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基于HR+/HER2-乳腺癌-FINEST研究中的化疗敏感性的前性II期新辅助药研究

Li Chen^1,2, Wen-Ya Wu^1,2, Fei Liang^3,4

¹Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Centre, Shanghai, P. R. China.

Cancer communications (London, England)

|January 4, 2025

概括

这项研究探讨了激素受体阳性 (HR +) / HER2-乳腺癌的新辅助治疗. 内分泌免疫疗法改善了化学不敏感患者的反应率,这表明了亚型特定的治疗策略.

科学领域:

在瘤学瘤学.
翻译研究是翻译研究.
基因组学就是基因组学.

背景情况:

激素受体阳性 (HR+) /人表皮生长因子受体2-阴性 (HER2-) 乳腺癌是最常见的类型,其特点是预后变化和复发风险高.
建议在HR+/HER2-乳腺癌中期至高风险患者进行新辅助疗法.
这项研究研究了HR+/HER2-乳腺癌的新新辅助治疗策略.

研究的目的:

探索HR+/HER2-乳腺癌的有效新辅助治疗策略.
评估不同新辅助治疗方案的疗效,包括化疗和内分泌免疫疗法.
通过下一代测序和数字病理学来确定治疗反应的预测生物标志物.

主要方法:

一项II阶段,单臂,前性研究招募了121名HR+/HER2-乳腺癌患者.
患者接受了初始的新辅助化疗,其中包括纳布-帕克利塔塞尔和卡博普拉丁 (nabPCb).
化学不敏感的患者被随机分配到化疗,内分泌免疫疗法 (dalpiciclib,letrozole,adebrelimab) 或手术. 瘤反应通过MRI进行评估,并使用NGS和SNF识别了分子亚型.

主要成果:

总体病理完整响应 (pCR) 率为4.1%,在继续服用nabPCb.患者中观察到的所有pCR.
与化疗相比,对化疗不敏感患者的内分泌免疫疗法改善了客观响应率 (ORR) (81.5%与66.7%相比).
探索性分析确定了SNF4亚型对nabPCb (21.1%pCR) 化学敏感,SNF2亚型对内分泌免疫疗法敏感 (45.5%响应).

结论:

在化学不敏感的HR+/HER2-乳腺癌患者中,转换为基于内分泌免疫的疗法增强了ORR,但不是pCR.
新辅助化疗和内分泌疗法并不相互排斥,可以整合到治疗策略中.
特定的分子亚型 (SNF4和SNF2) 对化学疗法和免疫疗法分别表现出不同的敏感性,指导个性化治疗方法.

关键词:

在HER2中,HER2是HER2.人力资源,人力资源,人力资源.这是SNF亚型.乳腺癌乳腺癌乳腺癌新辅助疗法是一种新辅助疗法.精密处理精密处理

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