Cho Dong Hui, Lee Se Kyung, Kim Sangmin, Choi Min-Young, Jung Seung Pil, Lee Jeonghui, Kim Jiyoung, Koo Min Young, Bae Soo Youn, Kim Jung-Han, Kim Jee Soo, Ho Kil Won, Lee Jeong Eon, Nam Seok Jin, Yang Jung-Hyun
Department of Surgery, Seoul Medical Center, Seoul, Korea.
J Korean Surg Soc. 2013 May;84(5):273-80. doi: 10.4174/jkss.2013.84.5.273. Epub 2013 Apr 24.
We analyzed the responses of patients with locally advanced breast cancer to neoadjuvant chemotherapy (NAC) and NAC combined with neoadjuvant human epidermal growth factor receptor-2 (HER2) targeted therapy (NCHTT).
We retrospectively reviewed 59 patients with HER2 amplified locally advanced breast cancer among patients who were treated surgically after neoadjuvant therapy at Samsung Medical Center between 2005 and 2009. Thirty-one patients received conventional NAC and 28 patients received NCHTT. Pathologic responses were assessed according to response evaluation criteria in solid tumors (RECIST) guidelines.
Pathologic complete response (pCR) was achieved in 13 out of 28 patients treated with NCHTT and in 6 out of 31 patients treated with NAC alone (46.4% vs. 19.4%, respectively, P = 0.049). Breast conserving surgery (BCS) was more frequently performed in the NCHTT group than in the NAC only group (71.4% vs. 19.4%, P < 0.001). The 3-year recurrence-free survival (RFS) rate was 100% in the NCHTT group and 76.4% in the NAC group (P = 0.014). Together, NCHTT, type of operation (BCS vs. mastectomy) and pathologic nodal status were significant prognostic factors for RFS in univariate analysis.
We found that NCHTT produced higher pCR rates than NAC alone in locally advanced breast cancer.
我们分析了局部晚期乳腺癌患者对新辅助化疗（NAC）以及NAC联合新辅助人表皮生长因子受体2（HER2）靶向治疗（NCHTT）的反应。
我们回顾性分析了2005年至2009年间在三星医疗中心接受新辅助治疗后接受手术的患者中59例HER2扩增的局部晚期乳腺癌患者。31例患者接受了传统NAC，28例患者接受了NCHTT。根据实体瘤疗效评价标准（RECIST）指南评估病理反应。
接受NCHTT治疗的28例患者中有13例达到病理完全缓解（pCR），而单独接受NAC治疗的31例患者中有6例达到pCR（分别为46.4%和19.4%，P = 0.049）。NCHTT组比仅NAC组更频繁地进行保乳手术（BCS）（71.4%对19.4%，P < 0.001）。NCHTT组的3年无复发生存率（RFS）为100%，NAC组为76.4%（P = 0.014）。在单因素分析中，NCHTT、手术类型（BCS与乳房切除术）和病理淋巴结状态是RFS的重要预后因素。
我们发现，在局部晚期乳腺癌中，NCHTT比单独使用NAC产生更高的pCR率。
