibited an intrinsic good prognosis with a limited role of chemotherapy, suggested to be modulated by the presence of tumor-infiltrating lymphocytes. A significant impact of chemotherapy on the overall survival was estimated in patients with metaplastic TNBC. Limitations were related to the retrospective design of all the studies and heterogeneous treatments received by the patients. Conclusions There is potential opportunity to consider treatment de-escalation and less intense therapies in some patients with early, special histology-type TNBC. International efforts are indispensable to validate prospective clinical decision models.
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Benefit of adjuvant chemotherapy in patients with special histology subtypes of triple-negative breast cancer: a systematic review

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