Medical Oncology Unit, Istituti Clinici Scientifici Maugeri-IRCCS, Pavia, Italy.
Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
Cancer Control. 2023 Jan-Dec;30:10732748231161466. doi: 10.1177/10732748231161466.
Neoadjuvant chemotherapy was originally designed to convert inoperable cancer. Nowadays, this concept has expanded since it can also offer the possibility to evaluate markers of response such as pathological complete response (pCR) with possible implications in long-term prognostic outcomes. A substantial body of literature tried to evaluate the ability of pCR to fulfill the conditions required to establish a preliminary endpoint, such as pCR, as a surrogate for the final endpoint, the overall survival (OS) but no systematic reviews have been performed yet. In this review we systematically analyzed the prognostic role of pCR in various cancers (breast, gastro-oesophageal, rectal, ovarian, bladder, lung) in which neoadjuvant treatment is a standard of care, evaluating articles published in the English language of phase III or phase II randomized controlled trials and meta-analyses. Since the continue development of immunotherapy in earlier stage, it has also been considered the impact of tumor-infiltrating lymphocyte on pCR.
新辅助化疗最初旨在使原本无法手术的癌症转变为可手术的癌症。如今,这个概念已经扩大,因为它还可以提供评估反应标志物(如病理完全缓解(pCR))的可能性,这可能对长期预后结果产生影响。大量文献试图评估 pCR 是否有能力满足初步终点(如 pCR)所需的条件,作为最终终点(总生存(OS))的替代,但尚未进行系统评价。在这篇综述中,我们系统地分析了新辅助治疗是标准治疗的各种癌症(乳腺癌、胃食管交界癌、直肠癌、卵巢癌、膀胱癌、肺癌)中 pCR 的预后作用,评估了发表在英语的 III 期或 II 期随机对照试验和荟萃分析中的文章。由于免疫疗法在早期阶段的不断发展,也考虑了肿瘤浸润淋巴细胞对 pCR 的影响。