{"entity":{"id":"paper-symmans-rcb-long-term-prognosis-subtype-jco-2017","kind":"paper","name":"Long-Term Prognostic Risk After Neoadjuvant Chemotherapy Associated With Residual Cancer Burden and Breast Cancer Subtype","aka":[],"tldr":"The 2017 validation of the residual cancer burden score, which graded how much triple-negative tumour is left after pre-surgery chemotherapy and found ten-year relapse-free survival of 86 percent with no residual tumour, 81 percent with minimal, 55 percent with moderate and 23 percent with extensive residual disease.","summary":"Symmans, Wei, Gould, Yu and colleagues measured the continuous residual cancer burden index (pathological complete response is 0; residual disease falls into RCB-I, II and III) and yp-stage in five prospectively followed cohorts: three receiving paclitaxel then fluorouracil, doxorubicin and cyclophosphamide (219, 262 and 342 patients), one receiving FAC alone (132) and one receiving trastuzumab with paclitaxel and FEC (203), with median event-free follow-up of 13.5, 9.1, 6.8, 16.4 and 7.1 years. Continuous residual cancer burden was prognostic within each subset independent of other variables, and RCB classes stratified risk overall, within subsets and within yp-stage. Ten-year relapse-free survival for pathological complete response, RCB-I, RCB-II and RCB-III was 86, 81, 55 and 23 percent for triple-negative disease; 83, 97, 74 and 52 percent for hormone receptor-positive/HER2-negative disease; and 95, 77, 47 and 21 percent in the trastuzumab cohort.","asOf":"2026-09-24","links":[{"label":"J Clin Oncol 2017","url":"https://doi.org/10.1200/JCO.2015.63.1010"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28135148/"}],"tags":["tnbc-evidence"],"related":["paper-symmans-j-clin-oncol","paper-yau-rcb-pooled-analysis-5161-lancet-oncol-2022"],"cancers":["tnbc","breast-hr-positive","breast-her2-positive"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["md-anderson"],"pathways":[],"terms":["rcb","pcr","neoadjuvant-adjuvant"],"trials":["ascent-05","tropion-breast03"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2017,"doi":"10.1200/JCO.2015.63.1010","pmid":"28135148","authors":"Symmans WF, Wei C, Gould R, et al.","paperType":"observational","findings":["Ten-year relapse-free survival in triple-negative disease by residual cancer burden class: 86 percent (complete response), 81 (RCB-I), 55 (RCB-II), 23 (RCB-III).","Continuous residual cancer burden prognostic within every phenotypic subset, independent of clinical and pathological variables."],"whatItMeans":"Turned residual disease from yes or no into a graded score; RCB II and III are now the entry criteria for post-neoadjuvant trials (ASCENT-05, TROPION-Breast03) and the population the ctDNA-guided idea targets.","caveats":["Single institution; the authors call for external validation, supplied by the 2022 pooled analysis.","Pre-immunotherapy chemotherapy regimens."],"changedPractice":true,"participants":1158},"route":"/key-papers/paper-symmans-rcb-long-term-prognosis-subtype-jco-2017/","neighbours":{"paper":[{"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-yau-rcb-pooled-analysis-5161-lancet-oncol-2022","kind":"paper","name":"Residual cancer burden after neoadjuvant chemotherapy and long-term survival outcomes in breast cancer: a multicentre pooled analysis of 5161 patients","route":"/key-papers/paper-yau-rcb-pooled-analysis-5161-lancet-oncol-2022/"}],"cancer":[{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"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/"}],"trial":[{"id":"ascent-05","kind":"trial","name":"ASCENT-05 / OptimICE-RD (AFT-65, GBG 119, NSABP B-63)","route":"/trials/ascent-05/"},{"id":"tropion-breast03","kind":"trial","name":"TROPION-Breast03","route":"/trials/tropion-breast03/"}],"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/"}],"idea":[{"id":"idea-tnbc-ctdna-guided-adjuvant-decisions","kind":"idea","name":"ctDNA-guided adjuvant decisions after residual disease: escalate the positive, spare the negative","route":"/ideas/idea-tnbc-ctdna-guided-adjuvant-decisions/"}]}}