{"entity":{"id":"paper-liedtke-neoadjuvant-response-survival-tnbc-jco-2008","kind":"paper","name":"Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer","aka":[],"tldr":"The 2008 MD Anderson series of 1,118 women that defined the triple-negative paradox: these tumours disappear completely with pre-surgery chemotherapy twice as often as other breast cancers, yet survival is worse, because the women left with residual disease relapse early and often.","summary":"Liedtke, Mazouni, Hess, André and colleagues analysed 1,118 patients treated with neoadjuvant chemotherapy at MD Anderson for stage I to III breast cancer between 1985 and 2004 with complete receptor data; 255 (23 percent) were triple-negative. Triple-negative patients had higher pathological complete response rates (22 versus 11 percent, p=0.034) but lower three-year progression-free and overall survival (both p<0.0001), more visceral metastases (p=0.0005), fewer bone recurrences (p=0.027) and shorter post-recurrence survival (p<0.0001), with excess recurrence and death confined to the first three years. Patients achieving pathological complete response had similar survival whether triple-negative or not (p=0.24); those with residual disease had worse survival if triple-negative (p<0.0001).","asOf":"2026-09-24","links":[{"label":"J Clin Oncol 2008","url":"https://doi.org/10.1200/JCO.2007.14.4147"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/18250347/"}],"tags":["tnbc-evidence"],"related":["paper-symmans-j-clin-oncol","paper-cortazar-ctneobc-pcr-pooled-analysis-lancet-2014"],"cancers":["tnbc"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["md-anderson"],"pathways":[],"terms":["pcr","rcb","neoadjuvant-adjuvant"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2008,"doi":"10.1200/JCO.2007.14.4147","pmid":"18250347","authors":"Liedtke C, Mazouni C, Hess KR, et al.","paperType":"observational","findings":["Pathological complete response 22 vs 11 percent for triple-negative vs other breast cancer (p=0.034).","Three-year progression-free and overall survival worse in triple-negative disease (p<0.0001); excess risk confined to the first three years.","With pathological complete response survival was equal (p=0.24); with residual disease triple-negative survival was worse (p<0.0001)."],"whatItMeans":"Made pathological complete response the organising endpoint of triple-negative drug development and residual disease its central unsolved problem; every post-neoadjuvant trial from CREATE-X to ASCENT-05 follows from this observation.","caveats":["Single-institution, retrospective, pre-taxane and taxane eras mixed.","Receptor testing methods changed over 1985 to 2004."],"changedPractice":true,"participants":1118},"route":"/key-papers/paper-liedtke-neoadjuvant-response-survival-tnbc-jco-2008/","neighbours":{"paper":[{"id":"paper-create-x-adjuvant-capecitabine-nejm-2017","kind":"paper","name":"Adjuvant Capecitabine for Breast Cancer after Preoperative Chemotherapy","route":"/key-papers/paper-create-x-adjuvant-capecitabine-nejm-2017/"},{"id":"paper-symmans-j-clin-oncol","kind":"paper","name":"Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy","route":"/key-papers/paper-symmans-j-clin-oncol/"},{"id":"paper-cortazar-ctneobc-pcr-pooled-analysis-lancet-2014","kind":"paper","name":"Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis","route":"/key-papers/paper-cortazar-ctneobc-pcr-pooled-analysis-lancet-2014/"}],"cancer":[{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"institution":[{"id":"md-anderson","kind":"institution","name":"MD Anderson Cancer Center","route":"/institutions/md-anderson/"}],"term":[{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"},{"id":"pcr","kind":"term","name":"Pathologic complete response (pCR)","route":"/terms/pcr/"},{"id":"rcb","kind":"term","name":"Residual cancer burden (RCB)","route":"/terms/rcb/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}],"roadmap":[{"id":"tnbc-roadmap","kind":"roadmap","name":"Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem","route":"/roadmaps/tnbc-roadmap/"}]}}