Wang Shan, Jin Zining, Li Zhaohui, Zhu Guolian, Liu Bin, Zhang Dianlong, Tang Shuhong, Yao Fan, Wen Jian, Zhao Yi, Wang Xiaolan, Jin Feng, Wang Jia
Department of Breast Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, China.
Transl Oncol. 2025 Jan;51:102173. doi: 10.1016/j.tranon.2024.102173. Epub 2024 Nov 5.
The combination of pyrotinib (Py) with cytotoxic agents proved to be effective in early human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC). However, the optimal chemotherapy regimen is unknown. This study attempts to explore it from real-world research data.
Information was collected from patients with early-stage HER2-positive BC from 23 centers across the country. They were categorized into the anthracycline group (A group) and non-anthracycline group (non-A group). Patients in the non-A group were further categorized into the platinum group and non-platinum group and the short-cycle (≤4 cycles) taxane group and long-cycle (>4 cycles) taxane group. Total pathological complete response (tpCR, ypT0/is ypN0) and breast pathological complete response (bpCR, ypT0/is) rates were assessed.
A total of 107 patients were enrolled. Postoperative pathology indicated a tpCR rate of 36.8 %, a bpCR rate of 42.1 % in the A group, the non-A group had a tpCR rate of 47.8 %, and a bpCR rate of 53.6 %, with P-values of 0.273 and 0.254, respectively. In the long-cycle taxane group, the tpCR and bpCR rates were 60.8 % and 66.7 %, respectively. In the short-cycle taxane group, the tpCR and bpCR rates were 11.1 % and 16.7 %, respectively (both P<0.001). The platinum group had higher tpCR rate (62.9 % vs. 32.4 %, respectively; P = 0.011) and bpCR rate (65.7 % vs. 41.2 %, respectively; P = 0.041).
As for a neoadjuvant therapy regimen with Py, an anthracycline-free regimen is feasible. Besides, platinum-containing, long-cycle taxane regimens appear to achieve superior efficacy under anthracycline-removed conditions.
吡咯替尼（Py）与细胞毒性药物联合使用已被证明对早期人表皮生长因子受体2（HER2）阳性乳腺癌（BC）有效。然而，最佳化疗方案尚不清楚。本研究试图从真实世界研究数据中进行探索。
收集了来自全国23个中心的早期HER2阳性BC患者的信息。他们被分为蒽环类药物组（A组）和非蒽环类药物组（非A组）。非A组患者进一步分为铂类组和非铂类组以及短周期（≤4周期）紫杉烷组和长周期（>4周期）紫杉烷组。评估总病理完全缓解（tpCR，ypT0/is ypN0）率和乳腺病理完全缓解（bpCR，ypT0/is）率。
共纳入107例患者。术后病理显示，A组的tpCR率为36.8%，bpCR率为42.1%；非A组的tpCR率为47.8%，bpCR率为53.6%，P值分别为0.273和0.254。在长周期紫杉烷组中，tpCR率和bpCR率分别为60.8%和66.7%。在短周期紫杉烷组中，tpCR率和bpCR率分别为11.1%和16.7%（均P<0.001）。铂类组的tpCR率（分别为62.9%和32.4%；P = 0.011）和bpCR率（分别为65.7%和41.2%；P = 0.041）更高。
对于含Py的新辅助治疗方案，不含蒽环类药物的方案是可行的。此外，在去除蒽环类药物的情况下，含铂的长周期紫杉烷方案似乎能取得更好的疗效。
