Mahtani Reshma, Collin Simon M, Tan Ziyu, Shah Chintal H, Adeyemi Basirat, Davies Sophie, John Ellie, Vidal Gregory
Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA.
Oncology Outcomes Research (O2R), Evidence Generation, Publications, and Partnerships, Global Medical Affairs, Oncology Business Unit, AstraZeneca, Cambridge CB2 0AA, UK.
Cancers (Basel). 2025 May 31;17(11):1848. doi: 10.3390/cancers17111848.
: This study analyzed real-world data to assess patient characteristics, treatment patterns, and clinical outcomes in patients with human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (eBC), as data for this patient group are limited. : This was a retrospective observational cohort study of patients in a US electronic health record-derived deidentified database. Patient characteristics, treatment patterns, and clinical outcomes were analyzed overall and by risk of recurrence (high-risk versus non-high-risk). : Of 1290 patients, 366 (28.4%) were classified as high-risk and 924 (71.6%) as non-high-risk. At 5 years, high-risk versus non-high-risk eBC had a lower probability of invasive disease-free survival (72.3% [95% CI: 66.8-77.1%] vs. 80.7% [95% CI: 77.6-83.5%]), distant recurrence-free survival (78.7% [95% CI: 74.1-83.6%] vs. 89.3% [95% CI: 86.9-91.7%]), and overall survival (86.9% [95% CI: 82.3-90.4%] vs. 91.8% [95% CI: 89.4-93.7%]), and a shorter time to mBC diagnosis (22.6 vs. 34.1 months, respectively). Neoadjuvant therapy use increased from 18.2% in 2011-2013 to 67.3% in 2018-2021 in high-risk eBC and from 4.1% to 34.4% in non-high-risk eBC. However, 32.7% of eligible patients with high-risk eBC did not receive neoadjuvant therapy in 2018-2021. Use of post-neoadjuvant and adjuvant therapy increased in high-risk (but not non-high-risk) eBC from 81.8% in 2011-2013 to 91.8% in 2018-2021. : High-risk HER2+ eBC manifested more aggressively than non-high-risk eBC. Utilization of neoadjuvant and (post-neo)adjuvant therapy increased over time. However, despite guideline recommendations, uptake of neoadjuvant therapy remains suboptimal.
本研究分析了真实世界数据，以评估人表皮生长因子受体2阳性（HER2+）早期乳腺癌（eBC）患者的特征、治疗模式和临床结局，因为该患者群体的数据有限。这是一项对美国电子健康记录衍生的去识别数据库中的患者进行的回顾性观察队列研究。对患者特征、治疗模式和临床结局进行了总体分析，并按复发风险（高风险与非高风险）进行了分析。在1290例患者中，366例（28.4%）被归类为高风险，924例（71.6%）为非高风险。在5年时，高风险与非高风险eBC的无侵袭性疾病生存率较低（72.3%[95%CI：66.8-77.1%]对80.7%[95%CI：77.6-83.5%]）、远处无复发生存率较低（78.7%[95%CI：74.1-83.6%]对89.3%[95%CI：86.9-91.7%]）和总生存率较低（86.9%[95%CI：82.3-90.4%]对91.8%[95%CI：89.4-93.7%]），且发生转移性乳腺癌（mBC）诊断的时间较短（分别为22.6个月和34.1个月）。新辅助治疗的使用在2011-2013年的高风险eBC中从18.2%增加到2018-2021年的67.3%，在非高风险eBC中从4.1%增加到34.4%。然而，在2018-2021年，32.7%符合条件的高风险eBC患者未接受新辅助治疗。新辅助治疗后和辅助治疗的使用在高风险（但非非高风险）eBC中从2011-2013年的81.8%增加到2018-2021年的91.8%。高风险HER2+eBC比非高风险eBC表现得更具侵袭性。新辅助和（新辅助后）辅助治疗的使用随时间增加。然而，尽管有指南建议，但新辅助治疗的采用率仍然不理想。
