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阿贝西利辅助治疗的可行性——来自德国一家大型乳腺中心的真实世界数据

Feasibility of Adjuvant Treatment with Abemaciclib-Real-World Data from a Large German Breast Center.

作者信息

Dannehl Dominik, Volmer Lea L, Weiss Martin, Matovina Sabine, Grischke Eva-Maria, Oberlechner Ernst, Seller Anna, Walter Christina B, Hahn Markus, Engler Tobias, Brucker Sara Y, Hartkopf Andreas D

机构信息

Department of Women's Health, Tuebingen University, 72076 Tuebingen, Germany.

Research Institute for Women's Health, Tuebingen University, 72076 Tuebingen, Germany.

出版信息

J Pers Med. 2022 Mar 2;12(3):382. doi: 10.3390/jpm12030382.

Abstract

Abemaciclib significantly improves invasive disease-free survival when combined with endocrine therapy in clinical high-risk patients with HR+/Her2- early breast cancer (eBC). The objective of the following study was to model how many patients with eBC would be available for adjuvant treatment with abemaciclib in a real-world setting. Patients that underwent complete surgical treatment for eBC between January 2018 and December 2020 in a large single-center university hospital in Germany were eligible. Descriptive statistics were used to describe the patient population that could benefit from abemaciclib according to the inclusion criteria of monarchE. Of 1474 patients with eBC, 1121 (76.1%) had a HR+/Her2- subtype. Of these, 217 (19.4%) fulfilled the monarchE inclusion criteria. Within patients that fulfilled the monarchE inclusion criteria, 48.9% received no adjuvant or neoadjuvant chemotherapy. Thus, in a real-world situation, fewer patients will be pretreated with chemotherapy than was the case in monarchE. Breast care units are facing a significant patient burden, since the 2-year abemaciclib therapy requires regular monitoring of toxicities. Specific care concepts to strengthen therapy adherence as well as further studies to deescalate adjuvant systemic treatment and individualize CDK 4/6 inhibitor therapy are therefore needed.

摘要

在HR+/Her2-早期乳腺癌(eBC)的临床高危患者中,阿贝西利与内分泌治疗联合使用时可显著提高无侵袭性疾病生存期。以下研究的目的是模拟在现实环境中有多少eBC患者可接受阿贝西利辅助治疗。2018年1月至2020年12月期间,在德国一家大型单中心大学医院接受eBC完全手术治疗的患者符合条件。根据monarchE的纳入标准,使用描述性统计来描述可从阿贝西利中获益的患者群体。在1474例eBC患者中,1121例(76.1%)为HR+/Her2-亚型。其中,217例(19.4%)符合monarchE纳入标准。在符合monarchE纳入标准的患者中,48.9%未接受辅助或新辅助化疗。因此,在现实情况下,接受化疗预处理的患者将比monarchE试验中的情况更少。乳腺护理单位面临着巨大的患者负担,因为阿贝西利2年治疗需要定期监测毒性。因此,需要加强治疗依从性的具体护理概念以及进一步研究以降低辅助全身治疗强度并使CDK 4/6抑制剂治疗个体化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adf8/8951288/ae629351596b/jpm-12-00382-g001.jpg

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