Does RECIST 1.1 Predict Nodal Response to Neoadjuvant Chemo-Immunotherapy in Breast Cancer?

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-09-24 DOI:10.1002/jso.70096

Matteo Redaelli, Jessica A Steadman, Tanya L Hoskin, Tina J Hieken

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引用次数: 0

Abstract

Background and objectives: Neoadjuvant chemoimmunotherapy (NACI) for node-positive breast cancer may induce immune cell activation in regional lymph nodes (LN), confounding post-NACI imaging. Here we evaluated RECIST 1.1 criteria to predict post-NACI pathologic LN status.

Methods: We studied patients with biopsy-proven cN+ non-distant metastatic breast cancer receiving NACI operated on 03/2020-09/2024 with both pre- and post-NACI cross-sectional imaging. Per RECIST 1.1, LN short axis diameter (SAD) was measured in target (defined as SAD ≥ 15 mm) and nontarget (SAD 10-14.9 mm) LNs. Groups were compared using Fisher's exact test.

Results: 75 patients, median age 53 years, were studied: 61% cN1, 12% cN2, and 27% cN3. Baseline median number of imaging-suspicious LN was 4 (IQR 2-5). Post-NACI, 64% had a nodal pathologic complete response (pCR/ypN0). 55% met RECIST 1.1 LN assessment criteria. 21 of 32 (66%) with an imaging CR (iCR) were ypN0, while 8 of 9 (89%) without an iCR were ypN0. Neither target (p = 0.24) nor combined target/nontarget LN iCR (p = 0.76) predicted ypN status. Nodal pCR rates were higher in those with ≤ 1 versus > 1 suspicious LN post-NACI (71% vs. 42%, p = 0.03).

Conclusions: RECIST 1.1 criteria did not predict nodal pCR for NACI-treated node-positive breast cancer patients. Other post-NACI imaging assessment strategies are needed.

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RECIST 1.1能预测乳腺癌新辅助化疗免疫治疗的淋巴结反应吗？

背景和目的：淋巴结阳性乳腺癌的新辅助化疗免疫治疗（NACI）可能诱导区域淋巴结（LN）的免疫细胞活化，混淆NACI后的成像。在这里，我们评估了RECIST 1.1标准来预测naci后病理LN状态。方法：对2020年3月3日至2024年9月接受NACI手术的活检证实的cN+非远处转移性乳腺癌患者进行NACI术前和术后的横断面成像研究。根据RECIST 1.1， LN短轴直径（SAD）在靶（定义为SAD≥15 mm）和非靶（SAD 10-14.9 mm） LNs中测量。各组采用Fisher精确检验进行比较。结果：75例患者，中位年龄53岁，61%为cN1, 12%为cN2, 27%为cN3。影像学可疑LN基线中位数为4例（IQR 2-5）。naci后，64%的患者有淋巴结病理完全缓解（pCR/ypN0）。55%符合RECIST 1.1 LN评估标准。有影像CR （iCR）的32例中有21例（66%）为ypN0，无iCR的9例中有8例（89%）为ypN0。靶标（p = 0.24）和靶标/非靶标LN iCR （p = 0.76）均不能预测ypN状态。可疑LN≤1的患者的节点pCR率高于可疑LN≤1的患者（71%对42%，p = 0.03）。结论：RECIST 1.1标准不能预测naci治疗的淋巴结阳性乳腺癌患者的淋巴结pCR。需要其他naci后影像学评估策略。

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

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.