化疗时间对三阴性乳腺癌的影响:现实世界的证据研究
Noiver Graciano1, Lucelly López2, Carlos A Rodriguez3
1Gynecologic Oncology Unit, Instituto de Cancerología Las Américas-AUNA, Medellín, Colombia.
Breast cancer research and treatment
|May 21, 2025
概括
新辅助化疗 (NACT) 可能有益于三阴性乳腺癌 (TNBC) 患者,这些患者患有晚期疾病,并达到病理完整反应 (pCR). 这一发现影响了侵略性TNBC的治疗决策.
科学领域:
- 在瘤学瘤学.
- 乳腺癌研究研究 乳腺癌研究
- 化疗疗的有效性 化疗的有效性
背景情况:
- 三重阴性乳腺癌 (TNBC) 是具有不良预后的侵袭性.
- 在TNBC中,化疗新辅助剂 (NACT) 与辅助剂 (ACT) 的最佳时间仍然存在争议.
- 现实世界的数据对于理解非转移性TNBC治疗结果至关重要.
研究的目的:
- 根据化疗时间 (NACT与ACT) 来评估非转移性TNBC患者的现实结果.
- 评估化疗时间对整体生存 (OS) 和无事件生存 (EFS) 的影响.
- 为了确定可能从特定的化疗时间策略中获益最多的患者子组.
主要方法:
- 从2008-2023年对711名非转移性TNBC患者进行了回顾性研究.
- 倾向性得分 (PS) 匹配用于调整NACT和ACT组之间的基线不平衡.
- 考克斯回归模型用于分析整体生存率 (OS) 和无事件生存率 (EFS).
主要成果:
- 73.8%的患者接受了新辅助化疗 (NACT),病理完整反应 (pCR) 率为37.3%.
- 未经调整的分析显示,NACT与更差的OS相关;然而,多变量分析表明潜在的OS和EFS好处.
- 分层分析显示,在达到pCR的晚期患者中,NACT优于ACT (HR 0.22,p < 0.010).
结论:
- 化疗时间显著影响TNBC中的OS和EFS,受初始瘤阶段和pCR的影响.
- 在获得pCR的晚期TNBC患者中,NACT比ACT更有好处.
- 这些发现支持NACT在预后分层和指导TNBC治疗决策中的作用.
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