Clinical and pathological factors related to complete patologic response and local recurrence in patients with locally advanced breast cancer, submitted to neoadjuvant chemotherapy

• Grant number: 12/19642-0
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2013
• End date: November 30, 2015
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: René Aloisio da Costa Vieira
• Grantee: René Aloisio da Costa Vieira
• Host Institution: Hospital do Câncer de Barretos. Fundação Pio XII (FP). Barretos , SP, Brazil
• Associated researchers: Cristovam Scapulatempo Neto ; Maria Aparecida Azevedo Koike Folgueira

Abstract

The locally advanced breast carcinoma (LABC) is a public health problem in Brazil. Although neoadjuvant chemotherapy (NC) does not modify the survival, it allows you to select patients with better prognosis, the ones with a pathologic complete response (PCR), and it increases the rate of conservative surgery. Currently a lot of schemes may be used, but when the combination of anthracyclines with taxane is used, the RPC reaches 24% of patients. Imaging tests are not sufficient to accurately predict the size of the tumor or the PCR and there is no uniformity in pathologic evaluation of these tumors. The pathological response is adverse and there may be fragmentation of the tumor bed and the appearance of multifocal residual lesions. In studies related to NC there is no exact description of the methodology used in the preoperative marking of the tumor and not always its whole area is resected after NC and there are not any universal evaluation criteria of the surgical AP, which may influence the findings related to treatment response, justifying further studies. There are several factors related to the PCR, either clinical, pathological, expression of markers by immunohistochemistry (IMH), or gene expression. Three genes were related to partial response by MAAKF. We initiated a study, approved by the Research Ethics committee number 135/2008 with 401 LABC patients who were with treated sequential chemotherapy regimen based on anthracycline and taxanes. That is the largest Brazilian series. 321 out of 401 patients were evaluated retrospectively and 80 prospectively in a controlled protocol (NCT00820690). This project will evaluate the impact of clinical, histological, macroscopic, genic expression evaluated by IMH, related to PCR and it will assess whether these factors are related to breast recurrence with the same chemotherapy regimen. Data evaluated by a single researcher, in a standardized way, comparing the two protocols will enable better assessment of factors related to the PRC and local recurrence. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

CARRARA, GUILHERME FREIRE ANGOTTI; EVANGELISTA, ADRIANE FEIJO; SCAPULATEMPO-NETO, CRISTOVAM; ABRAHAO-MACHADO, LUCAS FARIA; MORINI, MARIANA ANDOZIA; KERR, LIGIA MARIA; FOLGUEIRA, MARIA APARECIDA AZEVEDO KOIKE; DA COSTA VIEIRA, RENE ALOISIO. Analysis of RPL37A, MTSS1, and HTRA1 expression as potential markers for pathologic complete response and survival. BREAST CANCER, v. 28, n. 2, p. 307-320, MAR 2021. (12/19642-0)

DA COSTA VIEIRA, RENE ALOISIO; ANGOTTI CARRARA, GUILHERME FREIRE; SCAPULATEMPO NETO, CRISTOVAM; MORINI, MARIANA ANDOZIA; BRENTANI, MARIA MITZI; AZEVEDO KOIKE FOLGUEIRA, MARIA APARECIDA. The role of oncoplastic breast conserving treatment for locally advanced breast tumors. A matching case-control study. ANNALS OF MEDICINE AND SURGERY, v. 10, p. 61-68, SEP 2016. (12/19642-0)

GUILHERME FREIRE ANGOTTI CARRARA; CRISTOVAM SCAPULATEMPO-NETO; LUCAS FARIA ABRAHÃO-MACHADO; MARIA MITZI BRENTANI; JOÃO SOARES NUNES; MARIA APARECIDA AZEVEDO KOIKE FOLGUEIRA; RENÉ ALOISIO DA COSTA VIEIRA. Breast-conserving surgery in locally advanced breast cancer submitted to neoadjuvant chemotherapy. Safety and effectiveness based on ipsilateral breast tumor recurrence and long-term follow-up. Clinics, v. 72, n. 3, p. 134-142, 2017-03-00. (12/19642-0)