在NCDB中,黑人/非裔美国人和白人女性对新辅助内分泌治疗的反应差异
Veronica Jones1, Mary C Schroeder2, Mya L Roberson3
1Department of Surgery, City of Hope National Medical Center, 1500 E Duarte Rd, Duarte, CA, 91010, USA. vjones@coh.org.
Breast cancer research and treatment
|September 23, 2023
概括
患有HR+乳腺癌的黑人/非洲裔美国女性在新辅助内分泌疗法 (NET) 后显示出更高的瘤完整反应率和转移性进展率. 这表明独特的瘤生物学需要针对HR+乳腺癌量身定制的治疗方法.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 翻译医学是一种翻译医学.
背景情况:
- 与白人女性相比,黑人/非裔美国人 (BAA) 妇女患激素受体阳性乳腺癌 (HR+BC) 的死亡率较高.
- 治疗耐药性可能导致观察到的BAA女性HR+BC的结果差异.
研究的目的:
- 为了调查与治疗反应相关的因素,新辅助内分泌疗法 (NET) 在BAA妇女与HR+BC.
- 为了比较BAA和白人女性之间的NET反应.
主要方法:
- 利用国家癌症数据库 (NCDB) 对在2006-2017年间被诊断患有临床阶段I-III HR+ BC的妇女,并接受NET治疗.
- 进行单变量和多变量分析,以评估患者人口统计,NET持续时间和治疗反应 (临床与病理阶段) 之间的关联.
主要成果:
- 该研究包括1090名BAA妇女和9864名白人妇女;BAA妇女年轻,患有更多的并发症,并呈现在更高的阶段.
- 多变量分析显示,与白人女性相比,BAA女性更有可能实现完整的瘤下降阶段 (pT0/Tis) (OR 3.0) 以及更有可能进展到第四阶段疾病 (OR 2.4).
- 在没有出现第三阶段疾病的患者中观察到完全反应,而在出现第一阶段疾病的患者中,转移性进展是罕见的.
结论:
- 具有HR+BC的BAA女性表现出更高的瘤完整反应和进展到转移性疾病的可能性,独立于NET持续时间和初始临床阶段.
- 这些发现表明,在HR+BC的BAA女性中,瘤生物学存在显著的异质性.
- 在HR+乳腺癌管理中,需要更细微和个性化的治疗策略.
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