European Journal of Biomedical and Pharmaceutical Sciences

PREDICTORS OF PATHOLOGICAL COMPLETE RESPONSE FOLLOWING NEOADJUVANT CHEMOTHERAPY IN BREAST CANCER: A SINGLE-CENTER STUDY FROM THE ROYAL MEDICAL SERVICES, JORDAN

Sa’ed N. Alzghool* MD, Ahmad A. Alkofahi MD, Hamza Arabiyat MD, Ahmad M. Ejju MD, Tamer M. Alsalah
MD, Reema O. Jaradat MD, Jameelah Alsarairah MD and Doa’a Alsharbaji MD

ABSTRACT

Background: Achieving pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) is one of
the most well-established surrogate markers for improved prognosis in breast cancer. Predictive factor
identification for pCR is important especially in optimizing treatment approaches in adjuvant settings. Objectives:
To identify clinicopathological factors with pCR among breast cancer patients treated with NAC at the Royal
Medical Services in Jordan. Methods: This retrospective study was comprised of 262 patients with invasive breast
cancer who underwent NAC from (January 2022) to (December 2023) followed by surgical intervention. HR
(hormone receptor) status, HER-2 expression, lymph node involvement, tumor grade, and age were assessed.
Predictors of pCR were determined using logistic regression analysis. Results: Among them, twenty-one percent
of patients achieved pCR. On a multivariate analysis, the presence of HR (hormone receptor) negative tumors
(OR=2.708, p=0.005), positive HER-2 tumors (OR=2.271, p=0.012), and no lymph node metastasis (OR=2.607,
p=0.015) greatly increased the chances of pCR. The predictors remained non-significant for pCR. Conclusion:
Negative HR, positive HER-2, and no nodal involvement were independent predictors of pCR in this cohort of
Jordanians. Those results warrant changes to clinical practice for molecular subtype evaluation prior to NAC.

Keywords: Cancer of the breast, pathological complete response, chemotherapy, neoadjuvant therapy, predictors, hormonal receptors, HER2, Hashemite kingdom of Jordan.