long-term survival

长期生存
  • 文章类型: Journal Article
    尽管各种癌症疗法对患者的生存都取得了成功,这些治疗可能会产生负面副作用,对呼吸系统特别严重的损害。鉴于癌症治疗后呼吸道相关疾病的增加,我们敦促该领域考虑一门新学科,称为“肿瘤学-呼吸学”(或共呼吸学)。
    Despite the success of various cancer therapies on patient survival, these treatments can have negative side effects, particularly severe damage to the respiratory system. Given the rise in respiratory-associated illnesses in response to cancer treatment, we urge the field to consider a new discipline referred to as \'oncology-respirology\' (or onco-respirology).
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  • 文章类型: Journal Article
    背景:晚期胃癌(AGC)的预后相对较差,长期生存取决于及时的干预。目前,预测生存率仍然是一个热门话题。影像组学和免疫组织化学相关技术在癌症研究中的应用日益广泛。然而,它们在预测AGC患者长期生存率方面的整合尚未得到充分探索.
    方法:收集2015-2019年大连大学附属中山医院诊断为AGC的患者150例。遵循严格的纳入和排除标准,90例患者纳入分析。我们收集了入选患者的术后病理标本,使用免疫组织化学技术分析MAOA的表达水平,并将这些水平量化为MAOAHScore。获得患者腹部普通CT图像,描绘了L3椎体水平的感兴趣区域,并提取了影像组学特征。LassoCox回归用于选择重要特征以建立放射学风险评分,将其转换为名为风险的分类变量,并使用Cox回归来识别独立的预测因子以构建临床预测模型。ROC,DCA,和校准曲线验证了模型的性能。
    结果:入选患者的平均年龄为65.71岁,包括70名男性和20名女性。多因素Cox回归分析显示风险(P=0.001,HR=3.303),MAOAHScore(P=0.043,HR=2.055),和TNM分期(P=0.047,HR=2.273)是3年总生存期(OS)的独立预后危险因素,在3年疾病特异性生存期(DSS)的分析中也发现了类似的结果。开发的列线图可以预测3年的OS和DSS率,ROC曲线下面积(AUC)分别为0.81和0.797。联合校准和决策曲线分析(DCA)证实了列线图的良好预测性能和临床实用性。
    结论:结合免疫组织化学和肌肉脂肪特征可以更准确地预测胃癌患者的长期生存。本研究为更深入地理解AGC中的生存预测提供了新的视角和方法。
    BACKGROUND: The prognosis of advanced gastric cancer (AGC) is relatively poor, and long-term survival depends on timely intervention. Currently, predicting survival rates remains a hot topic. The application of radiomics and immunohistochemistry-related techniques in cancer research is increasingly widespread. However, their integration for predicting long-term survival in AGC patients has not been fully explored.
    METHODS: We Collected 150 patients diagnosed with AGC at the Affiliated Zhongshan Hospital of Dalian University who underwent radical surgery between 2015 and 2019. Following strict inclusion and exclusion criteria, 90 patients were included in the analysis. We Collected postoperative pathological specimens from enrolled patients, analyzed the expression levels of MAOA using immunohistochemical techniques, and quantified these levels as the MAOAHScore. Obtained plain abdominal CT images from patients, delineated the region of interest at the L3 vertebral body level, and extracted radiomics features. Lasso Cox regression was used to select significant features to establish a radionics risk score, convert it into a categorical variable named risk, and use Cox regression to identify independent predictive factors for constructing a clinical prediction model. ROC, DCA, and calibration curves validated the model\'s performance.
    RESULTS: The enrolled patients had an average age of 65.71 years, including 70 males and 20 females. Multivariate Cox regression analysis revealed that risk (P = 0.001, HR = 3.303), MAOAHScore (P = 0.043, HR = 2.055), and TNM stage (P = 0.047, HR = 2.273) emerged as independent prognostic risk factors for 3-year overall survival (OS) and The Similar results were found in the analysis of 3-year disease-specific survival (DSS). The nomogram developed could predict 3-year OS and DSS rates, with areas under the ROC curve (AUCs) of 0.81 and 0.797, respectively. Joint calibration and decision curve analyses (DCA) confirmed the nomogram\'s good predictive performance and clinical utility.
    CONCLUSIONS: Integrating immunohistochemistry and muscle fat features provides a more accurate prediction of long-term survival in gastric cancer patients. This study offers new perspectives and methods for a deeper understanding of survival prediction in AGC.
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  • 文章类型: Case Reports
    包括胸腔积液或血浆的液体活检通常用于晚期非小细胞肺癌(NSCLC)和胸腔积液(PE)的患者,以指导治疗。ALK-TKIs是ALK阳性突变患者的首选方案,ALK-TKIs与血管生成剂联合使用可能会提高生存率。我们在这里报告了一例ALK阳性肺腺癌,其中患者在接受精确的胸腔积液NGS并在多线ALK-TKI耐药后接受贝伐单抗联合治疗后,获得了97个月的延长的无进展生存期(PFS)。
    Liquid biopsies including pleural fluid or plasma are commonly applied for patients with advanced non-small cell lung cancer (NSCLC) and pleural effusion (PE) to guide the treatment. ALK-TKIs are the first options for patients with ALK-positive mutations and combining ALK-TKIs with angiogenic agents may improve survival. We report here one case with ALK-positive lung adenocarcinoma in which the patient achieved a prolonged progression-free survival (PFS) of 97 months after undergoing precise pleural effusion NGS and receiving combined bevacizumab treatment following multiple-line ALK-TKI resistance.
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  • 文章类型: Journal Article
    背景:肌肉减少性肥胖(SO)影响各种恶性肿瘤的预后。然而,其在接受新辅助化疗(NAC)治疗局部进展期胃癌(LAGC)患者中的临床意义尚不清楚.这项研究调查了NAC前后SO对术后发病率和生存率的影响。
    方法:来自207例LAGC患者的数据,在2010年1月至2019年10月期间接受NAC后接受根治性胃切除术的患者进行了回顾性分析.使用计算机断层扫描在NAC前后测量骨骼肌质量和内脏脂肪面积,以定义肌肉减少症和肥胖。共存的定义为SO。
    结果:在患者中,52(25.1%)和38(18.4%)在NAC前后发展了SO,分别。术前(34.6%)和术后(47.4%)NACSO与术后发病率最高相关;然而,仅NAC后SO是术后发病率的独立危险因素[风险比(HR)=9.550,95%置信区间(CI)=2.818-32.369;P<.001].NAC前的SO与较差的3年总体独立相关[46.2%与61.3%;HR=1.258(95%CI=1.023-1.547);P=.049]且无复发[39.3%vs.55.4%;HR1.285(95%CI1.045-1.579);P=0.017]生存率。
    结论:Pre-NACSO是接受NAC的LAGC患者的独立预后因素;NAC后SO独立预测术后发病率。
    BACKGROUND: Sarcopenic obesity (SO) affects outcomes in various malignancies. However, its clinical significance in patients undergoing neoadjuvant chemotherapy (NAC) for locally advanced gastric cancer (LAGC) remains unclear. This study investigated the impact of pre- and post-NAC SO on postoperative morbidity and survival.
    METHODS: Data from 207 patients with LAGC, who underwent NAC followed by radical gastrectomy between January 2010 and October 2019, were reviewed. Skeletal muscle mass and visceral fat area were measured pre- and post-NAC using computed tomography to define sarcopenia and obesity, the coexistence of which was defined as SO.
    RESULTS: Among the patients, 52 (25.1%) and 38 (18.4%) developed SO before and after NAC, respectively. Both pre- (34.6%) and post- (47.4%) NAC SO were associated with the highest postoperative morbidity rates; however, only post-NAC SO was an independent risk factor for postoperative morbidity [hazard ratio (HR) = 9.550, 95% confidence interval (CI) = 2.818-32.369; P < .001]. Pre-NAC SO was independently associated with poorer 3-year overall [46.2% vs. 61.3%; HR = 1.258 (95% CI = 1.023-1.547); P = .049] and recurrence-free [39.3% vs. 55.4%; HR 1.285 (95% CI 1.045-1.579); P = .017] survival.
    CONCLUSIONS: Pre-NAC SO was an independent prognostic factor in patients with LAGC undergoing NAC; post-NAC SO independently predicted postoperative morbidity.
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  • 文章类型: Journal Article
    这项研究的目的是评估六种程序性细胞死亡-1抑制剂(nivolumab,pembrolizumab,sintilmab,tislelizumab,托里帕利玛,和camrelizumab)已被用作中国晚期非小细胞肺癌(NSCLC)患者的一线治疗,尚不清楚。我们通过观察患者的生存数据来确定疗效的差异,目的是为未来的治疗方案提供信息。2015年6月至2023年4月的回顾性数据分析包括6组913例患者:nivolumab(123%,13.5%),pembrolizumab(421%,46.1%),辛替利玛(239%,26.1%),tislelizumab(64%,7.0%),托里帕利马(39%,4.3%),和camrelizumab(27%,3.0%)。每组的中位无进展生存期(PFS)分别为16.0、16.1、18.4、16.9、23.7和12.8个月,中位总生存期(OS)为33.7、36.1、32.5,未达到,nivolumab的30.9和46.0个月,sintilmab,pembrolizumab,tislelizumab,托里帕利玛,和camrelizumab组,分别。虽然两组之间的客观反应率存在差异(p<0.05),PFS和OS差异均无统计学意义(均p>0.05)。研究结果表明,这些PD-1抑制剂对NSCLC治疗的疗效相当。强调他们的集体适用性和帮助治疗决定。
    The purpose of this study was to assess the comparative efficacy of six programmed cell death-1 inhibitors (nivolumab, pembrolizumab, sintilimab, tislelizumab, toripalimab, and camrelizumab) that have been used as first-line therapy for Chinese patients with advanced non-small cell lung cancer (NSCLC), which remains unclear. We determined the differences in efficacy by observing patient survival data, with the goal of informing future treatment options. Retrospective data analysis from June 2015 to April 2023 included 913 patients across six groups: nivolumab (123%, 13.5%), pembrolizumab (421%, 46.1%), sintilimab (239%, 26.1%), tislelizumab (64%, 7.0%), toripalimab (39%, 4.3%), and camrelizumab (27%, 3.0%). The median progression-free survival (PFS) for each group was 16.0, 16.1, 18.4, 16.9, 23.7, and 12.8 months, and the median overall survival (OS) was 33.7, 36.1, 32.5, not reached, 30.9 and 46.0 months for the nivolumab, sintilimab, pembrolizumab, tislelizumab, toripalimab, and camrelizumab groups, respectively. While differences existed in the objective response rates among groups (p < 0.05), there were no significant differences (all p > 0.05) in PFS or OS. The findings suggest comparable efficacy among these PD-1 inhibitors for NSCLC treatment, underscoring their collective suitability and aiding treatment decisions.
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  • 文章类型: Case Reports
    由于其侵袭性和不良预后,管理广泛阶段的SCLC(ES-SCLC)长期以来一直是临床医生和肿瘤学家的挑战。我们报告了一例41岁的女性ES-SCLC存活了6年,无视这种疾病的典型不良预后。通过涉及化疗的重度治疗策略,靶向治疗,和免疫疗法,患者经历了强烈的反应,避免了远处转移,包括大脑参与。SCLC的长期生存病例强调需要进一步研究个性化策略和预后生物标志物。该病例对临床医生和研究人员都具有重要价值,因为它挑战了ES-SCLC的常规策略,并为旨在延长SCLC生存期的未来循证研究奠定了基础。
    Managing extensive-stage SCLC (ES-SCLC) has long been challenging for clinicians and oncologists due to its aggressive nature and poor prognosis. We report a case of a 41-year-old female with ES-SCLC who survived for six years, defying the disease\'s typically poor prognosis. Through a heavy treatment strategy involving chemotherapy, targeted therapy, and immunotherapy, the patient experienced robust responses and avoided distant metastasis, including brain involvement. The long-term survival case in SCLC highlights the need for further research into personalized strategies and prognostic biomarkers. This case holds significant value for both clinicians and researchers as it challenges the conventional strategies for ES-SCLC and sets the stage for future evidence-based studies aimed at extending survival in SCLC.
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  • 文章类型: Journal Article
    背景:放疗治疗的不可切除的III期非小细胞肺癌(NSCLC)的长期生存和适当替代终点的预测因素,仍不清楚,尤其是在免疫治疗时代。
    方法:本研究回顾性分析了2013年至2022年在中国国家癌症中心接受治疗的822例患者的前瞻性队列。固化馏分,长期生存的替代品,和相关因素使用混合治疗模型进行评估,通过对匹配的监控进行验证,流行病学,和最终结果(SEER)数据集。
    结果:27.3%的不可切除的III期NSCLC患者在接受放疗治疗后可获得长期生存。4年PFS和5年OS,当80%的患者被认为治愈时,显示与基于背景死亡率调整后的PFS和相对生存率的治愈率显着相关,R平方值超过0.85。长期生存的独立预测因素包括非鳞状细胞癌(非SCC)病理类型,N类,肿瘤总体积,以及与免疫检查点抑制剂(ICIs)联合治疗。
    结论:放射治疗,尤其是当与ICI结合时,为部分不可切除的III期NSCLC患者提供了潜在的治愈方法。肿瘤负荷和ICI是长期生存的关键预测因子。该研究建议4年PFS和5年OS作为治愈和长期生存评估的替代终点。
    BACKGROUND: The predictors of long-term survival and appropriate surrogate endpoints in unresectable stage III non-small cell lung cancer (NSCLC) treated with radiotherapy remain unclear, especially in the immune therapy era.
    METHODS: This study retrospectively analyzed a prospective cohort of 822 patients treated at the Chinese National Cancer Center from 2013 to 2022. Cure fractions, surrogates for long-term survival, and associated factors were assessed using a mixture cure model, with validation against a matched Surveillance, Epidemiology, and End Results (SEER) dataset.
    RESULTS: 27.3% of patients with unresectable stage III NSCLC can achieve long-term survival after treated by radiotherapy. 4-year PFS and 5-year OS, when 80% of patients were considered cured, showed significant correlations with cure rates based on background mortality-adjusted PFS and relative survival, with R-squared values exceeding 0.85. Independent predictors of long-term survival included non-squamous cell carcinoma (non-SCC) pathological type, N category, gross tumor volume, and treatment combination with immune checkpoint inhibitors (ICIs).
    CONCLUSIONS: Radiotherapy, especially when combined with ICIs, offers a potential cure for a proportion of patients with unresectable stage III NSCLC. Tumor burden and ICIs are key predictors of long-term survival. The study suggested 4-year PFS and 5-year OS as surrogate endpoints for cure and long-term survival assessment.
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  • 文章类型: Journal Article
    本研究旨在调查福建省儿童急性淋巴细胞白血病(cALL)的真实世界结果。中国。回顾性分析1414例福建地区初诊cALL患者的临床资料。患者按照中国儿童白血病组2008方案(CCLG-ALL2008组)或中国儿童癌症组2015方案(CCCG-ALL2015组)进行治疗。5年治疗放弃(TA)的累积发生率为4.2%±0.6%,与治疗期和风险分层显着相关。CCCG-ALL2015组的5-OS和EFS明显高于CCLG-ALL2008组。福建协和医院CCCG-ALL2015治疗患者的4年OS和EFS明显高于其他4家医院。cALL的真实世界TA大幅下降,福建省长期生存率显著提高,这可能与优化程序有关,多中心协作,提高治疗依从性。
    The present study aimed to investigate the real-world results of childhood acute lymphoblastic leukemia (cALL) cases in Fujian, China. The clinical data of 1414 patients with newly diagnosed cALL in Fujian were retrospectively analyzed. Patients were treated according to the Chinese Children Leukemia Group 2008 protocol (CCLG-ALL 2008 group) or Chinese Children\'s Cancer Group 2015 protocol (CCCG-ALL 2015 group). Cumulative incidence of treatment abandonment (TA) at 5 years was 4.2% ± 0.6% and significantly associated with treatment period and risk stratification. The 5-OS and EFS were significantly higher in the CCCG-ALL 2015 group than in the CCLG-ALL 2008 group. Patients treated with CCCG-ALL 2015 from Fujian Medical Union Hospital had a significantly higher 4-year OS and EFS than did those from the other four hospitals. Real-world TA of cALL greatly decreased, and its long-term survival significantly increased in Fujian, which may be related to optimizing programs, multi-center collaboration, and improving treatment compliance.
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  • 文章类型: Journal Article
    原发性胶质母细胞瘤(pGBM)是中枢神经体系恶性程度最高的肿瘤。放射治疗,化疗和手术治疗对pGBM患者的生存影响不大。一旦肿瘤复发,预后通常较差。迫切需要为患者开发新的疗法。近年来,研究表明,miRNA对基因有强大的调节作用。然而,调控pGBM长期生存特异性相关基因的主要miRNAs群仍不清楚。鉴于大多数胶质瘤患者的生存期相对较短,研究长期存活的pGBM患者对这种疾病具有重要价值。我们的研究旨在鉴定pGBM中存在的具有长期生存相关基因的关键miRNA,并揭示其潜在机制。从基因表达综合数据库获得GSE53733、GSE15824、GSE30563、GSE50161的基因表达谱。首先,根据存活时间分为3组,每组与正常对照组比较。然后我们获得了具有长期存活特异性(LTSDEGs)和短期存活特异性(STSDEGs)的差异表达基因(DEGs)。接下来,用LTSDEGs和STSDEGs一起进行基因本体论(GO)和京都基因和基因组百科全书(KEGG)分析。此外,我们使用UALCAN数据库来验证LTSDEGS和STSDEGS,并获得了长期验证的生存特异性DEGs(LTVSDEGs)和短期验证的生存特异性DEGs(STVSDEGs)。最后,我们建立了预测的关键miRNAs-LTVSDEGs相互作用网络。用免疫组织化学染色在HPA数据库中验证前4个LTVSDEGs的蛋白表达。总的来说,我们发现260个基因在LTSDEGs中改变,822个基因在STSDEGs中改变。GO和KEGG结果表明,主要变化集中在肿瘤代谢上。在UALCAN数据库中验证了9个LTVSDEGs和18个STVSDEGs。至于前4个LTVSDEGs中的蛋白质表达验证,对ZNF630、BLVRB和RPA3进行了验证,而未检测到TPBG。我们从预测的关键miRNA-LTVSDEGs相互作用网络中获得了59个关键miRNA。使用GSE90603验证了25个关键miRNA。最后,我们使用Sankey图构建了关键miRNAs-LTVSDEGs网络,包括25个miRNA和7个LTVSDEGs。总之,我们的研究表明,代谢变化与pGBM的生存之间存在密切的关系。此外,我们建立了pGBM的关键miRNAs-LTVSDEGs网络,这可能是延长pGBM患者寿命的关键途径。
    Primary glioblastoma(pGBM) is the most malignant tumor of the central nervous system. Radiotherapy, chemotherapy and surgical treatment have little effect on the survival of pGBM patients. The prognosis is often poorly once the tumor recurs. It is urgent to develop new therapies for patients. In recent years, studies have been clarified that miRNA have a powerful regulating effect on the genes. However, the main group of miRNAs in regulating long-term survival specific related genes of pGBM is still unclear. Given that the survival period of most glioma patients is relatively short, studying long-term survival patients with pGBM is of great value for this disease. Our study aim to identify key miRNAs with long-term survival related genes present in pGBM and uncover their potential mechanisms. The gene expression profiles of GSE53733, GSE15824, GSE30563, GSE50161 were obtained from the Gene Expression Omnibus database. Firstly, samples were divided into 3 groups according to its survival time and each group compare to the normal control group. Then we obtained differential expression genes (DEGs) with a long-term survival specific (LTSDEGs) and a short-term survival specific DEGs (STSDEGs). Next, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were conducted with LTSDEGs and STSDEGs together. Moreover, we used the UALCAN database to verify LTSDEGs and STSDEGs, and obtained long-term verified survival specific DEGs(LTVSDEGs) and short-term verified survival specific DEGs(STVSDEGs). Finally, we established the predicted key miRNAs-LTVSDEGs interaction network. The protein expressions of the top 4 LTVSDEGs were verified in the HPA database with immunohistochemical staining. In total, we found 260 genes changed in LTSDEGs and 822 genes changed in STSDEGs. GO and KEGG results shown that the major changes are focused on tumor metabolism. 9 LTVSDEGs and 18 STVSDEGs were verified in UALCAN database. As for protein expression verification in top 4 LTVSDEGs, ZNF630, BLVRB and RPA3 were verified, while TPBG was not detected. We obtained 59 key miRNA from the predicted key miRNAs-LTVSDEGs interaction network. 25 key miRNAs were verified using GSE90603. Finally, we constructed the key miRNAs-LTVSDEGs network using a Sankey diagram, including 25 miRNAs and 7 LTVSDEGs. In conclusion, our study shows that there is a close relationship between metabolic changes and survival in pGBM. Besides, we established a key miRNAs-LTVSDEGs network for pGBM, which could be the key path in prolonging the life of pGBM patients.
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  • 文章类型: Meta-Analysis
    背景:三阴性乳腺癌(TNBC)是一种威胁生命的乳腺癌亚型,治疗选择有限。因此,本网络荟萃分析(NMA)旨在评估和比较不同新辅助化疗(NCT)方案对TNBC患者长期生存的影响.
    方法:PubMed,Embase,Medline,科克伦图书馆,WebofScience,和主要的国际会议数据库被系统地搜索关于不同NCT方案在TNBC患者中的疗效的随机对照试验(RCT).从2000年1月至2023年6月进行了搜索。使用I2统计量评估研究异质性。使用危险比(HR)和95%置信区间(CIs)评估无病生存率(DFS)和总生存率(OS)。使用赔率比(OR)和95%CI来评估病理完全缓解(pCR)。主要结果是DFS。
    结果:我们对21个RCT进行了NMA检查,包括8873例TNBC患者。我们的研究将蒽环类和紫杉烷类的组合定义为首选治疗方案。在此基础上,添加以下任何一种新药都被认为是一种新的治疗选择:贝伐单抗(B),铂(P),聚ADP-核糖聚合酶抑制剂(PARPi),和免疫检查点抑制剂(ICI)。根据累积排名曲线(SUCRA)下的曲面值,DFS的前三个SUCRA面积值是紫杉烷,蒽环类药物,和环磷酰胺(TAC;89.23%);CT(84.53%);和B(81.06%)。OS前3位的SUCRA面积值分别为CT(83.70%),TAC(62.02%),和含B方案(60.06%)。pCR的SUCRA面积值排名前3位的是含B+P方案(82.7%),ICI+含P方案(80.2%),和含ICI的方案(61.8%)。
    结论:该NMA显示标准化疗是长期生存的良好选择。此外,就pCR而言,与含P方案相关的B可能是新辅助TNBC的最佳治疗选择。
    BACKGROUND: Triple-negative breast cancer (TNBC) is a life-threatening subtype of breast cancer with limited treatment options. Therefore, this network meta-analysis (NMA) aimed to evaluate and compare the effect of various neoadjuvant chemotherapy (NCT) options on the long-term survival of patients with TNBC.
    METHODS: PubMed, Embase, Medline, Cochrane Library, Web of Science, and major international conference databases were systematically searched for randomized controlled trials (RCTs) on the efficacy of various NCT options in patients with TNBC. Searches were performed from January 2000 to June 2023. Study heterogeneity was assessed using the I2 statistic. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate disease-free survival (DFS) and overall survival (OS). Odds ratios (ORs) and 95% CIs were used to evaluate the pathologic complete response (pCR). The primary outcome was DFS.
    RESULTS: We conducted an NMA of 21 RCTs involving 8873 patients with TNBC. Our study defined the combination of anthracyclines and taxanes as the preferred treatment option. On this basis, the addition of any of the following new drugs is considered a new treatment option: bevacizumab (B), platinum (P), poly-ADP-ribose polymerase inhibitors (PARPi), and immune checkpoint inhibitor (ICI). Based on the surface under the cumulative ranking curve (SUCRA) values, the top three SUCRA area values of DFS were taxanes, anthracycline, and cyclophosphamide (TAC; 89.23%); CT (84.53%); and B (81.06%). The top three SUCRA area values of OS were CT (83.70%), TAC (62.02%), and B-containing regimens (60.06%). The top three SUCRA area values of pCR were B + P-containing regimens (82.7%), ICI + P-containing regimens (80.2%), and ICI-containing regimens (61.8%).
    CONCLUSIONS: This NMA showed that standard chemotherapy is a good choice with respect to long-term survival. Moreover, B associated with P-containing regimens is likely to be the optimal treatment option for neoadjuvant TNBC in terms of pCR.
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