Department of Medical Oncology of Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Department of Breast, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.
Sci Rep. 2024 Nov 1;14(1):26364. doi: 10.1038/s41598-024-78176-x.
Explore whether the axillary outcomes differ among HER2 positive subgroups receiving standard dual-targeted therapy, aiming to identify subgroups exhibiting enhanced sensitivity to NAT among HER2-positive/node-positive breast cancer patients. HER2 positive female patients with biopsy-proven node-positive disease from April 2020 to May 2023 were included. All patients underwent standard Neoadjuvant HER2-targeted dual therapy and axillary lymph node dissection (ALND) at Breast Surgery Center of Sichuan Cancer Hospital. Univariate and multivariate analyses were used to identify factors associate with axillary pathological complete response (ApCR). Statistical analysis and graphing were performed using SPSS 24.0 and GraphPad Prism 9.0 software. This study enrolled 215 HER2 positive patients with a total ApCR rate of 76.7%, which included 49 HER2 2+/FISH + and 166 HER2 3 + cases with approximate ApCR rates of 63.3% and 80.7% (P = 0.011). Univariate and multivariate analysis indicated that HER2 3 + disease (OR = 2.43, 95% CI 1.21-4.88, P = 0.012), Ki-67 ≥ 20% disease (OR = 3.00, 95% CI 1.26-7.13, P = 0.013) and NAC regimen of TCb (OR = 2.71, 95% CI 1.39-5.38, P = 0.004) were more likely to achieve ApCR. Further subgroup analysis revealed that HER2 3 + patients receiving TCb regimen showed the highest ApCR rate of 88% compared to other subgroups. HER2 3 + breast cancer had a higher ApCR rate than HER2 2+/FISH + breast cancer during Neoadjuvant HER2-targeted dual therapy. HER2 positive patients could benefit from NAC regimen of TCb in axillary response.
探讨接受标准双靶治疗的 HER2 阳性亚组之间的腋窝结局是否存在差异，旨在确定 HER2 阳性/淋巴结阳性乳腺癌患者中对 NAT 敏感性增强的亚组。纳入 2020 年 4 月至 2023 年 5 月在四川省肿瘤医院乳腺外科接受经皮穿刺活检证实为淋巴结阳性疾病的 HER2 阳性女性患者。所有患者均接受新辅助 HER2 靶向双靶治疗和腋窝淋巴结清扫（ALND）。采用单因素和多因素分析方法确定与腋窝病理完全缓解（ApCR）相关的因素。统计分析和绘图采用 SPSS 24.0 和 GraphPad Prism 9.0 软件。本研究纳入 215 例 HER2 阳性患者，总 ApCR 率为 76.7%，其中 HER2 2+/FISH+49 例，HER2 3+166 例，ApCR 率分别为 63.3%和 80.7%（P=0.011）。单因素和多因素分析表明，HER2 3+疾病（OR=2.43，95%CI 1.21-4.88，P=0.012）、Ki-67≥20%疾病（OR=3.00，95%CI 1.26-7.13，P=0.013）和 NAC 方案 TCb（OR=2.71，95%CI 1.39-5.38，P=0.004）更有可能达到 ApCR。进一步的亚组分析显示，接受 TCb 方案治疗的 HER2 3+患者的 ApCR 率最高，为 88%，明显高于其他亚组。在新辅助 HER2 靶向双靶治疗期间，HER2 3+乳腺癌的 ApCR 率高于 HER2 2+/FISH+乳腺癌。HER2 阳性患者在腋窝反应中可能受益于 TCb 的 NAC 方案。
