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多西他赛、卡铂联合曲妥珠单抗作为早期人表皮生长因子受体2阳性乳腺癌患者新辅助治疗方案的回顾性分析

[Docetaxel, carboplatin plus trastuzumab as neoadjuvant setting in patients with early-stage human epidermal growth factor receptor 2 positive breast cancer: a retrospective analysis].

作者信息

Xin L, Zhang H, Zhang S, Cheng Y J, Liu Q, Xu L, Ye J M, Li T, Duan X N, Liu Y H, Li Z H

机构信息

Breast Disease Center, Peking University First Hospital, Beijing 100034, China.

Department of Pathology, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2021 Mar 1;59(3):222-227. doi: 10.3760/cma.j.cn112139-20201122-00811.

Abstract

To examine the efficacy of docetaxel, carboplatin plus trastuzumab regimen (TCH) as neoadjuvant setting in early-stage human epidermal growth factor receptor 2 (HER2) positive breast cancer. Totally 522 patients diagnosed with early-stage HER2 positive breast cancer at Breast Disease Center, Peking University First Hospital between January 2013 to December 2018 were enrolled, which constituted 21.8% (522/2 394) of early-stage invasive breast cancer. Clinical pathological factors were retrospectively analyzed. There were 113 female patients underwent TCH neoadjuvant chemotherapy, aging 52(13) years (range: 23 to 69 years). Pathologic complete pathological response(pCR) was defined as ypT0N0M0, and the rate of pCR was calculated. Kaplan-Meier method and Log-rank test were used for survival comparison. Patients who received trastuzumab-based therapy(=294) had higher disease-free survival (DFS) compared with those who omitted trastuzumab(=177) (84.4% 72.4%, χ²=4.095, =0.046). Eighteen of 113 patients (15.9%) experienced grade 3 to 4 chemotherapy-realted toxicity. Grade 3 to 4 neutropenia occurred in 12 patients, while grade 3 to 4 diarrhea occurred in 6 patients. Thirty-one of 113 (27.4%) patients achieved pCR. DFS and overall survival (OS) were similar between patients who achieved pCR and non-pCR (DFS: 91.8% 85.0%, OS: 92.5% 90.5%, all 0.05). According to Miller-Payne system, patients who achieved G4 to G5 had improved DFS compared with G1 to G3 (89.6% 81.5%, χ²=5.340, =0.021), but they had similar OS (91.4% 89.1%, χ²=1.008, =0.315). TCH is an effective regimen in neoadjuvant setting for patients with HER2 positive breast cancer. Patients who achieved G4 to G5 had improved DFS.

摘要

为研究多西他赛、卡铂联合曲妥珠单抗方案(TCH)作为新辅助治疗方案用于早期人表皮生长因子受体2(HER2)阳性乳腺癌的疗效。纳入2013年1月至2018年12月期间在北京大学第一医院乳腺疾病中心诊断为早期HER2阳性乳腺癌的522例患者,占早期浸润性乳腺癌的21.8%(522/2394)。对临床病理因素进行回顾性分析。113例女性患者接受了TCH新辅助化疗,年龄52(13)岁(范围:23至69岁)。病理完全缓解(pCR)定义为ypT0N0M0,并计算pCR率。采用Kaplan-Meier法和Log-rank检验进行生存比较。接受以曲妥珠单抗为基础治疗的患者(n = 294)与未使用曲妥珠单抗的患者(n = 177)相比,无病生存期(DFS)更高(84.4%对72.4%,χ² = 4.095,P = 0.046)。113例患者中有18例(15.9%)发生3至4级化疗相关毒性。12例患者发生3至4级中性粒细胞减少,6例患者发生3至4级腹泻。113例患者中有31例(27.4%)达到pCR。达到pCR和未达到pCR的患者之间DFS和总生存期(OS)相似(DFS:91.8%对85.0%,OS:92.5%对90.5%,均P>0.05)。根据Miller-Payne系统,达到G4至G5的患者与G1至G3的患者相比,DFS有所改善(89.6%对81.5%,χ² = 5.340,P = 0.021),但OS相似(91.4%对89.1%,χ² = 1.008,P = 0.315)。TCH是HER2阳性乳腺癌患者新辅助治疗的有效方案。达到G4至G5的患者DFS有所改善。

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