Taxane/anthracycline combinations reduced incidence of breast cancer recurrence in young women across molecular subtypes: a real-world evidence of Taiwan from 2011 to 2019.

IF 3 3区 医学 Q2 ONCOLOGY
Yu-Ning Chien, Li-Yin Lin, Yi-Chun Lin, Yi-Chen Hsieh, Shih-Hsin Tu, Hung-Yi Chiou
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Abstract

Purpose: Adolescent and young adult (AYA) patients with breast cancer generally have poor prognoses and a higher risk of secondary cancers compared to those at the same cancer stage. Notably, AYA patients in Asia exhibit a higher incidence rate of breast cancer, with Luminal A as the predominant molecular subtype, which contrasts with the trends observed in Western countries. This study aims to compare the efficacy of Taxane/Anthracycline combination-based regimens (TACB) versus Anthracycline-based regimens (AB) in AYA patients with stage I-II breast cancer, focusing on different molecular subtypes.

Methods: This study utilized data from the Taiwan National Health Insurance Research Database (NHIRD) and the Taiwan Cancer Registry (TCR) from 2011 to 2019. The study cohort included patients aged 15 to 39 years who were diagnosed with stage I-II breast cancer and received either TACB or AB regimens. Propensity score matching and Cox proportional hazards regression models were used to calculate the hazard ratios (HR) for recurrence.

Results: The results showed that TACB regimens significantly reduced the risk of recurrence compared to AB regimens across all patients (aHR 0.73, 95% CI 0.55-0.97). Specifically, for low/middle-recurrence risk groups, the aHR was 0.68 (95% CI 0.49-0.96), and for high-recurrence risk groups, it was 0.43 (95% CI 0.21-0.87). The analysis further indicated no significant differences in recurrence risk between AYA and non-AYA patients using TACB regimens.

Conclusion: The TACB regimens showed a more favorable prognosis than AB regimens across all molecular subtypes. Furthermore, TACB regimens not only outperformed AB treatments but also closed the gap in prognostic outcomes between AYA and non-AYA patients. We believe the findings of this study are highly reliable and can provide valuable guidance for physicians in choosing the most appropriate treatment strategies for AYA patients with stage I-II breast cancer.

紫杉类/蒽环类复方制剂降低了不同分子亚型年轻女性的乳腺癌复发率:2011年至2019年台湾地区的真实世界证据。
目的:与处于同一癌症阶段的患者相比,青少年乳腺癌患者的预后一般较差,且继发癌症的风险较高。值得注意的是,亚洲的青少年和青年乳腺癌患者发病率较高,主要分子亚型为Luminal A,这与西方国家观察到的趋势形成鲜明对比。本研究旨在比较以紫杉类/金霉素联合疗法(TACB)为基础的治疗方案与以蒽环类药物为基础的治疗方案(AB)对 I-II 期乳腺癌亚亚裔患者的疗效,重点关注不同的分子亚型:本研究利用了台湾国民健康保险研究数据库(NHIRD)和台湾癌症登记中心(TCR)2011 年至 2019 年的数据。研究队列包括 15 至 39 岁确诊为 I-II 期乳腺癌并接受 TACB 或 AB 方案治疗的患者。研究采用倾向评分匹配和考克斯比例危险回归模型计算复发危险比(HR):结果表明,与 AB 方案相比,TACB 方案能显著降低所有患者的复发风险(aHR 0.73,95% CI 0.55-0.97)。具体而言,低/中复发风险组的 aHR 为 0.68(95% CI 0.49-0.96),高复发风险组为 0.43(95% CI 0.21-0.87)。分析进一步表明,使用TACB疗法的AYA和非AYA患者的复发风险没有明显差异:结论:在所有分子亚型中,TACB 方案的预后均优于 AB 方案。此外,TACB疗法不仅优于AB疗法,还缩小了AYA和非AYA患者在预后结果上的差距。我们相信这项研究的结果非常可靠,能为医生选择最适合 I-II 期乳腺癌 AYA 患者的治疗策略提供有价值的指导。
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
CiteScore
6.80
自引率
2.60%
发文量
342
审稿时长
1 months
期刊介绍: Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
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