Tsai Jui-Hung, Li Chung-Liang, Yeh Dah-Cherng, Hung Chin-Sheng, Hung Chih-Chiang, Lin Chin-Yao, Kuo Yao-Lung
Department of Oncology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan, ROC.
Division of Breast Oncology and Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
Breast Cancer Res Treat. 2023 May;199(1):47-55. doi: 10.1007/s10549-023-06867-6. Epub 2023 Mar 4.
This study aimed to compare the effectiveness and safety of pegylated liposomal doxorubicin (PLD)-based and epirubicin-based combination therapy regimen as neoadjuvant therapy for early breast cancer.
Patients with stage I-III breast cancer who underwent neoadjuvant therapy followed by surgery between January 2018 and December 2019 were retrospectively reviewed. The primary outcome was pathological complete response (pCR) rate. The secondary outcome was radiologic complete response (rCR) rate. Outcomes were compared between treatment groups PLD-cyclophosphamide followed by docetaxel (LC-T group) or epirubicin-cyclophosphamide followed by docetaxel (EC-T group), using both propensity-score matched (matched) and unmatched data.
Data were analyzed from patients who received neoadjuvant LC-T (n = 178) or EC-T (n = 181) treatment. The overall pCR rate and rCR rate were higher in the LC-T group compared with the EC-T group (unmatched pCR: 25.3% vs. 15.5%, p = 0.026; rCR: 14.7% vs. 6.7%, p = 0.016; matched pCR: 26.9% vs. 16.1%, p = 0.034; rCR: 15.5% vs. 7.4%, p = 0.044). Analysis by molecular subtype showed that compared with EC-T treatment, LC-T treatment achieved significantly greater pCR rate in triple-negative subtype and greater rCR rate in Her2 (+) subtype.
Neoadjuvant PLD-based therapy may be a potential option for patients with early-stage breast cancer. The current results warrant further investigation.
本研究旨在比较聚乙二醇化脂质体阿霉素（PLD）方案和表柔比星方案联合治疗作为早期乳腺癌新辅助治疗的有效性和安全性。
回顾性分析2018年1月至2019年12月期间接受新辅助治疗后行手术的Ⅰ-Ⅲ期乳腺癌患者。主要结局为病理完全缓解（pCR）率。次要结局为影像学完全缓解（rCR）率。采用倾向评分匹配（匹配）和非匹配数据，比较PLD-环磷酰胺序贯多西他赛治疗组（LC-T组）和表柔比星-环磷酰胺序贯多西他赛治疗组（EC-T组）的结局。
分析了接受新辅助LC-T（n = 178）或EC-T（n = 181）治疗的患者数据。LC-T组的总体pCR率和rCR率高于EC-T组（非匹配pCR：25.3%对15.5%，p = 0.026；rCR：14.7%对6.7%，p = 0.016；匹配pCR：26.9%对16.1%，p = 0.034；rCR：15.5%对7.4%，p = 0.044）。分子亚型分析显示，与EC-T治疗相比，LC-T治疗在三阴性亚型中pCR率显著更高，在Her2（+）亚型中rCR率更高。
基于PLD的新辅助治疗可能是早期乳腺癌患者的一种潜在选择。目前的结果值得进一步研究。
