密集剂量多克索鲁比加环胺在修改的KEYNOTE522治疗三阴性乳腺癌的方案中
Nicholas Mai1, Sara Myers2, Sherry Shen1
1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
NPJ breast cancer
|June 4, 2024
概括
在新辅助剂KEYNOTE-522治疗三阴性乳腺癌 (TNBC) 的方案中,剂量密集的多克索鲁比加环胺 (ddAC) 是安全有效的. 化疗序列并没有影响病理完整反应,但ddAC首先增加了治疗延迟和细胞衰竭.
科学领域:
- 在瘤学瘤学.
- 临床试验分析
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 标准的新辅助剂KEYNOTE-522治疗三阴性乳腺癌 (TNBC) 的方案使用了q3week doxorubicin加环胺 (AC).
- 与其他方案中的标准AC相比,剂量密度AC (ddAC) 已显示出更好的整体存活率.
- 在TNBC治疗中,化疗和免疫治疗的最佳顺序是正在进行的研究领域.
研究的目的:
- 追溯分析将ddAC纳入TNBC的KN522疗法中的安全性和有效性.
- 评估ddac序列测序在卡博普拉丁/帕克利塔塞尔 (CbT) 之前或之后加上pembrolizumab对治疗结果的影响.
- 评估与不同化疗序列策略相关的治疗延迟和不良事件.
主要方法:
- 对128名接受KN522修改方案治疗的TNBC患者的回顾性分析.
- 基于ddAC与CbT给药序列的结果比较.
- 评估病理完整反应 (pCR) 率,治疗延迟和细胞衰竭的发生率.
主要成果:
- 观察到的总体pCR率为56%.
- 在ddAC-first (55%) 和CbT-first (58%) 测序 (p=0.77) 之间没有发现pCR率的显著差异.
- ddAC-first序列与整体治疗延迟率 (70%与51%,p=0.03) 和细胞衰竭率 (59%与31%,p=0.001) 的显着较高相关.
结论:
- 将ddAC纳入TNBC的KN522疗法是安全的,可以容忍的和有效的.
- 化疗序列 (ddAC与CbT首先) 不会改变pCR的疗效.
- 从ddAC开始导致治疗延迟和细胞衰竭的增加,这表明需要仔细监测患者.
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