A combination of Nottingham prognostic index and IHC4 score predicts pathological complete response of neo-adjuvant chemotherapy in estrogen receptor positive breast cancer

3^rd World Congress on Women’s Health & Breast Cancer

October 03-05, 2016 London, UK

Chang Gong, Weige Tan, Wei Luo, Weijuan Jia, Gehao Liang, Xinhua Xie, Erwei Song and Fengxi Su

Sun Yat Sen University, Guangzhou, China

Scientific Tracks Abstracts: J Cancer Sci Ther

Abstract :

Pathologic complete response (pCR) prediction after neo-adjuvant chemotherapy (NAC) is important for clinical decisionmaking in breast cancer. Nottingham prognostic index (NPI) and Immunohistochemical four (IHC4) score are costeffective prognostic biomarkers. However, whether these factors can predict pCR remains unknown. A new NPI+IHC4 scoring system was built on the combination of NPI and IHC4 score by variable assignment method. A new predictive biomarker named NPI+IHC4 was developed to predict pCR in a study set (n=443) and validated in an external validation set (n=296). Multivariate analysis of variables for a pCR was performed via logistic regression analysis. The ROC curves were employed to test the sensitivity and specificity of variables in predicting pCR and disease-free survival (DFS). In the study set, a lower IHC4 score, NPI and NPI+IHC4 were significantly associated with a high pCR rate; multivariable analysis showed tumor size, TNM, NPI and IHC4 score were independent predictors. NPI+IHC4 showed a better sensitivity and specificity for pCR prediction (AUC 0.699, 95% CI 0.626-0.772) than IHC4 score, NPI, tumor size and TNM stage. In the validation set, NPI+IHC4 had a better predictive value for pCR (AUC 0.665, 95% CI 0.579-0.751) than IHC4 score or NPI alone. In addition, ER+ patients with lower IHC4, NPI and NPI+IHC4 scores had significantly better DFS in both study and validation sets. NPI+IHC4 can predict pCR following NAC and prognosis in ER+ breast cancer. This study provides evidence that incorporating macro-anatomic features and molecular information can improve pCR prediction following NAC.

Biography :

Chang Gong has completed her PhD from Sun Yat Sen University and Post-doctoral studies from INSERM of France and Cardiff University of UK. She is a Breast Surgeon and an Associate Professor of Breast Tumor Center, Sun Yat Sen Memorial Hospital, Sun Yat Sen University. She has published more than 30 papers in cancer related journals.

Email: changgong282@163.com