Comparative Prognostic Utility of CPS+EG, Neo-Bioscore, and Conventional Staging Systems in Breast Cancer Patients Without Pathological Complete Response to Neoadjuvant Chemotherapy.

Authors

Tingting Deng, Huiling Xiang, Xiao Luo, Cuiju Yan, Lanxia Zhang, Qingguang Lin, Jinjing Ou, Chunyan Li, Fei Xu, Rongzhen Luo, Xi Lin

Published in

Clinical breast cancer. Volume 26. Issue 8. Pages 172-179. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

Breast cancer patients with non-pathologic complete response (non-pCR) after neoadjuvant chemotherapy (NAC) exhibit heterogeneous outcomes. While the CPS+EG and Neo-Bioscore staging systems integrate clinical, pathological, and biologic factors to improve post-NAC prognostication, their utility in the non-pCR cohort warrants further evaluation. This study aimed to compare their prognostic performance with traditional clinical (CS) and pathologic stage (PS).
This retrospective single-center study included 784 non-pCR breast cancer patients after NAC. Prognostic discrimination of CS, PS, CPS+EG, and Neo-Bioscore for DFS and OS was assessed by Kaplan-Meier analysis and concordance index (C-index). Subgroup analyses were performed by molecular subtype. An exploratory comparison with Residual Cancer Burden (RCB) was conducted in a subset of 167 patients with available RCB scores.
In the overall cohort, both CPS+EG and Neo-Bioscore provided superior prognostic stratification for DFS and OS compared to CS or PS alone (all C-index comparisons P < .001 vs. CS). Their performance was subtype-dependent. In HR-positive/HER2-negative and HER2-positive subtypes, CPS+EG and Neo-Bioscore showed significantly better prognostic value. However, in triple-negative breast cancer, neither composite score offered significant stratification, where PS emerged as the most robust predictor. In the RCB-available subset, RCB did not significantly stratify DFS or OS, whereas both CPS+EG and Neo-Bioscore showed significant associations with DFS.
The CPS+EG and Neo-Bioscore systems offer refined prognostic stratification for non-pCR patients, outperforming conventional staging systems in most subtypes. These readily available tools provide a practical framework for risk-adapted adjuvant therapy planning in the postneoadjuvant setting, though further prospective validation is warranted.

PMID:
42531656
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

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