CLINICAL AND BIOLOGICAL MODEL FOR EVALUATION OF THE EFFECTIVENESS OF SYSTEMIC THERAPY FOR BREAST CANCER

Abstract

Purpose: To create a unified system of accelerated clinical trials of new drugs and regimens for breast cancer (BC).

Materials and methods: The study included 1214 patients with BC of different stages (cT1N1, cT2N1-2, cT2-3N0-2, cT2-3N0-1, cT4N0M0). According to trepan biopsy data and immunohistochemical examination (IHC) expression of ER, PR, HER2, and Ki67 was determined. The expression TUBBßIII, TOP2a, analyzes on the BRCA1/2 mutation was studied. The clinical response to neoadjuvant treatment was determined using the physical method, ultrasonography-elas-tography, mammography, contrast magnetic resonance imaging (MRI) and single-photon emission computer mammotography (SPECT-CT).

Results: The correlation index of complete responses (cCR) and total pathomorphological responses (pCR) according to MRI was 0.80, according to ultrasound - 0.61, mammography - 0.60, palpation - 0.57. The low level of amplification of the TUBßIII mRNA gene with a high level of amplification of the TOP2-a gene is a predictor of the achievement of pCR. The inclusion of a neoadjuvant treatment of triply-negative BC carboplatin in addition to paclitaxel or eribulin increases the frequency of reaching pCR (ypT0/is(yp)N0) from 20.3% to 47%.