Tan Qingjian, Li Na, Wang Yan, Du Tian, Liang Gehao, Zhao Zixuan, Tang Jun, Wu Hao
Department of Breast Cancer, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong Province, People's Republic of China.
Breast Cancer (Dove Med Press). 2025 May 23;17:447-454. doi: 10.2147/BCTT.S512790. eCollection 2025.
Metaplastic breast carcinoma (MpBC) is a rare and aggressive subtype of breast cancer that often shows poor response to conventional neoadjuvant chemotherapy (NAC). This study aimed to evaluate the efficacy of combining NAC with immune checkpoint inhibitors (ICIs) in MpBC patients.
We conducted a retrospective analysis of MpBC patients treated with NAC, with or without the addition of immunotherapy, at Sun Yat-sen university Cancer center between 2017 and 2024. We assessed clinical and pathological response to NAC in MpBC patients.
40 MpBC patients treated with NAC were identified, 33 patients treated with NAC alone, 7 patients treated with NAC and immunotherapy, 4 (10%) patients achieved pCR. Among the 33 patients treated with NAC alone, only 2 (6%) achieved pCR. In contrast, 7 patients received additional immunotherapy, and 3 started immunotherapy at the initiation of NAC, with 2 of these (67%) achieving pCR. Patients who received immunotherapy after disease progression on NAC showed varying degrees of tumor response, from stable disease (SD) to partial response (PR).
We observed a promising response on addition of immunotherapy to NAC among patients with MpBC, suggesting that immunotherapy may have great potential in the treatment of metaplastic breast carcinoma.
化生性乳腺癌（MpBC）是一种罕见且侵袭性强的乳腺癌亚型，对传统新辅助化疗（NAC）往往反应不佳。本研究旨在评估NAC联合免疫检查点抑制剂（ICI）治疗MpBC患者的疗效。
我们对2017年至2024年期间在中山大学肿瘤防治中心接受NAC治疗（无论是否加用免疫治疗）的MpBC患者进行了回顾性分析。我们评估了MpBC患者对NAC的临床和病理反应。
共纳入40例接受NAC治疗的MpBC患者，其中33例仅接受NAC治疗，7例接受NAC联合免疫治疗，4例（10%）达到病理完全缓解（pCR）。在仅接受NAC治疗的33例患者中，只有2例（6%）达到pCR。相比之下，7例接受额外免疫治疗的患者中，3例在NAC开始时即开始免疫治疗，其中2例（67%）达到pCR。在NAC治疗疾病进展后接受免疫治疗的患者显示出不同程度的肿瘤反应，从疾病稳定（SD）到部分缓解（PR）。
我们观察到在MpBC患者中，NAC联合免疫治疗有良好的反应，提示免疫治疗在化生性乳腺癌治疗中可能具有巨大潜力。
