Article ; Online: Aspirin use is associated with improvement in distant metastases outcome in patients with residual disease after neoadjuvant chemotherapy.
Breast cancer research and treatment
2023 Volume 199, Issue 2, Page(s) 381–387
Abstract: Purpose: Aspirin (ASA) use has been correlated with improved outcomes in high-risk patients at risk for distant metastases. Breast cancer (BC) patients with residual disease, particularly nodal disease (ypN +) after neoadjuvant chemotherapy (NAC), are ... ...
| Abstract | Purpose: Aspirin (ASA) use has been correlated with improved outcomes in high-risk patients at risk for distant metastases. Breast cancer (BC) patients with residual disease, particularly nodal disease (ypN +) after neoadjuvant chemotherapy (NAC), are high-risk patients portending worse outcomes. We hypothesized that ASA use can reduce distant metastases and improve outcomes in these patients. Methods: Patients at our institutions from 2005 to 2018, with BC who did not achieve complete response (pCR) after NAC were reviewed (IRB protocol STU- 052012-019). Data, including evidence of ASA use, and clinico-pathologic parameters were analyzed. Survival outcomes were obtained (Kaplan Meier analysis) and univariate (UVA) and multivariable (MVA) Cox proportional hazards regression analyses were performed. Results: 637 did not achieve pCR (ypN+ = 422). 138 were ASA users. Median follow-up for the control and ASA group were 3.8 (IQR 2.2-6.3) and 3.8 (IQR 2.5-6.4) years, respectively. Majority were stage II/III. 387 were hormone receptor positive, 191 HER2 +, and 157 triple negative. On UVA, ASA use, PR status, pathologic and clinical stage showed significance for DMFS, and disease-free survival (DFS). On MVA, ASA use associated with improved 5-year DFS (p = .01, 87.0% vs 79.6%, adjusted HR = 0.48) and improved 5-year DMFS (p = .04, 92.8% vs 89.2%, adjusted HR = 0.57). In the ypN + patients, ASA use associated with improved 5-year DMFS (p = .008, 85.7% vs 70.7%, adjusted HR = 0.43) and DFS (p = .02, 86.8% vs 74.3%, adjusted HR = 0.48). Conclusion: For non-responders, particularly ypN + patients, ASA use associated with improved outcome. These hypotheses-generating results suggest for development of prospective clinical trials of augmented ASA use in selected very high-risk BC patients. |
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| MeSH term(s) | Humans ; Female ; Breast Neoplasms/pathology ; Neoadjuvant Therapy/methods ; Prospective Studies ; Chemotherapy, Adjuvant/methods ; Disease-Free Survival ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Receptor, ErbB-2 ; Prognosis | |||||
| Chemical Substances | Receptor, ErbB-2 (EC 2.7.10.1) | |||||
| Language | English | |||||
| Publishing date | 2023-03-30 | |||||
| Publishing country | Netherlands | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 604563-7 | |||||
| ISSN | 1573-7217 ; 0167-6806 | |||||
| ISSN (online) | 1573-7217 | |||||
| ISSN | 0167-6806 | |||||
| DOI | 10.1007/s10549-023-06920-4 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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