新辅助系统疗法能否为 HER2+ 乳腺癌 T1 期患者带来额外益处:基于不同高风险特征的亚组分析

Lidan Chang, Dandan Liu, Xuyan Zhao, Luyao Dai, Xueting Ren, Qian Hao, Peinan Liu, Hao Wu, Xiaobin Ma, Huafeng Kang
{"title":"新辅助系统疗法能否为 HER2+ 乳腺癌 T1 期患者带来额外益处:基于不同高风险特征的亚组分析","authors":"Lidan Chang, Dandan Liu, Xuyan Zhao, Luyao Dai, Xueting Ren, Qian Hao, Peinan Liu, Hao Wu, Xiaobin Ma, Huafeng Kang","doi":"10.1007/s12094-024-03472-x","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Neoadjuvant systemic therapy (NAST) is vital in the management of HER2-positive (HER2+) breast cancer. Nevertheless, the indications for NAST in tumors &lt;2 cm remain controversial.</p><h3 data-test=\"abstract-sub-heading\">Method</h3><p>A total of 7961 patients were screened from the Surveillance, Epidemiology, and End Result database. Independent prognostic factors were identified using multivariate Cox analysis. Subgroup analyses and Kaplan–Meier analyses were used to simulate whether NAST would provide a survival benefit with different high-risk characteristics. Nomograms were constructed, and an internal validation cohort was employed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Of the 7961 included patients, 1137 (14.3%) underwent NAST. In the total population, NAST was associated with poorer overall survival (OS) and breast cancer-specific survival (BCSS) (OS: <i>P</i> = 0.00093; BCSS: <i>P </i> &lt; 0.0001). Multivariate Cox analysis confirmed that NAST markedly affected the prognosis of enrolled patients. Besides, a direct association between T, N, age, subtype, and prognosis was observed. Subgroup analyses yielded in these three subgroups, T1c, hormone receptor-negative, and 61–69 years of age, NAST and AST had comparable OS, while NAST possessed worse BCSS. Notably, even in the N3, we still did not observe any additional benefit of NAST. The calculated C-index of 0.72 and 0.73 confirmed the predictability of the nomograms. The AUCs exhibit consistency in the training and validation cohorts.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Our findings suggest that NAST does not provide additional benefit to patients with T1 HER2+ breast cancer, even in the presence of lymph node metastasis, T1c, or hormone receptor negativity. This study facilitates the implementation of individualized management strategies.</p>","PeriodicalId":10166,"journal":{"name":"Clinical and Translational Oncology","volume":"6 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Can neoadjuvant systemic therapy provide additional benefits for T1 HER2+ breast cancer patients: a subgroup analysis based on different high-risk signatures\",\"authors\":\"Lidan Chang, Dandan Liu, Xuyan Zhao, Luyao Dai, Xueting Ren, Qian Hao, Peinan Liu, Hao Wu, Xiaobin Ma, Huafeng Kang\",\"doi\":\"10.1007/s12094-024-03472-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Introduction</h3><p>Neoadjuvant systemic therapy (NAST) is vital in the management of HER2-positive (HER2+) breast cancer. Nevertheless, the indications for NAST in tumors &lt;2 cm remain controversial.</p><h3 data-test=\\\"abstract-sub-heading\\\">Method</h3><p>A total of 7961 patients were screened from the Surveillance, Epidemiology, and End Result database. Independent prognostic factors were identified using multivariate Cox analysis. Subgroup analyses and Kaplan–Meier analyses were used to simulate whether NAST would provide a survival benefit with different high-risk characteristics. Nomograms were constructed, and an internal validation cohort was employed.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Of the 7961 included patients, 1137 (14.3%) underwent NAST. In the total population, NAST was associated with poorer overall survival (OS) and breast cancer-specific survival (BCSS) (OS: <i>P</i> = 0.00093; BCSS: <i>P </i> &lt; 0.0001). Multivariate Cox analysis confirmed that NAST markedly affected the prognosis of enrolled patients. Besides, a direct association between T, N, age, subtype, and prognosis was observed. Subgroup analyses yielded in these three subgroups, T1c, hormone receptor-negative, and 61–69 years of age, NAST and AST had comparable OS, while NAST possessed worse BCSS. Notably, even in the N3, we still did not observe any additional benefit of NAST. The calculated C-index of 0.72 and 0.73 confirmed the predictability of the nomograms. The AUCs exhibit consistency in the training and validation cohorts.</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>Our findings suggest that NAST does not provide additional benefit to patients with T1 HER2+ breast cancer, even in the presence of lymph node metastasis, T1c, or hormone receptor negativity. This study facilitates the implementation of individualized management strategies.</p>\",\"PeriodicalId\":10166,\"journal\":{\"name\":\"Clinical and Translational Oncology\",\"volume\":\"6 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Translational Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12094-024-03472-x\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Translational Oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12094-024-03472-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

导言新辅助系统疗法(NAST)在HER2阳性(HER2+)乳腺癌的治疗中至关重要。方法从监测、流行病学和最终结果数据库中筛选出 7961 例患者。采用多变量 Cox 分析确定了独立的预后因素。使用亚组分析和卡普兰-梅耶分析来模拟不同高危特征的 NAST 是否会带来生存获益。结果 在纳入的 7961 例患者中,有 1137 例(14.3%)接受了 NAST。在所有患者中,NAST与较差的总生存期(OS)和乳腺癌特异性生存期(BCSS)相关(OS:P = 0.00093;BCSS:P < 0.0001)。多变量 Cox 分析证实,NAST 会明显影响入组患者的预后。此外,还观察到 T、N、年龄、亚型与预后之间存在直接关联。亚组分析显示,在T1c、激素受体阴性和61-69岁这三个亚组中,NAST和AST的OS相当,而NAST的BCSS较差。值得注意的是,即使在 N3 组中,我们仍然没有观察到 NAST 有任何额外的益处。计算得出的 C 指数分别为 0.72 和 0.73,证实了提名图的可预测性。结论我们的研究结果表明,即使存在淋巴结转移、T1c 或激素受体阴性,NAST 也不会给 T1 HER2+ 乳腺癌患者带来额外的益处。这项研究有助于实施个体化管理策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Can neoadjuvant systemic therapy provide additional benefits for T1 HER2+ breast cancer patients: a subgroup analysis based on different high-risk signatures

Can neoadjuvant systemic therapy provide additional benefits for T1 HER2+ breast cancer patients: a subgroup analysis based on different high-risk signatures

Introduction

Neoadjuvant systemic therapy (NAST) is vital in the management of HER2-positive (HER2+) breast cancer. Nevertheless, the indications for NAST in tumors <2 cm remain controversial.

Method

A total of 7961 patients were screened from the Surveillance, Epidemiology, and End Result database. Independent prognostic factors were identified using multivariate Cox analysis. Subgroup analyses and Kaplan–Meier analyses were used to simulate whether NAST would provide a survival benefit with different high-risk characteristics. Nomograms were constructed, and an internal validation cohort was employed.

Results

Of the 7961 included patients, 1137 (14.3%) underwent NAST. In the total population, NAST was associated with poorer overall survival (OS) and breast cancer-specific survival (BCSS) (OS: P = 0.00093; BCSS:  < 0.0001). Multivariate Cox analysis confirmed that NAST markedly affected the prognosis of enrolled patients. Besides, a direct association between T, N, age, subtype, and prognosis was observed. Subgroup analyses yielded in these three subgroups, T1c, hormone receptor-negative, and 61–69 years of age, NAST and AST had comparable OS, while NAST possessed worse BCSS. Notably, even in the N3, we still did not observe any additional benefit of NAST. The calculated C-index of 0.72 and 0.73 confirmed the predictability of the nomograms. The AUCs exhibit consistency in the training and validation cohorts.

Conclusion

Our findings suggest that NAST does not provide additional benefit to patients with T1 HER2+ breast cancer, even in the presence of lymph node metastasis, T1c, or hormone receptor negativity. This study facilitates the implementation of individualized management strategies.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信