A multicenter study on efficacy of dual-target neoadjuvant therapy for HER2-positive breast cancer and a consistent analysis of efficacy evaluation of neoadjuvant therapy by Miller-Payne and RCB pathological evaluation systems (CSBrS-026).

IF 7 2区医学 Q1 ONCOLOGY

Chinese Journal of Cancer Research Pub Date : 2023-12-30 DOI:10.21147/j.issn.1000-9604.2023.06.13

Hongyu Xiang, Ling Xin, Jingming Ye, Ling Xu, Hong Zhang, Shuang Zhang, Yinhua Liu

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引用次数: 0

Abstract

Objective: The aim of this study was to investigate the factors influencing pathological complete response (pCR) rate in early breast cancer patients receiving neoadjuvant dual-target [trastuzumab (H) + pertuzumab (P)] therapy combined with chemotherapy. Additionally, the consistency of the Miller-Payne and residual cancer burden (RCB) systems in evaluating the efficacy of neoadjuvant therapy for early human epidermal growth factor receptor-2 (HER2)+ breast cancer was analyzed.

Methods: The clinicopathological data of female patients with early-stage HER2+ breast cancer who received dual-target neoadjuvant therapy at 26 hospitals of the Chinese Society of Breast Surgery (CSBrS) from March 2019 to December 2021 were collected. Patients were allocated to four groups: the HER2 immunohistochemistry (IHC) 3+/hormone receptor (HR)-, IHC3+/HR+, IHC2+ in situ hybridization (ISH)+/HR- and IHC2+ ISH+/HR+ groups. The overall pCR rate for patients, the pCR rate in each group and the factors affecting the pCR rate were analyzed. The consistency between the Miller-Payne and RCB systems in assessing the efficacy of neoadjuvant therapy was analyzed.

Results: From March 1, 2019, to December 31, 2021, 77,376 female patients with early-stage breast cancer were treated at 26 hospitals; 18,853 (24.4%) of these patients were HER2+. After exclusion of unqualified patients, 2,395 patients who received neoadjuvant dual-target (H+P) therapy combined with chemotherapy were included in this study. The overall pCR rate was 53.0%, and the patients' HR statuses and different HER2+ statuses were significantly correlated with the pCR rate (P<0.05). The consistency of the pathological efficacy assessed by the Miller-Payne and RCB systems was 88.0% (κ=0.717, P<0.001).

Conclusions: Different HER2 expression statuses and HR expression statuses are correlated with the pCR rate after dual-target neoadjuvant therapy in HER2+ breast cancer patients. There is a relatively good consistency between Miller-Payne and RCB systems in evaluating the pathologic efficacy of neoadjuvant therapy for HER2+ breast cancer.

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一项关于 HER2 阳性乳腺癌双靶点新辅助疗法疗效的多中心研究，以及米勒-佩恩和 RCB 病理评估系统对新辅助疗法疗效评估的一致性分析（CSBrS-026）。

研究目的本研究旨在探讨影响接受新辅助双靶点[曲妥珠单抗（H）+百妥珠单抗（P）]疗法联合化疗的早期乳腺癌患者病理完全应答率（pCR）的因素。此外，还分析了米勒-佩恩（Miller-Payne）系统和残留癌负担（RCB）系统在评估早期人表皮生长因子受体-2（HER2）+乳腺癌新辅助治疗疗效方面的一致性：收集2019年3月至2021年12月在中华医学会乳腺外科学分会（CSBrS）26家医院接受双靶点新辅助治疗的早期HER2+乳腺癌女性患者的临床病理资料。患者被分为四组：HER2免疫组化（IHC）3+/激素受体（HR）-组、IHC3+/HR+组、IHC2+原位杂交（ISH）+/HR-组和IHC2+ ISH+/HR+组。分析了患者的总体 pCR 率、各组的 pCR 率以及影响 pCR 率的因素。分析了米勒-佩恩系统和RCB系统在评估新辅助治疗疗效方面的一致性：从2019年3月1日至2021年12月31日，26家医院共治疗了77376名早期乳腺癌女性患者，其中18853名（24.4%）患者为HER2+。在排除不合格患者后，本研究纳入了 2395 名接受新辅助双靶点（H+P）疗法联合化疗的患者。总的 pCR 率为 53.0%，患者的 HR 状态和不同的 HER2+ 状态与 pCR 率显著相关（P0.05）。Miller-Payne和RCB系统评估的病理疗效一致性为88.0%（κ=0.717，P0.001）：不同的HER2表达状态和HR表达状态与HER2+乳腺癌患者接受双靶点新辅助治疗后的pCR率相关。在评估HER2+乳腺癌新辅助治疗的病理学疗效方面，Miller-Payne和RCB系统具有较好的一致性。

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来源期刊

Chinese Journal of Cancer Research 医学-肿瘤学

自引率

9.80%

发文量

1726

审稿时长

4.5 months

期刊介绍： Chinese Journal of Cancer Research (CJCR; Print ISSN: 1000-9604; Online ISSN:1993-0631) is published by AME Publishing Company in association with Chinese Anti-Cancer Association.It was launched in March 1995 as a quarterly publication and is now published bi-monthly since February 2013. CJCR is published bi-monthly in English, and is an international journal devoted to the life sciences and medical sciences. It publishes peer-reviewed original articles of basic investigations and clinical observations, reviews and brief communications providing a forum for the recent experimental and clinical advances in cancer research. This journal is indexed in Science Citation Index Expanded (SCIE), PubMed/PubMed Central (PMC), Scopus, SciSearch, Chemistry Abstracts (CA), the Excerpta Medica/EMBASE, Chinainfo, CNKI, CSCI, etc.