通过新辅助疗法在早期三阴性乳腺癌中演变的治疗毒性和病理反应
概括
基于 pembrolizumab 的新辅助化学免疫疗法 (CIT) 增加了早期三阴性乳腺癌 (eTNBC) 患者的毒性和剂量降低. 然而,这种升级不会影响改善的病理完整响应 (pCR) 率.
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:
- 基于 pembrolizumab 的化疗免疫疗法 (CIT) 是高风险早期三阴性乳腺癌 (eTNBC) 的标准.
- 化疗 (CT) 疗法可以导致累积毒性.
- 关于CT实践演变及其对治疗完成和有效性的影响的现实数据有限.
研究的目的:
- 评估eTNBC中化疗 (CT) 实践的演变.
- 评估治疗修改对新辅助疗程完成和有效性的影响.
- 为了比较新辅助CT和CIT之间的毒性和病理完整响应 (pCR) 率.
主要方法:
- 在一个综合性癌症中心进行了一项宏观的观察性研究.
- 从电子健康记录中提取了2019年2月至2024年2月期间接受治疗的366名eTNBC患者的数据.
- 患者接受了新辅助CT (n=247) 或CIT (n=119).
主要成果:
- 与CT组 (58.6%) 相比,在CIT组 (78.2%) 中,3/4级毒性更为频繁.
- 在CIT组中,剂量减少率 (48.7%),治疗延迟率 (65.2%) 和永久停药率 (31.1%) 较高.
- 在CIT组 (68.4%) 和CT组 (51.9%) 中,pCR率显著高于pCR,没有观察到对pCR有毒性的影响.
结论:
- 在eTNBC中新辅助性CIT导致毒性增加和剂量修改.
- 尽管有较高的毒性,但与CT相比,CIT显著提高了pCR率.
- 用CIT治疗的升级不会对pCR率产生负面影响,即使剂量减少.
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