Regional lymph node changes on breast MRI in patients with early-stage breast cancer receiving neoadjuvant chemo-immunotherapy
Author:
Affiliation:
1. University of California San Francisco Comprehensive Cancer Center
2. University of California, San Diego
3. Quantum Leap Healthcare Collaborative
4. Moffit Cancer Center
5. University of Chicago
Abstract
Purpose Establishing breast MRI imaging patterns associated with neoadjuvant immunotherapy is needed to monitor response. We analyzed serial breast MRIs in patients receiving neoadjuvant chemo-immunotherapy on the ISPY-2 clinical trial. Methods Patients had stage 2–3 HER2-negative breast cancer in a single institution. Regimens included: weekly paclitaxel (control), weekly paclitaxel in combination with pembrolizumab, or weekly paclitaxel in combination with pembrolizumab and intra-tumoral injection of SD-101, a TLR9 agonist. All patients then received AC and underwent surgery. Regional lymph nodes were retrospectively evaluated on breast MRI at baseline, 3 wks, 12 wks and 20 wks by a single blinded radiologist. MRIs were assessed for development of new regional lymphadenopathy, or increase in longest diameter or cortical thickness of largest regional lymph node. Results Between 12/2015-4/2021, a total of 43 patients enrolled to the control (n = 16) and paclitaxel + pembrolizumab +/- SD-101 (n = 27) arms. 25 patients had hormone-receptor positive disease and 18 patients had triple negative disease. 12 of 27 patients (44.4%) receiving chemo-immunotherapy experienced increased lymphadenopathy within the first 12 weeks compared to 1 of 16 patients (6.3%) in the control group (p = 0.014). Increased lymphadenopathy was observed despite concomitant decrease in breast tumor size at all time points. 11 of 12 patients with increased lymphadenopathy had pathologically negative nodes at surgery. There was no association between lymphadenopathy and lower residual cancer burden (p = 0.696) or immune-related toxicity. Conclusions Chemo-immunotherapy was associated with early increases in regional lymphadenopathy despite decreased breast tumor size. Increased lymphadenopathy was not associated with node-positive disease at surgery.
Publisher
Research Square Platform LLC
Reference38 articles.
1. Pembrolizumab for Early Triple-Negative Breast Cancer;Schmid P;N Engl J Med,2020
2. Pembrolizumab plus Chemotherapy in Advanced Triple-Negative Breast Cancer;Cortes J;N Engl J Med,2022
3. Abstract GS3-06: GS3-06 Palbociclib After CDK4/6i and Endocrine Therapy (PACE): A Randomized Phase II Study of Fulvestrant, Palbociclib, and Avelumab for Endocrine Pre-treated ER+/HER2- Metastatic Breast Cancer;Mayer EL;Cancer Res,2023
4. LBA21 KEYNOTE-756: Phase III study of neoadjuvant pembrolizumab (pembro) or placebo (pbo) + chemotherapy (chemo), followed by adjuvant pembro or pbo + endocrine therapy (ET) for early-stage high-risk ER+/HER2– breast cancer;Cardoso F;Ann Oncol,2023
5. The diverse functions of the PD1 inhibitory pathway;Sharpe AH;Nat Rev Immunol,2018
1.学者识别学者识别
2.学术分析学术分析
3.人才评估人才评估
"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370
www.globalauthorid.com
TOP
Copyright © 2019-2024 北京同舟云网络信息技术有限公司 京公网安备11010802033243号 京ICP备18003416号-3