未经证实:在靶向治疗的时代,人表皮生长因子受体2(HER2)阳性乳腺癌患者在新辅助治疗中是否免除蒽环类药物的使用存在争议.
UNASSIGNED:我们的目的是回顾性分析蒽环类药物组和非蒽环类药物组之间病理完全缓解(pCR)率的差异。
UNASSIGNED:CSBrS-012研究(2010-2020)包括接受新辅助化疗(NAC)的女性原发性乳腺癌患者,这些患者在NAC后接受了标准的乳腺和腋窝手术。
UNASSIGNED:应用Logistic比例风险模型来估计协变量与pCR的关联。进行倾向评分匹配(PSM)以平衡基线特征的差异,亚组分析采用Cochran-Mantel-Haenszel检验进行.
UNASSIGNED:共纳入2507例患者:蒽环类药物组(n=1581,63%)和非蒽环类药物组(n=926,37%)。蒽环类药物组17.1%(271/1581)的患者和非蒽环类药物组29.3%(271/926)的患者记录pCR,两组之间的pCR率差异有统计学意义[比值比(OR)=2.00,95%置信区间(CI)(1.65-2.43);p<0.001)。在随后的子群分析中,在PSM之前,在非靶向[OR=1.91,95%CI(1.13-3.23);p=0.015]和双HER2靶向人群[OR=0.55,95%CI(0.33-0.92);p=0.021)中,蒽环类和非蒽环类之间的pCR率存在实质性差异,而PSM后差异消失。蒽环类和非蒽环类药物组之间的pCR率对于单一目标人群没有差异,在PSM之前或之后。
UNASSIGNED:在存在曲妥珠单抗和/或帕妥珠单抗的情况下,接受蒽环类药物治疗的HER2阳性乳腺癌患者的pCR率并不优于接受非蒽环类药物治疗的患者.因此,我们的研究进一步为HER2阳性乳腺癌患者在靶向治疗时代免除蒽环类药物治疗提供了临床证据.
UNASSIGNED: In the era of targeted therapy, whether patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer are exempted from anthracycline usage in the neoadjuvant setting is controversial.
UNASSIGNED: Our objective was to retrospectively analyze the differences in pathological complete remission (pCR) rates between the anthracycline group and the nonanthracycline group.
UNASSIGNED: The CSBrS-012
study (2010-2020) included female primary breast cancer patients with neoadjuvant chemotherapy (NAC) who underwent standard breast and axillary surgery post-NAC.
UNASSIGNED: A logistic proportional hazard model was applied to estimate the association of covariates with pCR. Propensity score matching (PSM) was performed to balance the differences in baseline characteristics, and subgroup analyses were performed using the Cochran-Mantel-Haenszel test.
UNASSIGNED: A total of 2507 patients were enrolled: the
anthracycline group (n = 1581, 63%) and the nonanthracycline group (n = 926, 37%). A pCR was recorded in 17.1% (271/1581) of patients in the
anthracycline group and in 29.3% (271/926) in the nonanthracycline group, and the difference in the pCR rate between the two groups was statistically significant [odds ratio (OR) = 2.00, 95% confidence interval (CI) (1.65-2.43); p < 0.001). In the subsequent subgroup analysis, substantial differences in pCR rates between the
anthracycline and nonanthracycline groups were detected in the nontargeted [OR = 1.91, 95% CI (1.13-3.23); p = 0.015] and dual-HER2-targeted populations [OR = 0.55, 95% CI (0.33-0.92); p = 0.021) before PSM, whereas differences vanished after PSM. The pCR rates between the anthracycline and nonanthracycline groups did not differ for the single target population, either before or after PSM.
UNASSIGNED: In the presence of trastuzumab and/or pertuzumab, the pCR rate of patients with HER2-positive breast cancer receiving anthracycline was not superior to that of patients receiving nonanthracycline. Thus, our
study further provides clinical evidence for exempting
anthracycline treatment in HER2-positive breast cancer in the era of targeted therapy.