Department of Medicine, Siriraj Hospital, Bangkok, Thailand.
Chemotherapy Unit, Lopburi Cancer Hospital, Lopburi, Thailand.
PLoS One. 2018 Dec 19;13(12):e0209040. doi: 10.1371/journal.pone.0209040. eCollection 2018.
To characterize the clinical pattern and evaluate real-life practices in the management of patients with triple-negative breast cancer (TNBC) in Thailand.
In this multicenter, prospective, observational cohort, females (aged ≥18 years) with histologically and immunohistochemically confirmed TNBC were enrolled. Patient data was collected at four study visits-an inclusion visit (for enrollment), and three subsequent follow-up visits at 12±1, 24±1, and 36±1 months after completion of first day of any planned chemotherapy.
Of the 293 enrolled patients, 262 (89.4%) had early-stage TNBC (Stage I: 46 patients, Stage II: 151 patients, and Stage III: 65 patients) and 31 (10.6%) had metastatic TNBC (mTNBC). Chemotherapy was prescribed to 95.4% of the early-stage patients and to 100.0% of the mTNBC patients; most commonly as anthracycline-based in combination with cyclophosphamide and other agents. Patients' performance status and consensus guidelines were the major factors affecting choice of treatment. In early-stage patients, median disease-free survival (DFS) and overall survival (OS) had not been reached for Stage I and II patients, and were calculated to be 37.0 months and 40.0 months, respectively, in Stage III patients. In mTNBC patients, progression-free survival (PFS) and OS were found to be 10.0 months and 14.0 months, respectively. In Stage III patients, anthracycline-based regimens were found to be associated with increase in DFS (p = 0.0181) and OS (p = 0.0027) compared to non-anthracycline-based regimens. In mTNBC patients, non-taxane-based regimens were associated with an increase in PFS (p = 0.0025). The 3-year survival rates in early-stage and mTNBC patients were 85.0% and 21.0%, respectively.
Clinical management of TNBC in Thailand follows the general guidelines for treatment of TNBC. However, prognosis and survival outcomes are suboptimal, especially in progressive disease. This study is the first assessment in the existing practices in which the results could pave to way to improve the treatment outcome of TNBC in Thailand.
描述泰国三阴性乳腺癌(TNBC)患者的临床特征,并评估其实践中的治疗方案。
本研究为多中心、前瞻性、观察性队列研究,纳入了经组织学和免疫组织化学证实为 TNBC 的女性患者(年龄≥18 岁)。在四次研究访视中收集患者数据:纳入访视(入组)和随后的三次随访,在首次计划化疗的第 1 天完成后 12±1、24±1 和 36±1 个月进行。
在 293 名入组患者中,262 名(89.4%)为早期 TNBC(Ⅰ期:46 例,Ⅱ期:151 例,Ⅲ期:65 例),31 名(10.6%)为转移性 TNBC(mTNBC)。95.4%的早期患者和 100.0%的 mTNBC 患者接受了化疗;最常见的方案为蒽环类药物联合环磷酰胺和其他药物。患者的体能状态和共识指南是影响治疗选择的主要因素。在早期患者中,Ⅰ期和Ⅱ期患者的无疾病进展生存期(DFS)和总生存期(OS)尚未达到,Ⅲ期患者的中位 DFS 和 OS 分别计算为 37.0 个月和 40.0 个月。在 mTNBC 患者中,无进展生存期(PFS)和 OS 分别为 10.0 个月和 14.0 个月。在Ⅲ期患者中,与非蒽环类药物方案相比,蒽环类药物方案与 DFS(p = 0.0181)和 OS(p = 0.0027)的增加相关。在 mTNBC 患者中,非紫杉烷类药物方案与 PFS 的增加相关(p = 0.0025)。早期和 mTNBC 患者的 3 年生存率分别为 85.0%和 21.0%。
泰国 TNBC 的临床管理遵循 TNBC 治疗的一般指南。然而,预后和生存结果并不理想,特别是在进展性疾病中。本研究是对现有实践的首次评估,结果可能为改善泰国 TNBC 的治疗结果铺平道路。