Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Center, Peking University Cancer Hospital & Institute, Beijing, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Center, Peking University Cancer Hospital & Institute, Beijing, China.
Clin Breast Cancer. 2023 Jun;23(4):423-430. doi: 10.1016/j.clbc.2023.02.009. Epub 2023 Feb 21.
INTRODUCTION/BACKGROUND: To investigate the differences in pathological response and survival outcomes between dose-dense and conventional-interval neoadjuvant chemotherapy (NAC) in patients with triple-negative breast cancer (TNBC).
Patients with TNBC who received NAC including epirubicin plus cyclophosphamide followed by weekly paclitaxel were included. A total of 494 patients were divided into either the dose-dense anthracycline (ddEC-wP) group or conventional interval anthracycline (EC-wP) group.
The breast pathological complete response (bpCR, ypT0/is) rate was 45.3% (n = 101) in the dose-dense group and 34.3% (n = 93) in the conventionally scheduled group, which was a significant difference (P = .013), and in the 251 pN+ cases, the lymph node pathological complete response (LNpCR, ypN0) rate was 57.9% (n = 62) in the dose-dense group and 43.7% (n = 63) in the conventionally scheduled group, which was a significant difference (P = .026) in the univariate analysis. In the multivariate logistic regression analysis, 3 variables were predictive of bpCR: pathological type, surgical methods and type of chemotherapy, with P values of .012, .001 and .021, respectively. Two variables were predictive of LNpCR: type of chemotherapy and Her-2 expression, with P values of .039 and .020, respectively. After a median follow-up of 54 months, there was no significant difference in survival for disease-free survival (DFS) (hazard ratio [HR], 0.788; 95% confidence interval [CI], 0.508 to 1.223; P = .288), distant disease-free survival (DDFS) (HR, 0. 709; 95% CI, 0.440 to 1.144; P = .159) or overall survival (OS) (HR, 0. 750; 95% CI, 0.420 to 1.338; P = .330) between the 2 groups.
Our study demonstrated that TNBC achieved a higher bpCR rate and LNpCR rate after dose-dense neoadjuvant chemotherapy than the conventional scheme. The survival benefit of the 2 groups did not reach statistical difference.
介绍/背景：为了研究三阴性乳腺癌（TNBC）患者密集剂量和常规间隔新辅助化疗（NAC）之间的病理反应和生存结果的差异。
接受包括表柔比星加环磷酰胺随后每周紫杉醇的 NAC 的 TNBC 患者被纳入研究。共有 494 名患者被分为密集型蒽环类药物（ddEC-wP）组或常规间隔蒽环类药物（EC-wP）组。
密集组的乳房病理完全缓解（bpCR，ypT0/is）率为 45.3%（n=101），常规组为 34.3%（n=93），差异有统计学意义（P=0.013），在 251 例 pN+病例中，淋巴结病理完全缓解（LNpCR，ypN0）率在密集组为 57.9%（n=62），在常规组为 43.7%（n=63），差异有统计学意义（P=0.026）。在单变量逻辑回归分析中，有 3 个变量与 bpCR 相关：病理类型、手术方法和化疗类型，P 值分别为 0.012、0.001 和 0.021。有 2 个变量与 LNpCR 相关：化疗类型和 Her-2 表达，P 值分别为 0.039 和 0.020。中位随访 54 个月后，两组间无病生存（DFS）（风险比[HR]，0.788；95%置信区间[CI]，0.508 至 1.223；P=0.288）、远处无病生存（DDFS）（HR，0.709；95%CI，0.440 至 1.144；P=0.159）或总生存（OS）（HR，0.750；95%CI，0.420 至 1.338；P=0.330）无显著差异。
本研究表明，与常规方案相比，密集型新辅助化疗后 TNBC 达到更高的 bpCR 率和 LNpCR 率。两组的生存获益未达到统计学差异。
