对早期乳腺癌的新辅助"降级"治疗进行查和探索
Nana Zhang1, Ming Shan1, Zhenfeng Huang1
1Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
Frontiers in pharmacology
|April 9, 2025
概括
在短期新辅助化疗后达到病理完整反应 (pCR) 表明乳腺癌早期的预后良好. 这表明,在精选患者中,化疗可能会降低化疗升级的可能性.
科学领域:
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
- 临床治疗学 临床治疗学
背景情况:
- 新辅助化疗改善了高风险乳腺癌患者的预后.
- 病理完整反应 (pCR) 作为替代终点在敏感患者中缓解治疗的实用性需要进一步研究.
研究的目的:
- 评估可操作的临床II-IIIA阶段乳腺癌患者的长期结果,这些患者在接受新辅助化疗后迅速实现了pCR.
- 确定pCR是否可以指导乳腺癌治疗中的降级策略.
主要方法:
- 在2012-2022年期间治疗的143名乳腺癌患者 (临床阶段II-IIIA) 的回顾性分析.
- 患者在接受新辅助化疗后16周内实现了pCR.
- 使用卡普兰-梅尔和考克斯回归分析评估的预后.
主要成果:
- 在pCR患者中观察到高4年无病生存率 (95.3%) 和整体生存率 (96.9%).
- 在辅助化学疗法和没有辅助化学疗法组之间的4年DFS显著差异 (76.4%对95.2%,P <0.05).
- 在HER2+和TNBC亚型中,有针对性的治疗或以为基础的药物没有显著的预后影响.
结论:
- 在短时间的新辅助化疗后获得pCR的早期乳腺癌患者表现出良好的结果.
- 这些发现支持选择患者的化学疗法降级的可能性,与新辅助药量身定制治疗原则保持一致.
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