在接受新辅助向治疗后,非病理完整反应的患者中,HER2状态和生存结果的变化
Xiaofei Ren1,2, Xiangmei Zhang1,3, Xiangmin Ma4
1Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Hebei Medical University, Shijiazhuang City, Hebei, China.
Medicine
|September 29, 2023
概括
双重 HER2 向治疗显著改善了 HER2 阳性乳腺癌的病理完整反应 (pCR) 率. 新辅助治疗改变了HER2的表达,即使在观察到HER2阴性后,也建议继续使用抗HER2治疗.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 临床医学 临床医学
背景情况:
- 人类表皮生长因子受体2 (HER2) 是乳腺癌的一个子集的关键驱动因素.
- 新辅助治疗旨在减少瘤负担,并在手术前评估治疗反应.
- 了解HER2表达动态后新辅助疗法对优化治疗策略至关重要.
研究的目的:
- 在HER2阳性乳腺癌患者接受新辅助治疗后,研究HER2表达的变化.
- 为了比较双 HER2 向治疗 (特拉斯图祖马布 + 珀图祖马布) 与单一 HER2 向治疗 (特拉斯图祖马布) 在 HER2 表达和治疗结果上的疗效.
- 分析HER2表达状态对病理完整反应 (pCR) 和无病生存率 (DFS) 的影响.
主要方法:
- 从499名HER2阳性乳腺癌患者的临床病理学数据的回顾性分析.
- 患者被分为双标 (特拉斯图祖马布+珀图祖马布) 和单标 (特拉斯图祖马布) 的新辅助化疗组.
- 在新辅助治疗之前和之后评估了HER2表达水平;pCR和DFS被评估.
主要成果:
- 双重目标组的pCR率 (60.07%) 与单一目标组 (37.81%) 相比显著更高.
- 在非pCR患者中的13.11%观察到HER2表达的负转化率,在双重目标组 (17.65%) 中更高.
- 获得pCR的患者比没有pCR (92.21%) 的患者显著改善了DFS (98.43%);在治疗后HER2阴性患者中,复发很少发生.
结论:
- 新辅助治疗,特别是双重HER2向治疗,有效地改变HER2表达并改善HER2阳性乳腺癌中的PCR率.
- 在新辅助治疗后的HER2表达状态与治疗反应和长期结果相关.
- 虽然即使观察到HER2阴性,也建议继续使用抗HER2治疗,但对这一亚组的最佳策略需要进一步调查.
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