聚乙二醇化脂质体阿霉素、表柔比星和吡柔比星在激素受体（HR）≤10%/人表皮生长因子受体2（HER2）阴性乳腺癌中的新辅助化疗反应及预后比较：一项探索性真实世界多中心队列研究
Comparison of neoadjuvant chemotherapy response and prognosis among pegylated liposomal doxorubicin, epirubicin and pirarubicin in HR ⩽ 10%/HER2-negative breast cancer: an exploratory real-world multicentre cohort study.
作者信息
Hong Yue, Peng Jing, Chen Qitong, Zhou Qin, Xu Feng, Yao Jia, Zou Qiongyan, Yuan Liqin, Li Lun, Long Qian, Liao Liqiu, Liu Mingwen, Liu Xuan, Zhang Danhua, Wang Shouman, Yi Wenjun
机构信息
Department of General Surgery, The Second Xiangya Hospital, Central South University, No. 139, Renmin Central Road, Changsha 410011, China.
Clinical Research Centre For Breast Disease In Hunan Province, No. 139, Renmin Central Road, Changsha 410011, China.
出版信息
Ther Adv Med Oncol. 2024 Sep 23;16:17588359241279695. doi: 10.1177/17588359241279695. eCollection 2024.
BACKGROUND
Pegylated liposomal doxorubicin (PLD), epirubicin and pirarubicin are the main anthracyclines widely used in China. PLD demonstrates therapeutic response comparable to epirubicin and pirarubicin in neoadjuvant chemotherapy (NAC) of breast cancer.
OBJECTIVES
The objectives of our study were to retrospectively assess the real-world effectiveness and prognostic characteristics of PLD as NAC for HR ⩽ 10%/human epidermal growth factor receptor 2 (HER2)-negative breast cancer.
DESIGN
This was a retrospective study.
METHODS
Our study enrolled patients with HR ⩽ 10%/HER2-negative breast cancer who received PLD-, epirubicin- or pirarubicin-based NAC from three centres in Hunan Province, China, between 2015 and 2022. We employed inverse probability of treatment weighting to balance the differences in patients' characteristics among the PLD, epirubicin, and pirarubicin groups. The endpoints were pathological complete response (pCR), event-free survival (EFS), and overall survival (OS).
RESULTS
A total of 267 patients were included. After NAC, the pCR rates in PLD group were superior to epirubicin group (PLD, 34.1%; epirubicin, 20.8%, = 0.038). The differences in EFS (log-rank = 0.99) and OS (log-rank = 0.33) among the three groups were not statistically significant. Among the three groups, non-pCR patients had worse EFS than pCR patients (log-rank = 0.014). For patients with pCR, the differences in EFS (log-rank = 0.47) and OS (log-rank = 0.38) were not statistically significant among the three groups, and the EFS (log-rank = 0.59) and OS (log-rank = 0.14) of non-pCR patients in the PLD group were similar to those in the epirubicin and pirarubicin groups.
CONCLUSION
PLD had a similar therapeutic response and prognosis compared to epirubicin or pirarubicin in NAC for patients with HR ⩽ 10%/HER2 negative breast cancer, which means that PLD represents a potential NAC option.
背景
聚乙二醇化脂质体阿霉素（PLD）、表柔比星和吡柔比星是中国广泛使用的主要蒽环类药物。在乳腺癌新辅助化疗（NAC）中，PLD显示出与表柔比星和吡柔比星相当的治疗反应。
目的
我们研究的目的是回顾性评估PLD作为HR≤10%/人表皮生长因子受体2（HER2）阴性乳腺癌NAC的真实世界有效性和预后特征。
设计
这是一项回顾性研究。
方法
我们的研究纳入了2015年至2022年期间在中国湖南省三个中心接受基于PLD、表柔比星或吡柔比星的NAC的HR≤10%/HER2阴性乳腺癌患者。我们采用治疗权重逆概率来平衡PLD、表柔比星和吡柔比星组患者特征的差异。终点为病理完全缓解（pCR）、无事件生存期（EFS）和总生存期（OS）。
结果
共纳入267例患者。NAC后，PLD组的pCR率优于表柔比星组（PLD，34.1%；表柔比星，20.8%，P = 0.038）。三组之间的EFS（对数秩检验P = 0.99）和OS（对数秩检验P = 0.33）差异无统计学意义。在三组中，非pCR患者的EFS比pCR患者差（对数秩检验P = 0.014）。对于pCR患者，三组之间的EFS（对数秩检验P = 0.47）和OS（对数秩检验P = 0.38）差异无统计学意义，PLD组非pCR患者的EFS（对数秩检验P = 0.59）和OS（对数秩检验P = 0.14）与表柔比星组和吡柔比星组相似。
结论
在HR≤10%/HER2阴性乳腺癌患者的NAC中，PLD与表柔比星或吡柔比星相比具有相似的治疗反应和预后，这意味着PLD是一种潜在的NAC选择。
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