Development of Predictive Models for Response to Neoadjuvant Therapy in Luminal Breast Cancer Using Fourier Transform Infrared (FTIR) Spectroscopy

• Grant number: 24/15681-8
• Support Opportunities: Regular Research Grants
• Start date: September 01, 2025
• End date: August 31, 2028
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Carlos Eduardo Paiva
• Grantee: Carlos Eduardo Paiva
• Host Institution: Hospital do Câncer de Barretos. Fundação Pio XII (FP). Barretos , SP, Brazil
• Associated researchers: Bianca Sakamoto Ribeiro Paiva ; Márcia Maria Chiquitelli Marques Silveira ; Raul de Oliveira Freitas ; Yara Cristina de Paiva Maia

Abstract

Breast cancer (BC) is the most common type among women, with approximately 70% of cases presenting hormone receptor-positive (HR+) status, typically of the luminal A and B subtypes. Neoadjuvant therapy, in addition to reducing tumor size to enable breast-conserving surgery, allows for the assessment of tumor sensitivity to systemic treatment and the identification of predictive biomarkers of response, advancing precision medicine. This prospective longitudinal study aims to develop predictive models of therapeutic response for postmenopausal patients with HR+/HER2- BC, utilizing machine learning combined with ATR-FTIR spectral analysis of blood, saliva, and tumor tissue samples. The study will be divided into two cohorts: one undergoing neoadjuvant chemotherapy (NAC) with the T-AC regimen (Cohort I) and the other undergoing neoadjuvant hormone therapy (NAHT) with anastrozole for six months (Cohort II). The Magee Equation 3, a clinical surrogate for Oncotype DX, will be used to categorize the treatment group the patient will follow; if low risk, NAHT, and if high risk, NAC. Clinical and pathological responses, as well as toxicity and quality of life, will be evaluated throughout the treatment. Biological samples (tumor tissue, blood, and saliva) will be collected at distinct time points, including rebiopsy (after 2-4 weeks of initiation) for patients in the NAHT group. Expected outcomes include the standardization of a patient categorization method for those undergoing neoadjuvant therapy and the development of non-invasive, low-cost predictive tools through ATR-FTIR, contributing to the personalization of treatment and improvement of clinical outcomes. (AU)