Zheng Jun-Sheng, Wang Xiao-Wen, Shi Zhi-Qiang, Bi Zhao, Wang Yong-Sheng, Qiu Peng-Fei
Department of Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Front Oncol. 2025 Aug 15;15:1635243. doi: 10.3389/fonc.2025.1635243. eCollection 2025.
Advanced triple-negative breast cancer (aTNBC) has a poor prognosis, and there is a dearth of relevant real-world research data. This study is aimed at analyzing the survival outcomes and subgroup characteristics of aTNBC in the first-line treatment stage, providing data support for clinical treatment decisions.
A retrospective analysis was conducted on 215 patients with aTNBC who received first-line salvage treatment at Shandong Cancer Hospital from January 2018 to March 2023 (74 patients of metastatic breast cancer [dnMBC] and 141 patients of recurrent metastatic breast cancer [rMBC]). Progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan-Meier method, and hazard ratio (HR) were calculated using the Cox regression model. Spearman correlation analysis was used to evaluate the relationship between PFS and OS.
The median PFS for aTNBC patients during the first-line treatment phase was 8.40 months (95% CI: 7.56-9.24 months), while the median OS was 23.87 months (95% CI: 20.53-27.21 months). Multivariate Cox regression and interaction analyses identified several independent prognostic factors affecting PFS, including dnMBC, platinum-containing regimen, immunotherapy, and local treatment of metastasis. For OS, independent prognostic factors included dnMBC, G3, and platinum-containing regimen. Additional survival analysis showed that the risk of disease progression and death was significantly lower in dnMBC patients compared to rMBC patients (PFS: HR = 0.70, 95% CI: 0.51-0.95, = 0.025; OS: HR = 0.65, 95% CI: 0.45-0.95, = 0.023). Furthermore, in both groups, PFS and OS were positively correlated ( = 0.54; = 0.58).
In patients with aTNBC, those with dnMBC demonstrate a more pronounced survival benefit, with this advantage being consistent across various clinicopathological parameters. Therefore, stratifying patients by metastatic category in clinical trials may improve evaluation of treatment efficacy and support more individualized patient management.
晚期三阴性乳腺癌（aTNBC）预后较差，且缺乏相关的真实世界研究数据。本研究旨在分析aTNBC一线治疗阶段的生存结局和亚组特征，为临床治疗决策提供数据支持。
对2018年1月至2023年3月在山东省肿瘤医院接受一线挽救治疗的215例aTNBC患者进行回顾性分析（74例转移性乳腺癌[dnMBC]患者和141例复发性转移性乳腺癌[rMBC]患者）。采用Kaplan-Meier法评估无进展生存期（PFS）和总生存期（OS），并使用Cox回归模型计算风险比（HR）。采用Spearman相关性分析评估PFS与OS之间的关系。
aTNBC患者一线治疗阶段的中位PFS为8.40个月（95%CI：7.56 - 9.24个月），而中位OS为23.87个月（95%CI：20.53 - 27.21个月）。多因素Cox回归和交互分析确定了影响PFS的几个独立预后因素，包括dnMBC、含铂方案、免疫治疗和转移灶的局部治疗。对于OS，独立预后因素包括dnMBC、G3和含铂方案。进一步的生存分析表明，与rMBC患者相比，dnMBC患者疾病进展和死亡风险显著更低（PFS：HR = 0.70，95%CI：0.51 - 0.95，P = 0.025；OS：HR = 0.65，95%CI：0.45 - 0.95，P = 0.023）。此外，在两组中，PFS与OS均呈正相关（P = 0.54；P = 0.58）。
在aTNBC患者中，dnMBC患者表现出更显著的生存获益，且这一优势在各种临床病理参数中均一致。因此，在临床试验中按转移类别对患者进行分层可能会改善治疗疗效评估，并支持更个体化的患者管理。
