Highly accurate response prediction in high-risk early breast cancer patients using a biophysical simulation platform.
Highly accurate response prediction in high-risk early breast cancer patients using a biophysical simulation platform.
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使用生物物理模拟平台对高风险早期乳腺癌患者进行高度准确的反应预测。
DOI：
10.1007/s10549-022-06722-0
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发表时间：
2022-11
影响因子：
3.8
通讯作者：
Nanda, Rita
中科院分区：
文献类型：
--
作者：
Howard, Frederick M.;He, Gong;Peterson, Joseph R.;Pfeiffer, J. R.;Earnest, Tyler;Pearson, Alexander T.;Abe, Hiroyuki;Cole, John A.;Nanda, Rita
早期乳腺癌（EBC）对新辅助化疗（NAC）的病理完全反应（pCR）在很大程度上取决于乳腺癌亚型，但目前还没有临床分级模型来预测反应和指导治疗选择。对NAC反应的生物物理模拟有可能解决这一未满足的需求。我们对生物物理模拟模型作为pCR预测因子进行了回顾性评估。纳入2010年1月1日至2020年3月31日期间在芝加哥大学接受标准NAC治疗EBC的患者。通过对患者结果不知情的研究人员使用基线乳房MRI、临床病理特征和治疗方案来预测反应。共纳入141例患者的144个肿瘤；59例三阴性，49例HER2阳性，36例激素受体阳性/HER2阴性。一半的患者存在淋巴结疾病，大多数患者接受蒽环类药物治疗（58.3%）。pCR生物物理模拟的敏感性和特异性分别为88.0%（95%置信区间[CI] 75.7 - 95.5）和89.4% (95% CI 81.3 - 94.8)，无论亚型如何，结果都很稳健。在预测pCR的患者中，5年无事件生存率为98%，而预测残留疾病的患者为79% （log-rank p = 0.01, HR 4.57, 95% CI 1.36 - 15.34）。在平均5.4年的随访中，没有预测pCR的患者出现疾病复发。生物物理模拟模型可以根据基线MRI和临床数据准确预测pCR和长期结果，是指导NAC升级/降级的有前途的工具。在线版本包含补充材料，可在10.1007/s10549-022-06722-0获得。
Pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in early breast cancer (EBC) is largely dependent on breast cancer subtype, but no clinical-grade model exists to predict response and guide selection of treatment. A biophysical simulation of response to NAC has the potential to address this unmet need. We conducted a retrospective evaluation of a biophysical simulation model as a predictor of pCR. Patients who received standard NAC at the University of Chicago for EBC between January 1st, 2010 and March 31st, 2020 were included. Response was predicted using baseline breast MRI, clinicopathologic features, and treatment regimen by investigators who were blinded to patient outcomes. A total of 144 tumors from 141 patients were included; 59 were triple-negative, 49 HER2-positive, and 36 hormone-receptor positive/HER2 negative. Lymph node disease was present in half of patients, and most were treated with an anthracycline-based regimen (58.3%). Sensitivity and specificity of the biophysical simulation for pCR were 88.0% (95% confidence interval [CI] 75.7 – 95.5) and 89.4% (95% CI 81.3 – 94.8), respectively, with robust results regardless of subtype. In patients with predicted pCR, 5-year event-free survival was 98%, versus 79% with predicted residual disease (log-rank p = 0.01, HR 4.57, 95% CI 1.36 – 15.34). At a median follow-up of 5.4 years, no patients with predicted pCR experienced disease recurrence. A biophysical simulation model accurately predicts pCR and long-term outcomes from baseline MRI and clinical data, and is a promising tool to guide escalation/de-escalation of NAC. The online version contains supplementary material available at 10.1007/s10549-022-06722-0.
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影响因子：
3.4
作者：
McGowan JV;Chung R;Maulik A;Piotrowska I;Walker JM;Yellon DM
通讯作者：
Yellon DM
DOI：
10.1186/s13058-017-0846-1
发表时间：
2017-05-18
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Braman NM;Etesami M;Prasanna P;Dubchuk C;Gilmore H;Tiwari P;Plecha D;Madabhushi A
通讯作者：
Madabhushi A
影响因子：
3.9
作者：
Michishita, Shintaro;Kim, Seung Jin;Noguchi, Shinzaburo
通讯作者：
Noguchi, Shinzaburo
影响因子：
3.8
作者：
Maadi H;Nami B;Tong J;Li G;Wang Z
通讯作者：
Wang Z
影响因子：
11.1
作者：
Bitencourt AGV;Gibbs P;Rossi Saccarelli C;Daimiel I;Lo Gullo R;Fox MJ;Thakur S;Pinker K;Morris EA;Morrow M;Jochelson MS
通讯作者：
Jochelson MS