Comparison of T-DM1 and trastuzumab-pertuzumab in HER2-positive breast cancer patients with residual disease after neoadjuvant therapy: a retrospective study.

IF 2.5 3区 医学 Q3 ONCOLOGY
Junxiao Wang, Yushuai Yu, Qisheng Lin, Xin Wang
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Abstract

Background: For HER2-positive early-stage breast cancer patients who have received neoadjuvant chemotherapy with trastuzumab and pertuzumab (HP), it remains unclear whether to intensify treatment with T-DM1 or to continue with HP therapy in the presence of residual disease identified in postoperative pathology.

Methods: This retrospective study included patients at two cancer centers in China from January 2020 to August 2022. Patients were subsequently treated with either continued HP or intensified therapy with T-DM1 for one year. A multivariable Cox proportional hazards regression model was used to identify factors influencing patient outcomes. Propensity score matching(PSM) was employed to mitigate the impact of confounding variables, and disease-free survival(DFS) between the T-DM1 and HP groups was compared.

Results: Before PSM, 114 patients were included, with 24 in the T-DM1 group and 90 in the HP group. Multivariate analysis revealed that patients in ypStage I/II had a higher DFS than those in ypStage III. In the T-DM1 group, 14 patients (58.3%) experienced thrombocytopenia, with 12 affected during cycles 2 to 4. After PSM, no statistically significant difference in DFS between the two groups (P = 0.48). The 1, 2, and 3-year DFS rates for the T-DM1 group were 94.7%, 94.7%, and 94.7%, respectively, while for the HP group, they were 100%,100%, and 89.5%.

Conclusions: In patients with HER2-positive early breast cancer who have residual disease after receiving neoadjuvant treatment with HP, the continued administration of HP can achieve therapeutic effects comparable to those of T-DM1, without significant complications.

T-DM1和曲妥珠单抗-帕妥珠单抗在her2阳性乳腺癌患者新辅助治疗后残留病变中的比较:一项回顾性研究
背景:对于接受曲妥珠单抗和帕妥珠单抗(HP)新辅助化疗的her2阳性早期乳腺癌患者,在术后病理发现残留病变的情况下,是否应加强T-DM1治疗或继续HP治疗尚不清楚。方法:这项回顾性研究纳入了2020年1月至2022年8月在中国两个癌症中心的患者。患者随后接受持续HP或强化T-DM1治疗一年。采用多变量Cox比例风险回归模型确定影响患者预后的因素。采用倾向评分匹配(PSM)来减轻混杂变量的影响,并比较T-DM1组和HP组之间的无病生存(DFS)。结果:PSM前纳入114例患者,其中T-DM1组24例,HP组90例。多变量分析显示,ypi /II期患者的DFS高于ypiii期患者。在T-DM1组中,14例患者(58.3%)出现血小板减少,其中12例发生在第2至4周期。经PSM治疗后,两组患者的DFS差异无统计学意义(P = 0.48)。T-DM1组1年、2年和3年的DFS分别为94.7%、94.7%和94.7%,而HP组分别为100%、100%和89.5%。结论:在接受HP新辅助治疗后残留病变的her2阳性早期乳腺癌患者中,持续给予HP可达到与T-DM1相当的治疗效果,且无明显并发症。
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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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