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基于的化疗用于早期的三阴性乳腺癌

Sofia Re Mason^1,2,3,4, Melina L Willson⁵, Sam J Egger^6,7

¹Garvan Institute of Medical Research, Darlinghurst, Australia.

The Cochrane database of systematic reviews

|September 8, 2023

概括

基于的化疗改善了早期三阴性乳腺癌 (TNBC) 的无疾病生存率 (DFS) 和整体生存率 (OS). 虽然与毒性增加有关,但它支持在TNBC治疗方案中使用制剂.

科学领域:

在瘤学瘤学.
临床药理学临床药理学
基于证据的医学基于证据的医学.

背景情况:

三阴性乳腺癌 (TNBC) 是一种具有不良预后的侵袭性亚型.
化疗在改善TNBC早期的病理完整反应 (pCR) 方面表现有前途.
早期TNBC中金化疗的长期生存益处和指导方针建议仍然不一致.

研究的目的:

在TNBC早期评估基化疗的益处和危害.
评估化疗作为辅助和新辅助治疗.

主要方法:

随机对照试验 (RCT) 的系统审查和元分析.
采用了Cochrane搜索方法,最新的搜索时间为2022年4月4日.
主要结局包括无病生存 (DFS) 和整体生存 (OS);次要结局包括pCR,治疗坚持,毒性和生活质量.

主要成果:

化疗在新辅助和辅助环境中显著改善了DFS和OS (高确定性证据).
在化疗中观察到病理完整反应 (pCR) 率的增加 (高确定性证据).
的使用导致更频繁的化疗延迟,剂量减少和III/IV级血液毒性 (中度确定性证据).

结论:

基于的化疗,特别是碳,改善了TNBC早期的长期DFS和OS.
无论BRCA突变状况,HRD状况或人环素使用情况,都观察到好处.
增加的毒性需要谨慎管理,但严重的不良事件,如神经病变和与治疗有关的死亡并没有显著增加.

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