Tracking Utilization of Neoadjuvant Endocrine Therapy (NET) and Neoadjuvant Chemotherapy (NCT) for Hormone Receptor-Positive Breast Cancer (HR + BC) in the U.S.A. Over Time – A TriNetX Database Study

IF 2.7 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2026-07-01 Epub Date: 2026-06-19 DOI:10.1016/j.clbc.2026.05.008

Jubin K. Lim, Anna E. Gibson, Jian He, Alexis Antonucci, Harry D. Bear

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引用次数: 0

Abstract

Purpose

Hormone receptor-positive breast cancer (HR + BC) responds well to neoadjuvant endocrine therapy (NET), increasing chances for breast conserving surgery with less toxicity than neoadjuvant chemotherapy (NCT). A National Cancer Database study found that NET use increased by only 0.5% between 2004 and 2012. We investigated the utilization of NET, NCT, and no neoadjuvant therapy (no NT) from 2005 to 2023.

Methods

We queried the TriNetX database for patients with HR + BC (stages I-III, ER+, PR+, ERBB2-) who underwent mastectomies in the US and evaluated utilization of NET, NCT, or no NT. We trended each use by all ages, age ≤ 50 years, or ≥ 51 years across roughly 5-year increments. NET cases were less than 10 for 2005-2009, and rounding obscured the exact count, so this period was excluded from the trend analysis.

Results

The use of NET remained below 1%, while NCT utilization was approximately 11%, and breast conserving surgery was achieved more frequently with NET than NCT (p < .0001). Both therapy types were used more frequently with advanced cancer stage (p < .0001), and NCT use was higher than NET in both age groups (p < .0001). NET and NCT use did not show significant trends when all ages were combined (p = .39). However, age-stratified analyses revealed significant declines in NCT use within each age group, with similar NET patterns and increasing no NT (p < .0001), indicating that overall results may mask weighted subgroup trends.

Conclusions

This study highlights underutilization of NET, despite its low toxicity and efficacy in improving patient outcomes. Increased efforts are needed to address this gap and consider NET as an option for HR + BC.

查看原文本刊更多论文

美国激素受体阳性乳腺癌（HR + BC）的新辅助内分泌治疗（NET）和新辅助化疗（NCT）随时间的跟踪使用- TriNetX数据库研究

目的：激素受体阳性乳腺癌（HR + BC）对新辅助内分泌治疗（NET）反应良好，增加了保乳手术的机会，而且比新辅助化疗（NCT）的毒性更小。国家癌症数据库的一项研究发现，2004年至2012年间，使用。NET的人数只增加了0.5%。我们调查了2005年至2023年间NET、NCT和无新辅助治疗（no NT）的使用情况。方法：我们在TriNetX数据库中查询了在美国接受乳房切除术的HR + BC （I-III期，ER+期，PR+期，ERBB2-期）患者，并评估了NET、NCT或无NT的使用情况。我们对所有年龄段（年龄≤50岁或≥51岁）的每种使用趋势进行了大约5年的增量分析。2005-2009年净病例少于10例，四舍五入掩盖了确切的计数，因此这一时期被排除在趋势分析之外。结果：NET的使用率保持在1%以下，而NCT的使用率约为11%，NET比NCT更频繁地实现保乳手术（p < 0.0001）。两种治疗类型在晚期癌症患者中使用频率更高（p < 0.0001），两个年龄组中NCT的使用均高于NET （p < 0.0001）。当所有年龄段合并使用NET和NCT时，NET和NCT的使用没有显着趋势（p = 0.39）。然而，年龄分层分析显示，在每个年龄组中，NCT使用显著下降，NET模式相似，无NT增加（p < 0.0001），表明总体结果可能掩盖了加权亚组趋势。结论：本研究强调了NET的利用不足，尽管其毒性低且在改善患者预后方面有效。需要加大努力解决这一差距，并考虑将。NET作为HR + BC的一种选择。

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

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.