Mastology Department, Hospital do Servidor Público Estadual (HSPE-FMO), São Paulo, Brazil.
Mastology Department, Women's Health Hospital, São Paulo, Brazil.
Chin Clin Oncol. 2024 Oct;13(5):65. doi: 10.21037/cco-24-54. Epub 2024 Sep 23.
Neoadjuvant chemotherapy (NAC), traditionally used for locally advanced disease, is now applied for operable disease, particularly to treat aggressive breast cancer (BC). This study aimed to characterize the pathological complete response (pCR) and its relationship with overall survival (OS) and disease-free survival (DFS) among BC patients receiving NAC in a Brazilian public reference center, as well as the association between pCR and BC subtypes.
A retrospective cohort study used a comprehensive BC database from a Brazilian women's health reference center, including patients diagnosed between 2011 and 2020 who underwent NAC. We collected demographic, cancer-specific, and treatment-related data, analyzing OS and DFS based on pCR status using the semiparametric Kaplan-Meier method, with the date of BC diagnosis as the starting point.
The study included 1,601 patients, with an average age of 49 years and a majority presenting stage IIIa disease (35%). Most had invasive nonspecial type (NST) BC (94%), and a significant portion (86.7%) exhibited a Ki-67 index <14. The overall pCR rate was 22.7%, with higher frequencies observed in the triple negative and luminal B subtypes. Patients who achieved pCR had significantly higher survival rates (89% alive vs. 61%, P<0.001) and better DFS (90% vs. 66%, P<0.001), except in the luminal A subtype, where pCR did not correlate with improved OS or DFS.
These updated real-world data (RWD) from BC patients who underwent NAC in Brazil revealed a pCR rate of 22.7% in all cancer subtypes and stages. pCR was not associated with better outcomes in patients with luminal A, contrasting with other subtypes.
新辅助化疗（NAC）传统上用于局部晚期疾病，现在也用于可手术疾病，特别是用于治疗侵袭性乳腺癌（BC）。本研究旨在巴西公立参考中心，描述接受 NAC 的 BC 患者的病理完全缓解（pCR）及其与总生存（OS）和无病生存（DFS）的关系，以及 pCR 与 BC 亚型的关系。
本研究使用巴西妇女健康参考中心的综合 BC 数据库进行回顾性队列研究，包括 2011 年至 2020 年期间接受 NAC 的患者。我们收集了人口统计学、癌症特异性和治疗相关数据，根据 pCR 状态使用半参数 Kaplan-Meier 方法分析 OS 和 DFS，以 BC 诊断日期为起点。
本研究纳入了 1601 例患者，平均年龄为 49 岁，大多数为 IIIa 期疾病（35%）。大多数为浸润性非特殊型（NST）BC（94%），大部分（86.7%）Ki-67 指数<14。总体 pCR 率为 22.7%，三阴性和 luminal B 亚型的频率较高。达到 pCR 的患者的生存率明显更高（89%存活 vs. 61%，P<0.001），DFS 更好（90% vs. 66%，P<0.001），除了 luminal A 亚型，pCR 与 OS 或 DFS 无改善相关。
巴西接受 NAC 的 BC 患者的这些更新的真实世界数据（RWD）显示，所有癌症亚型和分期的 pCR 率为 22.7%。pCR 与 luminal A 患者的更好结局无关，与其他亚型相反。
