Ma Sung Jun, Serra Lucas M, Yu Brian, Farrugia Mark K, Iovoli Austin J, Yu Han, Yao Song, Oladeru Oluwadamilola T, Singh Anurag K
Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA.
Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY 14203, USA.
Cancers (Basel). 2022 Jan 21;14(3):534. doi: 10.3390/cancers14030534.
The purpose of this study was to evaluate nationwide trends in pathologic complete response (pCR) and its racial variations for breast cancer. The National Cancer Database was queried for women from 2010 to 2017 with non-metastatic breast cancer who underwent neoadjuvant chemotherapy. The primary endpoints, pCR and overall survival, were evaluated using Cochran-Armitage test, logistic, and Cox regression multivariable analyses. A total of 104,161 women were analyzed. Overall, pCR improved from 2010 to 2017 (15.1% to 27.2%, trend < 0.001). Compared to non-Hispanic White (NHW) women, Hispanic White (HW) women were more likely to have pCR for hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-positive tumors (adjusted odds ratio (aOR) 1.29, 95% confidence interval (CI) 1.08-1.53, = 0.005). Black women were less likely to have pCR for HR-HER2+ tumors (aOR 0.81, 95% CI 0.73-0.89, < 0.001) and triple negative (aOR 0.82, 95% CI 0.77-0.87, < 0.001) tumors, but more likely for HR+HER2- tumors (aOR 1.13, 95% CI 1.03-1.24, = 0.009). Among patients who achieved pCR, Asian or Pacific Islander (API) women were associated with better survival (adjusted hazards ratio (aHR) 0.52, 95% CI 0.33-0.82, = 0.005) than NHW women. Despite positive trends in pCR rates, the likelihood of pCR and survival outcomes may be intricately dependent on racial/ethnic groups and tumor receptor subtypes.
本研究的目的是评估全国范围内乳腺癌病理完全缓解（pCR）的趋势及其种族差异。对2010年至2017年接受新辅助化疗的非转移性乳腺癌女性患者的国家癌症数据库进行了查询。使用 Cochr an - Armitage检验、逻辑回归和Cox回归多变量分析评估主要终点，即pCR和总生存期。共分析了104,161名女性。总体而言，2010年至2017年pCR有所改善（从15.1%提高到27.2%，趋势<0.001）。与非西班牙裔白人（NHW）女性相比，西班牙裔白人（HW）女性对于激素受体（HR）阳性、人表皮生长因子受体2（HER2）阳性肿瘤更有可能达到pCR（调整优势比（aOR）为1.29，95%置信区间（CI）为1.08 - 1.53，P = 0.005）。黑人女性对于HR - HER2 +肿瘤（aOR为0.81，95% CI为0.73 - 0.89，P < 0.001）和三阴性（aOR为0.82，95% CI为0.77 - 0.87，P < 0.001）肿瘤达到pCR的可能性较小，但对于HR + HER2 -肿瘤（aOR为1.13，95% CI为1.03 - 1.24，P = 0.009）更有可能。在达到pCR的患者中，亚洲或太平洋岛民（API）女性与NHW女性相比生存期更好（调整风险比（aHR）为0.52，95% CI为0.33 - 0.82，P = 0.005）。尽管pCR率呈上升趋势，但pCR的可能性和生存结果可能与种族/族裔群体以及肿瘤受体亚型密切相关。
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