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新辅助药与辅助化疗在节点阴性,T1三阴性乳腺癌中的使用和益处

Jesus D Anampa¹, Alvaro Alvarez Soto², Shuwen Lin¹

¹Department of Medical Oncology, Montefiore Medical Center, Bronx, NY.

Clinical breast cancer

|June 14, 2025

概括

与辅助化疗 (ACT) 相比,新辅助化疗 (NACT) 对T1b/T1c节点阴性三阴性乳腺癌 (TNBC) 的生存率没有差异. 然而,T1a节点阴性TNBC患者在NACT治疗中表现更差.

科学领域:

在瘤学瘤学.
乳腺癌研究研究乳腺癌研究
临床试验临床试验

背景情况:

三阴性乳腺癌 (TNBC) 缺乏向疗法,因此化疗至关重要.
新辅助化疗 (NACT) 越来越多地使用,但其对早期结节阴性TNBC (T1N0) 的益处尚未明确.
了解小瘤治疗疗效对于个性化医学至关重要.

研究的目的:

评估T1N0 TNBC患者接受NACT与辅助化疗 (ACT) 的病理反应和生存结果.
在早期TNBC中比较NACT和ACT队列之间的整体存活率 (OS) 和乳腺癌特异性存活率 (BCSS).
研究瘤大小 (T1a,T1b,T1c) 对治疗结果的影响.

主要方法:

使用监测,流行病学和最终结果 (SEER) 数据库 (2010-2020) 的回顾性队列研究.
考克斯回归模型分析了NACT和ACT组之间的OS差异.
累积发病率函数和危险模型评估了BCSS,比较了NACT和ACT.

主要成果:

在T1b/T1c节点阴性TNBC患者中没有观察到BCSS或OS的显著差异,这些患者接受了NACT与ACT治疗.
与ACT相比,患有T1a节点阴性TNBC的患者在NACT下经历了更糟糕的BCSS和OS,与ACT相比.
病理完整反应 (pCR) 与改善的生存率相关 (OS HR 0.28,BCSS HR 0.21),T1a瘤中的pCR率较低 (18%) 与T1c瘤中的pCR率较低 (47%).

结论:

辅助化疗 (ACT) 和新辅助化疗 (NACT) 对T1b和T1c节点阴性TNBC提供了可比的生存益处.
在T1a节点阴性TNBC中观察到NACT的劣质结局值得进一步调查.
瘤大小是影响NACT在早期TNBC有效性的关键因素.

关键词:

考克斯模型考克斯模型新辅助化学疗法新辅助化学疗法总体生存率总体生存率倾向性得分的得分是多少?塞尔·塞尔 (Seer) 是一个看得见的人.

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