新辅助化疗和新辅助化疗联合免疫疗法在三阴性乳腺癌中导致不同的肿瘤缩小模式。
Neoadjuvant Chemotherapy and Neoadjuvant Chemotherapy With Immunotherapy Result in Different Tumor Shrinkage Patterns in Triple-Negative Breast Cancer.
作者信息
Zou Jiachen, Zhang Liulu, Chen Yuanqi, Lin Yingyi, Cheng Minyi, Zheng Xingxing, Zhuang Xiaosheng, Wang Kun
机构信息
Department of The First Clinical Medicine, Guangdong Medical University, Zhanjiang, China.
Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangdong Medical University, Guangzhou, China.
出版信息
J Breast Cancer. 2024 Feb;27(1):27-36. doi: 10.4048/jbc.2023.0136. Epub 2023 Nov 17.
PURPOSE
This study aims to explore whether neoadjuvant chemotherapy with immunotherapy (NACI) leads to different tumor shrinkage patterns, based on magnetic resonance imaging (MRI), compared to neoadjuvant chemotherapy (NAC) alone in patients with triple-negative breast cancer (TNBC). Additionally, the study investigates the relationship between tumor shrinkage patterns and treatment efficacy was investigated.
METHODS
This retrospective study included patients with TNBC patients receiving NAC or NACI from January 2019 until July 2021 at our center. Pre- and post-treatment MRI results were obtained for each patient, and tumor shrinkage patterns were classified into three categories as follows: 1) concentric shrinkage (CS); 2) diffuse decrease; and 3) no change. Tumor shrinkage patterns were compared between the NAC and NACI groups, and the relevance of the patterns to treatment efficacy was assessed.
RESULTS
Of the 99 patients, 65 received NAC and 34 received NACI. The CS pattern was observed in 53% and 20% of patients in the NAC and NACI groups, respectively. Diffuse decrease pattern was observed in 36% and 68% of patients in the NAC and NACI groups. The association between the treatment regimens (NAC and NACI) and tumor shrinkage patterns was statistically significant ( = 0.004). The postoperative pathological complete response (pCR) rate was 45% and 82% in the NAC and NACI groups ( 0.001), respectively. In the NACI group, 17% of patients with the CS pattern and 56% of those with the diffuse decrease pattern achieved pCR ( = 0.903). All tumor shrinkage patterns were associated with achieved a high pCR rate in the NACI group.
CONCLUSION
Our study demonstrates that the diffuse decrease pattern of tumor shrinkage is more common following NACI than that following NAC. Furthermore, our findings suggest that all tumor shrinkage patterns are associated with a high pCR rate in patients with TNBC treated with NACI.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT04909554.
目的
本研究旨在探讨与单纯新辅助化疗（NAC）相比，新辅助免疫化疗（NACI）在三阴性乳腺癌（TNBC）患者中基于磁共振成像（MRI）是否会导致不同的肿瘤缩小模式。此外，还研究了肿瘤缩小模式与治疗效果之间的关系。
方法
本回顾性研究纳入了2019年1月至2021年7月在本中心接受NAC或NACI治疗的TNBC患者。获取了每位患者治疗前和治疗后的MRI结果，并将肿瘤缩小模式分为以下三类：1）同心缩小（CS）；2）弥漫性缩小；3）无变化。比较了NAC组和NACI组之间的肿瘤缩小模式，并评估了这些模式与治疗效果的相关性。
结果
99例患者中，65例接受了NAC，34例接受了NACI。NAC组和NACI组分别有53%和20%的患者出现CS模式。NAC组和NACI组分别有36%和68%的患者出现弥漫性缩小模式。治疗方案（NAC和NACI）与肿瘤缩小模式之间的关联具有统计学意义（P = 0.004）。NAC组和NACI组的术后病理完全缓解（pCR）率分别为45%和82%（P < 0.001）。在NACI组中，CS模式的患者中有17%达到pCR，弥漫性缩小模式的患者中有56%达到pCR（P = 0.903）。在NACI组中，所有肿瘤缩小模式都与高pCR率相关。
结论
我们的研究表明，NACI后肿瘤缩小的弥漫性缩小模式比NAC后更常见。此外，我们的研究结果表明，在接受NACI治疗的TNBC患者中，所有肿瘤缩小模式都与高pCR率相关。
试验注册
ClinicalTrials.gov标识符：NCT04909554。
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