Kedzierawski Piotr, Macek Pawel, Ciepiela Izabela, Kowalik Artur, Gozdz Stanislaw
Department of Oncology, Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, 25-713 Kielce, Poland.
Radiotherapy Clinic, Holycross Cancer Centre, 25-734 Kielce, Poland.
Diagnostics (Basel). 2021 Jun 23;11(7):1144. doi: 10.3390/diagnostics11071144.
The aim of this study was to evaluate the probability of pathologic complete regression (pCR) by the BRCA1 gene mutation status in patients with triple-negative breast cancer (TNBC) treated with neoadjuvant chemotherapy. The study involved 143 women (mean age 55.4 ± 13.1 years) with TNBC. The BRCA1 mutation was observed in 17% of the subjects. The most commonly used (85.3%) chemotherapy regimen was four cycles of adriamycine and cyclophosphamide followed by 12 cycles of paclitaxel (4AC + 12T). The differences between clinico-pathological factors by BRCA1 status were estimated. Odds ratios and 95% confidence intervals for pCR vs. non-pCR were calculated using logistic regression. The probability distribution of pCR based on BRCA1 status was estimated using beta distributions. The presence of T3-T4 tumours, cancer in stages II and III, lymphovascular invasion, and the use of chemotherapy schedules other than 4AC + 12T significantly decreased the odds of pCR. It was established that there was a 20% chance that pCR in patients with the BRCA1 mutation was 50% or more times as frequent than in patients without the mutation. Thus, the BRCA1 mutation can be a predictive factor for pCR in patients with TNBC.
本研究的目的是评估接受新辅助化疗的三阴性乳腺癌（TNBC）患者中，BRCA1基因突变状态与病理完全缓解（pCR）概率之间的关系。该研究纳入了143例TNBC女性患者（平均年龄55.4±13.1岁）。17%的受试者检测到BRCA1突变。最常用的（85.3%）化疗方案是4个周期的阿霉素和环磷酰胺，随后是12个周期的紫杉醇（4AC + 12T）。评估了BRCA1状态在临床病理因素方面的差异。使用逻辑回归计算pCR与非pCR的比值比和95%置信区间。基于BRCA1状态的pCR概率分布采用贝塔分布进行估计。T3 - T4期肿瘤、II期和III期癌症、淋巴管浸润以及使用4AC + 12T以外的化疗方案均显著降低了pCR的几率。研究确定，BRCA1突变患者出现pCR的可能性比未突变患者高50%或更多，且这种情况出现的概率为20%。因此，BRCA1突变可能是TNBC患者pCR的一个预测因素。
