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三阴性乳腺癌患者的临床病理特征和治疗挑战:一项回顾性队列研究。

Clinicopathological Features and Treatment Challenges in Triple Negative Breast Cancer Patients: A Retrospective Cohort Study.

机构信息

Department of Clinical Oncology and Nuclear Medicine, Zagazig University, Faculty of Medicine, ZAGAZIG, EGYPT.

出版信息

Turk Patoloji Derg. 2021;37(2):121-129. doi: 10.5146/tjpath.2020.01516.

Abstract

OBJECTIVE

As the genetic and molecular profiles of triple negative breast carcinoma (TNBC) are elucidated, multiple therapeutic targets have been produced. TNBC with less than 1% androgen receptor (AR) expression may respond to enzalutamide with greater response association in higher levels. A metronomic dose of capecitabine and docetaxel are effective developed drugs for angiogenic process inhibition. We aimed to demonstrate the treatment outcome of triple-negative breast cancer patients in correlation to their clinicopathological features.

MATERIALS AND METHODS

A retrospective cohort study of 80 TNBC patients was conducted. The patients underwent proper observation with the reporting of their treatment and follow-up data. Patients with a metastatic disease, neoadjuvant chemotherapy, follow-up drop or data shortage were excluded from the survival analysis.

RESULTS

The study results revealed a significant association between negative androgen expression and younger age ≤35 years, premenopausal status, higher grade, extracapsular extension, lymphovascular invasion, Ki 67, and CA15-3 (p=0.003, 0.02, < 0.001, 0.001, 0.027, 0.005, 0.009 respectively). The three-year overall survival (OS) in patients who received bicalutamide was better than those patients who received capecitabine or docetaxel but of no significance (p=0.46). The three-year disease free survival (DFS) was significantly better in the bicalutamide arm versus the other two groups (p=0.012).

CONCLUSIONS

We concluded that extended adjuvant antiandrogen such as bicalutamide and metronomic capecitabine are well tolerated with accepted compliance and affordability compared to docetaxel and are warranted for problem-solving and better DFS and OS in some TNBC patients.

摘要

目的

随着三阴性乳腺癌(TNBC)的遗传和分子谱的阐明,已经产生了多个治疗靶点。AR 表达低于 1%的 TNBC 可能对恩杂鲁胺更敏感,在较高水平下反应关联更大。卡培他滨和多西他赛的节拍剂量是抑制血管生成过程的有效开发药物。我们旨在证明三阴性乳腺癌患者的治疗结果与他们的临床病理特征相关。

材料和方法

对 80 例 TNBC 患者进行了回顾性队列研究。对患者进行了适当的观察,并报告了他们的治疗和随访数据。排除了转移性疾病、新辅助化疗、随访中断或数据不足的患者进行生存分析。

结果

研究结果表明,雄激素表达阴性与年龄≤35 岁、绝经前状态、较高的分级、包膜外扩展、淋巴血管侵犯、Ki67 和 CA15-3 呈显著相关(p=0.003、0.02、<0.001、0.001、0.027、0.005、0.009)。接受比卡鲁胺治疗的患者的 3 年总生存率(OS)优于接受卡培他滨或多西他赛治疗的患者,但无统计学意义(p=0.46)。比卡鲁胺组的 3 年无病生存率(DFS)明显优于其他两组(p=0.012)。

结论

我们得出的结论是,与多西他赛相比,延长辅助抗雄激素治疗(如比卡鲁胺和节拍卡培他滨)具有良好的耐受性和可接受的依从性和可负担性,并且在一些 TNBC 患者中具有解决问题的潜力,并能更好地提高 DFS 和 OS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd32/10512684/84bd3e81403b/TurkPatolojiDerg-37-10271-g001.jpg

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