Assessment of novel prognostic biomarkers to predict pathological complete response in patients with non-metastatic triple-negative breast cancer using a window of opportunity design.

IF 4.3 2区 医学 Q2 ONCOLOGY
Therapeutic Advances in Medical Oncology Pub Date : 2024-05-24 eCollection Date: 2024-01-01 DOI:10.1177/17588359241248329
Chitradurga Rajashekhar Akshatha, Dhanapathi Halanaik, Rajesh Nachiappa Ganesh, Nanda Kishore, Prasanth Ganesan, Smita Kayal, Harichandra Kumar, Biswajit Dubashi
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引用次数: 0

Abstract

Background: Triple-negative breast cancer (TNBC) includes approximately 20% of all breast cancer and is characterized by its aggressive nature, high recurrence rates, and visceral metastasis. Pathological complete response (pCR) is an established surrogate endpoint for survival. The window of opportunity studies provide valuable information on the disease biology prior to definitive treatment.

Objectives: To study the association of dynamic change in pathological, imagining, and genomic biomarkers that can prognosticate pCR. The study aims to develop a composite prognostic score.

Design: Clinical, interventional, and prognostic biomarker study using the novel window of opportunity design.

Methods: The study aims to enroll 80 treatment-naïve, pathologically confirmed TNBC patients, administering a single dose of paclitaxel and carboplatin during the window period before neoadjuvant chemotherapy (NACT). Tumor tissue will be obtained through a tru-cut biopsy, and positron emission tomography and computed tomography scans will be performed for each patient at two time points aiming to evaluate biomarker alterations. This will be followed by the administration of standard dose-dense NACT containing anthracyclines and taxanes, with the study culminating in surgery to assess pCR.

Results: The study would develop a composite prognostic risk score derived from the dynamic change in the Ki-67, tumor-infiltrating lymphocytes, Standardized Uptake Value (SUV max), Standardized Uptake Value for lean body mass (SUL max), and gene expression level pre- and post-intervention during the window period prior to the start of definitive treatment. This outcome will aid in categorizing the disease biology into risk categories.

Trial registration: The current study is approved by the Institutional Ethics Committee [Ethics: Protocol. no. JIP/IEC/2020/019]. This study was registered with ClinicalTrials.gov [CTRI Registration: CTRI/2022/06/043109].

Conclusion: The validated biomarker score will help to personalize NACT protocols in patients in TNBC planned for definitive treatment.

利用机会之窗设计评估新型预后生物标志物,以预测非转移性三阴性乳腺癌患者的病理完全反应。
背景:三阴性乳腺癌(TNBC)约占所有乳腺癌的 20%,其特点是侵袭性强、复发率高和内脏转移。病理完全缓解(pCR)是已确立的生存替代终点。机会之窗研究为确定性治疗前的疾病生物学研究提供了宝贵的信息:研究可预示 pCR 的病理、影像和基因组生物标志物动态变化的关联性。研究旨在制定一个综合预后评分:设计:临床、介入和预后生物标志物研究,采用新颖的机会之窗设计:该研究旨在招募80名未经治疗、病理确诊的TNBC患者,在新辅助化疗(NACT)前的窗口期给予单剂量紫杉醇和卡铂。将通过切片活检获取肿瘤组织,并在两个时间点对每位患者进行正电子发射断层扫描和计算机断层扫描,以评估生物标记物的变化。随后将给予含有蒽环类和紫杉类药物的标准剂量NACT,最后通过手术评估pCR:该研究将根据干预前后的 Ki-67、肿瘤浸润淋巴细胞、标准化摄取值(SUV max)、瘦体重标准化摄取值(SUL max)和基因表达水平在明确治疗开始前的窗口期的动态变化,得出综合预后风险评分。这一结果将有助于将疾病生物学分为不同的风险类别:本研究已获得机构伦理委员会批准[伦理:协议编号:JIP/IEC/2020/019]。本研究已在 ClinicalTrials.gov 注册[CTRI 注册:CTRI/2022/06/043109]:经过验证的生物标志物评分将有助于为计划接受明确治疗的 TNBC 患者制定个性化的 NACT 方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.20
自引率
2.00%
发文量
160
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
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