在绝经前的荷尔蒙受体阳性乳腺癌中辅助性卵巢功能抑制
Robert B Basmadjian1,2, Sasha Lupichuk1,2, Yuan Xu1,2,3
1Department of Community Health Sciences, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada.
JAMA network open
|March 13, 2024
概括
辅助性卵巢功能抑制 (OFS) 使用塔莫西芬或芳酶抑制剂并没有显著降低绝经前乳腺癌复发风险. 然而,至少两年的激素治疗加上OFS改善了无复发生存率.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 在绝经前激素受体阳性乳腺癌中辅助性卵巢功能抑制 (OFS) 的有效性在观察环境中仍未得到充分研究.
- 目标试验模拟是分析现实数据以估计治疗结果的有价值方法.
研究的目的:
- 分析绝经前早期乳腺癌的激素治疗和OFS治疗模式.
- 评估将OFS添加到他莫西芬 (TAM) 或芳香酶抑制剂 (AI) 和生存率之间的关联.
- 检查激素治疗持续时间加上OFS (H-OFS) 对生存的影响.
主要方法:
- 加拿大阿尔伯塔省的一项以人口为基础的队列研究包括在2010-2020年期间诊断的绝经前早期乳腺癌患者.
- 目标试验模拟模仿了SOFT和TEXT试验的资格标准.
- 带有反向概率加权的边际结构考克斯模型分析了5年无复发生存率.
主要成果:
- 在2647名符合条件的患者中,AI+OFS与TAM单独 (HR,0.76) 或TAM+OFS与TAM单独 (HR,0.87) 的5年复发风险并没有显著降低.
- 与接受H-OFS<2年 (HR,0.69) 的患者相比,接受H-OFS≥2年的患者显示出明显更好的5年无复发生存率.
结论:
- 将OFS添加到TAM或AI并没有显著降低与单独TAM相比的复发风险,在这个观察队列中.
- 至少2年的H-OFS持续时间与绝经前早期乳腺癌中明显改善的无复发生存率有关.
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