Dose dense doxorubicin plus cyclophosphamide in a modified KEYNOTE522 regimen for triple negative breast cancer.

IF 6.5 2区医学 Q1 ONCOLOGY

NPJ Breast Cancer Pub Date : 2024-06-04 DOI:10.1038/s41523-024-00643-5

Nicholas Mai, Sara Myers, Sherry Shen, Stephanie Downs-Canner, Mark Robson, Larry Norton, Yuan Chen, Tiffany Traina, Nour Abuhadra

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Abstract

The KEYNOTE-522 (KN522) regimen for neoadjuvant treatment of triple negative breast cancer (TNBC) utilized q3week dosing for doxorubicin plus cyclophosphamide (AC); however, dose-dense AC (ddAC) has demonstrated superior overall survival (OS) compared to q3week AC in anthracycline and taxane-based regimens. We performed a retrospective analysis assessing the use of ddAC in KN522 and the impact of sequencing ddAC before or after carboplatin/paclitaxel (CbT) plus pembrolizumab on multiple outcomes. 128 patients with TNBC were included. Overall pathologic complete response (pCR) rate of 56%. Sequencing of ddAC vs CbT first showed no difference in pCR rate (ddAC 55% vs. CbT 58%, p = 0.77). However, ddAC first compared to CbT first correlated with a significant increase in the incidence of overall treatment delays (ddAC 70% vs. CbT 51%, p = 0.03), with cytopenias most frequent (ddAC 59% vs. CbT 31%, p = 0.001). ddAC in a modified KN522 regimen is safe, tolerable, and effective. Efficacy is comparable regardless of chemotherapy sequencing, but ddAC first is significantly associated with higher rates of treatment delays and cytopenias.

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在治疗三阴性乳腺癌的 KEYNOTE522 改良方案中采用剂量密集的多柔比星加环磷酰胺。

用于三阴性乳腺癌（TNBC）新辅助治疗的KEYNOTE-522（KN522）方案采用了多柔比星加环磷酰胺（AC）的q3周剂量；然而，在基于蒽环类和类固醇的方案中，与q3周剂量的AC相比，剂量密集型AC（ddAC）的总生存期（OS）更优。我们进行了一项回顾性分析，评估在 KN522 中使用 ddAC 的情况，以及在卡铂/紫杉醇（CbT）加培莫单抗之前或之后排序 ddAC 对多种结果的影响。共纳入了 128 例 TNBC 患者。总体病理完全应答率（pCR）为 56%。ddAC 与先用 CbT 相比，pCR 率没有差异（ddAC 55% 与 CbT 58%，p = 0.77）。然而，先进行 ddAC 与先进行 CbT 相比，总体治疗延误的发生率显著增加（ddAC 70% vs. CbT 51%，p = 0.03），其中细胞减少最为常见（ddAC 59% vs. CbT 31%，p = 0.001）。无论化疗顺序如何，疗效都相当，但首先使用ddAC与较高的治疗延迟率和细胞减少率明显相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.