Neoadjuvant response stratification based on complete, partial, and no response in HR-positive/HER2-positive breast cancer.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2025-11-01 Epub Date: 2025-08-28 DOI:10.1007/s10549-025-07812-5

Ahmet Necati Sanli, Bilal Turan, Deniz Esin Tekcan Sanli, Isa Karaca, M Kadri Altundag, Fatih Aydogan

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引用次数: 0

Abstract

Background: This study aimed to evaluate the prognostic relevance of stratified pathological response -complete response (CR), partial response (PR), and no response (NR)- to neoadjuvant chemotherapy (NAC) in patients with hormone receptor-positive and HER2-positive (HR + /HER2 +) breast cancer.

Methods: A total of 8277 HR + /HER2 + breast cancer patients treated with NAC between 2010 and 2021 were retrospectively identified from the SEER database. Patients were categorized into CR, PR, and NR groups. Overall survival (OS) and disease-specific survival (DSS) were analyzed using Kaplan-Meier and Cox regression models.

Results: CR, PR, and NR rates were 52.3%, 41.4%, and 6.2%, respectively. Five-year OS rates were 96.3% (CR), 91.1% (PR), and 79.3% (NR), while 10-year DSS rates were 94.0% (CR), 83.4% (PR), and 76.2% (NR) (p < 0.001). In multivariate analysis, PR and NR were associated with significantly increased mortality risk compared to CR (OS HR: 2.16 and 4.20; DSS HR: 2.95 and 5.46; all p < 0.001). Progesterone receptor (PrgR) negativity independently predicted worse OS and DSS, whereas ER status had no significant impact. Additional adverse prognostic factors included advanced age, nodal metastasis, rural residence, and mastectomy. Radiotherapy did not retain significance in multivariate models.

Conclusion: Pathological response to NAC is a strong independent prognostic marker in HR + /HER2 + breast cancer. Partial responders represent a clinically distinct group with intermediate outcomes, highlighting the need for response-adapted therapeutic strategies beyond conventional staging systems.

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基于hr阳性/ her2阳性乳腺癌完全、部分和无反应的新辅助反应分层

背景：本研究旨在评估激素受体阳性和HER2阳性（HR + /HER2 +）乳腺癌患者对新辅助化疗（NAC）的分层病理反应-完全反应（CR），部分反应（PR）和无反应（NR）的预后相关性。方法：从SEER数据库中回顾性筛选2010年至2021年间接受NAC治疗的8277例HR + /HER2 +乳腺癌患者。患者分为CR组、PR组和NR组。采用Kaplan-Meier和Cox回归模型分析总生存期（OS）和疾病特异性生存期（DSS）。结果：CR、PR、NR分别为52.3%、41.4%、6.2%。5年OS率分别为96.3% （CR）、91.1% （PR）和79.3% (NR)， 10年DSS率分别为94.0% （CR）、83.4% （PR）和76.2% （NR）。(p)结论：NAC的病理反应是HR + /HER2 +乳腺癌的一个强有力的独立预后指标。部分应答者代表了具有中间结果的临床独特组，强调了在传统分期系统之外需要适应应答的治疗策略。

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

Breast Cancer Research and Treatment 医学-肿瘤学

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.