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早期乳腺癌的新辅助系统疗法:前性观察多中心BRIDE研究结果
Stefania Gori1, Alessandra Fabi2, Catia Angiolini3
1Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy.
Cancers
|October 14, 2023
概括
新辅助系统疗法 (NAT) 在意大利越来越多地用于早期乳腺癌 (EBC),患者和瘤因素指导治疗决策. HER2阳性和三阴性EBC亚型从NAT中受益最多,改善了患者的生存率.
科学领域:
- 在瘤学瘤学.
- 临床医学 临床医学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 新辅助全身疗法 (NAT) 是早期乳腺癌 (EBC) 的关键治疗方式.
- 了解NAT的现实应用,包括患者选择和治疗选择,对于优化治疗策略至关重要.
- 该BRIDE研究提供了关于NAT对EBC的意大利当前临床实践的见解.
研究的目的:
- 评估意大利EBC患者中NAT的利用率,患者选择标准和治疗方法.
- 分析患者/瘤特征之间的关联以及管理NAT的决定.
- 报告基于用NAT治疗的EBC亚型的病理完整响应 (pCR) 率.
主要方法:
- 从多中心前性观察性BRIDE研究中对1276名EBC患者 (I-III阶段) 的分析.
- 多变量分析以确定与NAT管理相关的因素.
- 基于EBC分子亚型 (HER2阳性,激素受体阳性/阴性,三阴性) 的NAT类型和pCR率的亚组分析.
主要成果:
- 13.9%的EBC患者接受了NAT,而85.9%接受了初级手术.
- 更年期状态,瘤大小 (cT),淋巴结状态 (cN),等级,HER2阳性和三阴性 (TN) 状态显著影响了NAT决策.
- 根据亚型,NAT的使用率有所不同:HER2+/HR-为53.2%,HER2+/HR+为27.9%,HER2-/HR+为7.1%,TN EBC为30.3%.
- pCR率为74.2% (HER2+/HR-),52.3% (HER2+/HR+),17.2% (HER2-/HR+) 和37.9% (TN) 的情况.
结论:
- 意大利的临床实践表明,患者和瘤特征指导瘤学家对EBC的NAT的决定.
- 对于HER2阳性和三阴性EBC亚型,NAT特别推,与ESMO和AIOM指南保持一致.
- 使用NAT实现pCR与显著改善患者存活率有关,这强调了在EBC管理中考虑NAT的重要性.
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