CBCSG010临床试验生物标志物分析中的早期三阴性乳腺癌升级辅助疗法定制研究

IF 14.8 2区 医学 Q1 ONCOLOGY
Wenya Wu, Yunsong Yang, Wentao Yang, Da Pang, Yunjiang Liu, Yuan Sheng, Xinzheng Li, Shiyou Yu, Yali Cao, Guoqin Jiang, Feng Jin, Binlin Ma, Junjie Li, Zhiming Shao
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引用次数: 0

摘要

背景:三阴性乳腺癌(TNBC)是一种高度异质性疾病:三阴性乳腺癌(TNBC)是一种高度异质性疾病。CBCSG010试验是一项前瞻性多中心III期临床试验,证实了在TNBC患者中添加卡培他滨辅助治疗可显著提高5.9%的5年无病生存率(DFS)。在这项研究中,我们试图确定从辅助治疗中获益的特定人群:在这项回顾性探索分析中,我们对 CBCSG010 临床试验中 TNBC 患者的肿瘤组织进行了 RNA 测序。我们采用单样本基因组富集分析算法和生存分析来描述TNBC微环境的内在分子特征,并评估免疫相关基因表达水平或免疫细胞数量与卡培他滨疗效之间的关联。此外,我们还对福尔马林固定、石蜡包埋的标本进行了PD-L1和CD8两种标记物的免疫组化染色以及基质肿瘤浸润淋巴细胞(sTILs)的苏木精-伊红染色,以验证生物信息学分析的结果:结果:我们发现,接受卡培他滨治疗的TNBC患者免疫浸润较高,预后较好。我们用PD-L1联合阳性评分(CPS)≥25分、sTIL阳性细胞≥10%和CD8阳性细胞≥10%作为界定 "免疫热 "患者的临界值。Kaplan-Meier曲线显示,在免疫热患者中,卡培他滨组和对照组的5年DFS率分别为96.9%和79.4%(危险比为0.13;95% CI为0.03-0.52;P=0.049,卡培他滨更优)。在卡培他滨组,免疫热患者的5年DFS率高于免疫冷患者(96.9% vs 76.4%;危险比,0.11;95% CI,0.04-0.29;P=.028):我们的研究表明,免疫热型TNBC患者更有可能从卡培他滨辅助治疗中获益,而且免疫治疗与化疗相结合对免疫热型患者可能更有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tailoring Escalation Adjuvant Therapy for Early-Stage Triple-Negative Breast Cancer in the CBCSG010 Clinical Trial Biomarker Analysis.

Background: Triple-negative breast cancer (TNBC) is a highly heterogeneous disease. The CBCSG010 trial is a prospective and multicenter phase III clinical trial confirming that adding adjuvant capecitabine significantly improved the 5-year disease-free survival (DFS) rate in patients with TNBC by 5.9%. In this study, we attempted to identify the specific population that benefited from adjuvant therapy.

Methods: In this retrospective exploratory analysis, we performed RNA sequencing of tumor tissues from patients with TNBC in the CBCSG010 clinical trial. A single-sample gene set enrichment analysis algorithm and survival analysis were performed to characterize the intrinsic molecular features of the TNBC microenvironment and assess the associations between immune-related gene expression levels or immune cell counts with capecitabine treatment efficacy. Additionally, we performed immunohistochemical staining of 2 markers, PD-L1 and CD8, and hematoxylin-eosin staining of stromal tumor-infiltrating lymphocytes (sTILs) on formalin-fixed, paraffin-embedded specimens to validate findings from bioinformatics analyses.

Results: We found that patients with TNBC with high immune-infiltration treated with capecitabine were more likely to have a better prognosis. We used a cutoff of ≥25 combined positive score (CPS) of PD-L1, ≥10% positive sTILs, and ≥10% positive cells of CD8 to define the "immune-hot" patients. Among immune-hot patients, Kaplan-Meier curves showed that 5-year DFS rates were 96.9% and 79.4% in the capecitabine and control groups, respectively (hazard ratio, 0.13; 95% CI, 0.03-0.52; P=.049 in favor of capecitabine). In the capecitabine group, the 5-year DFS rate was higher for immune-hot patients than for immune-cold patients (96.9% vs 76.4%; hazard ratio, 0.11; 95% CI, 0.04-0.29; P=.028).

Conclusions: Our study suggested that immune-hot patients with TNBC are more likely to benefit from adjuvant capecitabine, and that combining immunotherapy with chemotherapy may be expected to be more effective in immune-hot patients.

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来源期刊
CiteScore
20.20
自引率
0.00%
发文量
388
审稿时长
4-8 weeks
期刊介绍: JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.
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