雄激素受体在接受新辅助治疗的三阴性乳腺癌中的作用：一项系统评价和荟萃分析
Effect of Androgen receptors in Triple-Negative Breast Cancer Given Neoadjuvant Therapy: A Systematic Review and Meta-Analysis.
作者信息
Kalangi Ottofianus Alvedo Hewick, Sutjonong Tioky, Indrawan Erica A, Pratama Hayyan Ageng, Azhar Yohana, Wihandono Asdi
机构信息
Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Surgical Oncology Department, Faculty of Medicine, Padjajaran University/ Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
出版信息
Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4115-4122. doi: 10.31557/APJCP.2024.25.12.4115.
OBJECTIVE
Triple-negative breast cancer (TNBC) is a type of breast cancer that does not express the estrogen receptor (ER), the progesterone receptor (PR), or the human epidermal growth factor receptor 2 (HER2). TNBC has limited treatment targets, including the androgen receptor (AR). However, the therapeutic strategies-based AR expression in TNBC remains uncertain. The aim of this study is to compare the effect of neoadjuvant treatment on TNBC androgen receptor-positive versus receptor-negative patients.
METHODS
A systematic search was performed through databases to search for cohort studies that compared the effect of neoadjuvant treatment on TNBC androgen receptor-positive versus TNBC receptor-negative patients. The Mantel-Haenzel and Inverse Variance methods obtained a fixed-effects model of pooled odds or hazard ratios for the primary outcomes.
RESULTS
Fifteen cohort studies, including 2,713 patients with TNBC, were assessed. The effect of neoadjuvant chemotherapy is less superior on AR+ patients than AR- (OR = 0.60, p = 0.02). For survival outcomes, the AR+ subtype is associated with better 3-year DFS (HR = 0.93, p = 0.69) and 3-year OS (HR = 0.71, p = 0.20) compared with AR-. The statistical value is insignificant.
CONCLUSION
The prognostic value of AR expression in TNBC is not fully understood, which is an inconclusive result.
目的
三阴性乳腺癌（TNBC）是一种不表达雌激素受体（ER）、孕激素受体（PR）或人表皮生长因子受体2（HER2）的乳腺癌类型。TNBC的治疗靶点有限，包括雄激素受体（AR）。然而，基于TNBC中AR表达的治疗策略仍不明确。本研究的目的是比较新辅助治疗对TNBC雄激素受体阳性与受体阴性患者的效果。
方法
通过数据库进行系统检索，以寻找比较新辅助治疗对TNBC雄激素受体阳性与TNBC受体阴性患者效果的队列研究。Mantel-Haenzel法和逆方差法获得了主要结局的合并比值比或风险比的固定效应模型。
结果
评估了15项队列研究，包括2713例TNBC患者。新辅助化疗对AR+患者的效果不如AR-患者（OR = 0.60，p = 0.02）。对于生存结局，与AR-亚型相比，AR+亚型的3年无病生存率（HR = 0.93，p = 0.69）和3年总生存率（HR = 0.71，p = 0.20）更好。统计值无显著性差异。
结论
TNBC中AR表达的预后价值尚未完全明确，这是一个尚无定论的结果。
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