Lv Huina, Hong Yanyan, Zhang Yuting, Li Siyu, Li Bingbing, Zhang Mingjun
Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, P.R. China.
Department of Oncology, Anhui Medical University, Hefei, Anhui 230032, P.R. China.
Oncol Lett. 2024 Aug 23;28(5):509. doi: 10.3892/ol.2024.14642. eCollection 2024 Nov.
The current evidence for the use of nanoparticle albumin-bound paclitaxel (nab-PTX) for adjuvant breast cancer chemotherapy is insufficient. The present study aimed to assess the efficacy and toxicity of nab-PTX in comparison with solvent-based paclitaxel (sb-PTX) in postoperative adjuvant breast cancer treatment. A total of 345 patients were included in the study and separated into nab-PTX (n=289) and sb-PTX (n=56) groups based on the type of taxane used in the adjuvant chemotherapy regimen. The study evaluated the baseline characteristics in both groups and the risk factors for postoperative recurrence of mammary cancer. Furthermore, data concerning disease-free survival (DFS) and adverse effects were obtained and analyzed, and group confounding variables were addressed using 1:2 propensity score matching (PSM). Comparisons before PSM revealed significant differences in baseline characteristics including age, underlying disease, lymph node involvement, vascular invasion, human epidermal growth factor receptor 2 and axillary surgery (P<0.05). Following PSM, there were 90 patients in the nab-PTX group and 56 in the sb-PTX group, with no significant differences in the baseline differences (P>0.05). Before PSM, the 73-month DFS rate was 97.9% in the nab-PTX group compared with 91.1% in the sb-PTX group. However, there were no significant differences between the groups before or after PSM (P=0.15 and P=0.49, respectively). Additionally, Cox regression analysis demonstrated a significantly lower chance of recurrence in patients aged >45 years [hazard ratio (HR), 0.197; 95% confidence interval (CI), 0.052-0.753; P=0.018], whereas underlying disease (HR, 5.352; 95% CI, 1.310-21.854; P=0.019) and lymph node infiltration (HR, 8.930; 95% CI, 1.121-71.161; P=0.039) significantly increased the risk of recurrence. Regarding safety, the sb-PTX group had a significantly greater incidence of anaphylaxis, whereas the nab-PTX group had significantly increased rates of anemia and peripheral neuropathy (P<0.05). In summary, the 73-month DFS rate of the nab-PTX cohort exceeded that of the sb-PTX cohort, but no significant difference was detected between them. Underlying disease, lymph node metastasis and an age of ≤45 years are significant predictors of postoperative recurrence of breast cancer.
目前，纳米白蛋白结合型紫杉醇（nab-PTX）用于辅助性乳腺癌化疗的证据不足。本研究旨在评估nab-PTX与溶剂型紫杉醇（sb-PTX）相比在术后辅助性乳腺癌治疗中的疗效和毒性。该研究共纳入345例患者，根据辅助化疗方案中使用的紫杉烷类型分为nab-PTX组（n = 289）和sb-PTX组（n = 56）。该研究评估了两组的基线特征以及乳腺癌术后复发的危险因素。此外，获取并分析了无病生存期（DFS）和不良反应的数据，并使用1:2倾向评分匹配（PSM）处理组间混杂变量。PSM前的比较显示，两组在年龄、基础疾病、淋巴结受累、血管侵犯、人表皮生长因子受体2和腋窝手术等基线特征方面存在显著差异（P<0.05）。PSM后，nab-PTX组有90例患者，sb-PTX组有56例患者，基线差异无统计学意义（P>0.05）。PSM前，nab-PTX组73个月的DFS率为97.9%，而sb-PTX组为91.1%。然而，PSM前后两组之间均无显著差异（分别为P = 0.15和P = 0.49）。此外，Cox回归分析表明，年龄>45岁的患者复发几率显著降低[风险比（HR），0.197；95%置信区间（CI），0.052 - 0.753；P = 0.018]，而基础疾病（HR，5.352；95%CI，1.310 - 21.854；P = 0.019）和淋巴结浸润（HR，8.930；95%CI，1.121 - 71.161；P = 0.039）显著增加复发风险。在安全性方面，sb-PTX组过敏反应发生率显著更高，而nab-PTX组贫血和周围神经病变发生率显著增加（P<0.05）。总之，nab-PTX队列的73个月DFS率超过了sb-PTX队列，但两者之间未检测到显著差异。基础疾病、淋巴结转移和年龄≤45岁是乳腺癌术后复发的重要预测因素。
