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Residual Cancer Burden — SCE Medical Oncology MCQ

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ModerateBreast CancerResidual Cancer BurdenSCE Medical Oncology

A 55-year-old woman has neoadjuvant chemotherapy for TNBC. Her pathology report after surgery describes a Residual Cancer Burden (RCB) score. What does RCB measure?

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Correct answer: B — RCB quantifies residual disease after neoadjuvant therapy using tumour bed area

The Residual Cancer Burden (RCB) index (Symmans et al JCO 2007) provides a continuous measure of residual disease after neoadjuvant chemotherapy, classified into: RCB-0 (pCR — best prognosis), RCB-I (near-complete, excellent prognosis), RCB-II (moderate residual — consider additional adjuvant therapy), RCB-III (extensive residual — worst prognosis, consider treatment change). RCB guides adjuvant treatment decisions, particularly for TNBC (capecitabine for non-pCR per CREATE-X) and HER2+ (T-DM1 for non-pCR per KATHERINE).

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer