在双重点新辅助治疗后,HER2(2+) /FISH阳性和HER2(3+) 乳腺癌患者之间的治疗反应和生存率的差异:一项匹配的病例对照研究
Sicheng Zhou1, Xuhui Qin2, Wei Xing3
1Department of Thyroid and Breast Surgery, Peking University First Hospital, Beijing, China.
Frontiers in oncology
|April 21, 2025
概括
患有HER2(3+) 乳腺癌 (BC) 的患者对双重向的新辅助疗法 (NAT) 呈现出比HER2(2+) /FISH阳性BC更好的反应. 在HER2阳性BC患者中,HER2表达水平会影响治疗疗效和预后.
科学领域:
- 在瘤学瘤学.
- 医学研究 医学研究
- 临床试验 临床试验
背景情况:
- 双重向的新辅助疗法 (NAT) 对人类表皮生长因子受体2 (HER2) 阳性乳腺癌 (BC) 有效.
- 在基于TCbHP的双点NAT后,在HER2 (((3+) 和HER2 (((2+) /光局部杂交 (FISH) 阳性BC之间存在响应和预后的差异.
研究的目的:
- 为了比较治疗反应和预后在HER2 (((3+) 与HER2 (((2+) /FISH阳性乳腺癌患者接受双重点NAT.
- 确定影响HER2-阳性BC.病理完整反应 (pCR) 和侵入性无病生存 (IDFS) 的因素.
主要方法:
- 对接受NAT和手术的HER2阳性侵入性BC患者的回顾性分析 (2019年1月 - 2022年12月).
- 倾向性得分匹配 (PSM) 适用于308名患者,导致132对匹配对 (66对).
- 评估病理完整反应 (pCR) 和无侵袭性疾病生存率 (IDFS).
主要成果:
- 在HER2(3+) 组中,pCR率明显高于HER2(2+) /FISH阳性组 (P<0.001).
- 瘤等级,激素受体 (HR) 状态和HER2状态显著影响了pCR.
- 3年IDFS率在HER2 (((3+) BC患者中更好,尽管在统计学上不显著 (P=0.083). 阳性淋巴结,HER2(3+) 和pCR是IDFS的独立预后因素.
结论:
- 在双目标NAT治疗后,HER2(2+) /FISH阳性BC患者的治疗反应和预后与HER2(3+) 患者相比较差.
- HER2表达水平是治疗疗效和患者预后的关键决定因素, HER2阳性乳腺癌患者接受基于TCbHP的双NAT治疗.
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