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比较可手术的三阴性乳腺癌患者中基于顺铂的与标准术前化疗:倾向评分匹配和治疗反概率加权分析。

Comparison of cisplatin-based versus standard preoperative chemotherapy in patients with operable triple-negative breast cancer: propensity score matching and inverse probability of treatment weighting analysis.

机构信息

Department of Breast Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-Ku, Kyoto, 606-8507, Japan.

Department of Breast Surgery, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-Ku, Kobe, 651-2273, Japan.

出版信息

Breast Cancer Res Treat. 2024 Apr;204(2):261-275. doi: 10.1007/s10549-023-07163-z. Epub 2023 Dec 21.

Abstract

PURPOSE

The efficacy of carboplatin is non-equivalent to that of cisplatin (CDDP) for various tumor types in curative settings. However, the role of CDDP in operable triple-negative breast cancer (TNBC) patients remains unknown. We conducted a multicenter observational study to examine the effects of CDDP added to preoperative chemotherapy in patients with TNBC.

METHODS

This retrospective study consecutively included previously untreated patients with stage I-III TNBC treated with preoperative chemotherapy with or without CDDP. The primary endpoint was distant disease-free survival (DDFS). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to minimize confounding biases in comparisons between the two groups.

RESULTS

A total of 138 patients were enrolled in the study. Of these, 52 were in the CDDP group and 86 in the non-CDDP group. DDFS was significantly better in the CDDP group than in the non-CDDP group (unadjusted hazard ratio (HR) 0.127 and p < 0.001, PSM HR 0.141 and p < 0.003, IPTW HR 0.123 and p =  < 0.001). Furthermore, among the patients with residual cancer burden (RCB) class II/III, DDFS was better in the CDDP group than in the non-CDDP group (unadjusted HR 0.192 and p = 0.013, PSM HR 0.237 and p = 0.051, IPTW HR 0.124 and p = 0.059).

CONCLUSION

Our study showed that CDDP-containing regimens achieved favorable prognoses in patients with operable TNBC, especially for the RCB class II/III population. Confirmative studies are warranted to elucidate the role of CDDP in TNBC treatment.

摘要

目的

在各种肿瘤的治疗环境中,卡铂的疗效与顺铂(CDDP)不同。然而,CDDP 在可手术的三阴性乳腺癌(TNBC)患者中的作用尚不清楚。我们进行了一项多中心观察性研究,以研究 CDDP 联合术前化疗在 TNBC 患者中的疗效。

方法

这项回顾性研究连续纳入了接受术前化疗且未经治疗的 I-III 期 TNBC 患者,这些患者接受了含或不含 CDDP 的术前化疗。主要终点是远处无病生存(DDFS)。采用倾向评分匹配(PSM)和逆概率处理加权(IPTW)来最小化两组之间比较的混杂偏倚。

结果

共纳入 138 例患者。其中,52 例患者在 CDDP 组,86 例患者在非 CDDP 组。与非 CDDP 组相比,CDDP 组的 DDFS 显著更好(未调整的风险比(HR)为 0.127,p<0.001,PSM HR 为 0.141,p<0.003,IPTW HR 为 0.123,p<0.001)。此外,在残留肿瘤负荷(RCB)分级 II/III 的患者中,CDDP 组的 DDFS 优于非 CDDP 组(未调整 HR 为 0.192,p=0.013,PSM HR 为 0.237,p=0.051,IPTW HR 为 0.124,p=0.059)。

结论

本研究表明,含 CDDP 的方案可使可手术的 TNBC 患者获得良好的预后,尤其是对于 RCB 分级 II/III 的人群。需要进一步的研究来阐明 CDDP 在 TNBC 治疗中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79a6/10948496/831b18313d67/10549_2023_7163_Fig1_HTML.jpg

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