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Using MammaPrint® and BluePrint® genomic signatures, the study evaluates their ability to predict pathological complete response (pCR) rates after NAC in 404 patients. Associations between subtype and clinical variables are analyzed via multivariate logistic regression and statistical tests by nodal status, showing MammaPrint/BluePrint-related higher pCR odds for specific genomic categories.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/neoadjuvant-chemotherapy-for-t3-tumors-in-the-era-of-precision-medicine-biology-is-still-king/374074/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/neoadjuvant-chemotherapy-for-t3-tumors-in-the-era-of-precision-medicine-biology-is-still-king/374074.png","ImageObject",300,407,{"name":92,"@type":93},"Lucas Martin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical challenge does cT3 breast cancer create for treatment planning?","Question",{"text":112,"@type":113},"cT3 breast cancer, especially when node positive, can make upfront surgical resection difficult due to large tumor size, limiting options for breast-conserving surgery.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the study designed to evaluate genomic prediction of NAC benefit?",{"text":117,"@type":113},"The study assessed the utility of MammaPrint/BluePrint for predicting pathological complete response (pCR) in 404 cT3 early-stage breast cancer patients. Multivariate logistic regression evaluated associations with pCR likelihood, with comparisons stratified by nodal status.",{"name":119,"@type":110,"acceptedAnswer":120},"Which genomic categories showed higher odds of achieving pCR after NAC?",{"text":121,"@type":113},"MammaPrint High-Risk/BluePrint BasalType and HER2-Type categories had significantly higher odds of pCR compared with BluePrint Luminal-Type, based on reported odds ratios and p-values.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},374074,1790579967,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Communication  \nNeoadjuvant Chemotherapy for T3 Tumors in the Era of Precision Medicine—Biology Is Still King  \nRakhshanda Layeequr Rahman 1,*, Alfredo Santillan 2, Mehran Habibi 3, Peter Beitsch 4, Pat Whitworth 5, Harshini Ramaswamy 6, Nicole Chmielewski-Stivers 6, Andrea Menicucci 6, William Audeh 6 and Joyce O’Shaughnessy 7  \nAcademic Editor: Shinji Miwa  \nReceived: 7 December 2024  \nRevised: 29 December 2024  \nAccepted: 30 December 2024  \nPublished: 9 January 2025  \nCitation: Rahman, R.L.; Santillan, A.; Habibi, M.; Beitsch, P.; Whitworth, P.; Ramaswamy, H.; Chmielewski-Stivers, N.; Menicucci, A.; Audeh, W.; O’Shaughnessy, J. Neoadjuvant Chemotherapy forT3 Tumors in the Era of Precision Medicine—Biology Is Still King. Int. J. Mol. Sci. 2025, 26, 491 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)ijms26020491  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) .  \n1 School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA  \n2 Texas Oncology, San Antonio, TX 78240, USA  \n3 Northwell Health, Staten Island, NY 10305, USA  \n4 Dallas Surgical Group, Dallas, TX 75231, USA  \n5 Nashville Breast Center, Nashville, TN 37203, USA  \n6 Agendia Inc., Irvine, CA 92618, USA; [william.audeh@agendia.com](william.audeh@agendia.com) (W.A.)  \n7 Baylor University Medical Center, Texas Oncology, Dallas, TX 75246, USA  \n* Correspondence: [rrahman2@metrohealth.org](rrahman2@metrohealth.org)  \nAbstract: Clinical T3 (cT3) breast cancer (BC) presents a challenge for achieving cosmetically acceptable breast conservation, and neoadjuvant chemotherapy (NAC) is commonly used for cytoreduction in these high-risk cancers. MammaPrint® risk-of-recurrence and BluePrint® molecular subtyping genomic signatures have demonstrated high accuracy in predicting chemotherapy benefits. Here, we examined the utility of MammaPrint/BluePrint for predicting pathological Complete Response (pCR) rates to NAC among 404 patients diagnosed with cT3 early-stage BC. The association of genomic subtype and clinical features with the likelihood of pCR was evaluated by multivariate logistic regression. Differences in pCR rates between genomic risk categories were evaluated by a two-sided proportional z-test and stratified by nodal status. MammaPrint/BluePrint subtyping was associated with significantly higher odds ratios (ORs) for pCR in MammaPrint High-Risk/BluePrint BasalType (OR = 3.06, 95% CI: 1.15–8.19, p = 0.025) and HER2-Type (OR = 6.27, 95% CI: 2.19–19.38, p = 0.001) compared to BluePrint Luminal-Type. Of the 209 patients with hormone receptorpositive, HER2-negative disease, 6.7% achieved pCR, and MammaPrint High-Risk was associated with a significantly higher pCR rate (9.3%) compared to MammaPrint Low-Risk cancers (0%), regardless of nodal involvement (p = 0.036) . These data show that for patients with MammaPrint Low-Risk, cT3 tumors are less likely to have clinically impactful cytoreduction from NAC, regardless of nodal involvement.  \nKeywords: cT3; locally advanced disease; neoadjuvant chemotherapy (NAC); pathological Complete Response (pCR); 70-gene signature; 80-gene signature; molecular subtyping; precision oncology  \n1. Introduction  \nClinical T3 (cT3) breast cancer, particularly node positive disease, continues to be avexing problem for clinicians, because the large tumor size may render upfront surgical resection challenging and breast-conserving surgery untenable. For this reason, major cancer societies, such as the American Society of Clinical Oncology (ASCO) [1] and the National Comprehensive Cancer Network (NCCN) [2], recommend neoadjuvant chemotherapy therapy (NAC) for down-staging for cT3 cancers. The goal of NAC ","cbCaiii6hoCLIe3H","https://ap.wps.com/l/cbCaiii6hoCLIe3H","pdf",877248,"English","# Abstract\n# Introduction","[{\"question\":\"What clinical challenge does cT3 breast cancer create for treatment planning?\",\"answer\":\"cT3 breast cancer, especially when node positive, can make upfront surgical resection difficult due to large tumor size, limiting options for breast-conserving surgery.\"},{\"question\":\"How was the study designed to evaluate genomic prediction of NAC benefit?\",\"answer\":\"The study assessed the utility of MammaPrint/BluePrint for predicting pathological complete response (pCR) in 404 cT3 early-stage breast cancer patients. Multivariate logistic regression evaluated associations with pCR likelihood, with comparisons stratified by nodal status.\"},{\"question\":\"Which genomic categories showed higher odds of achieving pCR after NAC?\",\"answer\":\"MammaPrint High-Risk/BluePrint BasalType and HER2-Type categories had significantly higher odds of pCR compared with BluePrint Luminal-Type, based on reported odds ratios and p-values.\"}]","Neoadjuvant Chemotherapy for T3 Tumors in the Era of Precision Medicine - Biology Is Still King | PDF",1790201095,23]