We analyzed 297 patients from the GeparQuattro (GBG40), GeparQuinto (GBG44), and GeparSixto (GBG66) trials and compared changes in tumor cells, tumor-infiltrating lymphocytes (TILs), and the proliferation marker Ki-67 from pre-treatment to treatment. Our results indicate that “on-treatment” biopsies may play an important role in identifying patients who are unlikely to achieve a complete pathological response (pCR), thus enabling early adjustment of therapy.
What does this mean?
- Patients without invasive tumor cells in the biopsy had a 50% pCR rate, compared to only 8% for patients with residual tumor.
- An increase in TILs was associated with a higher likelihood of pCR and better disease-free survival (DFS), particularly in triple-negative breast cancer (TNBC).
- Sustained or increased Ki-67 levels were associated with a lower likelihood of pCR and poorer DFS.
Our results offer exciting approaches for adjusting therapy in breast cancer patients and could help to better understand mechanisms of therapy resistance.
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