针对转移性三阴性炎性乳腺癌患者的免疫检查点抑制剂（INCORPORATE）：一项国际队列研究

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer Pub Date : 2024-10-28 DOI:10.1016/j.ejca.2024.115097

Carmine Valenza , Dario Trapani , Paola Zagami , Gabriele Antonarelli , Luca Boscolo Bielo , Eleonora Nicolò , Joana Mourato Ribeiro , Lorenzo Guidi , Carolina Reduzzi , Martina Spotti , Laura Adamoli , Javier Cortès , Barbara Pistilli , Sara M. Tolaney , Naoto Ueno , Rachel M. Layman , Massimo Cristofanilli , Lisa A. Carey , Elisabetta Munzone , Carmen Criscitiello , Giuseppe Curigliano

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引用次数: 0

摘要

背景炎性乳腺癌（IBC）是临床表现最具侵袭性的乳腺癌，与非 IBC 相比，它再现了一种免疫脆弱性更强的特殊生物学特性。转移性三阴性IBC（mTN-IBC）患者接受免疫检查点抑制剂（ICIs）和化疗的情况与三阴性非IBC患者类似。方法我们开展了一项多中心、国际性、回顾性队列研究，以评估2015年1月至2023年4月期间接受ICIs加一线化疗的转移性三阴性原发性IBC患者中ICIs的活性。42例患者的样本量可以检测到6个月真实世界无进展生存期（rwPFS）率从仅接受化疗的40%提高到接受ICI和化疗的60%。结果纳入了来自8个国际IBC转诊中心的41例患者（61%为原发性、新发mTN-IBC，61%为内脏疾病）。所有患者都接受了 ICIs 和一线化疗，24% 的患者接受了乳腺手术和/或局部放疗。中位随访时间为 19.3 个月，6 个月 rwPFS 率为 30%（95% 置信区间 [CI]，17-45%），中位 rwPFS 为 3.3 个月（95% CI：2.2-5.4），中位总生存期为 15.7 个月（95% CI：6.8-16.3）。结论这项单样本分析显示，尽管接受了 ICI 治疗，但 mTN-IBC 患者的预后不佳，这与基于 IBC 免疫易感性临床前证据的预期获益形成了鲜明对比。这些结果表明，有必要进一步研究免疫疗法在这种侵袭性罕见乳腺癌中的作用。

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Immune checkpoint inhibitors for patients with metastatic triple-negative inflammatory breast cancer (INCORPORATE): An international cohort study

Background

Inflammatory breast cancer (IBC) is the most aggressive clinical presentation of breast cancer, recapitulating a specific biology with more immune-vulnerability than non-IBC. Patients with metastatic, triple-negative IBC (mTN-IBC) receive immune checkpoint inhibitors (ICIs) and chemotherapy, similarly to patients with triple-negative non-IBC. However, the benefit derived from ICI incorporation in this rare type of breast cancer is unknown.

Methods

We conducted a multicenter, international, retrospective, cohort study to evaluate the activity of ICIs in patients with metastatic, triple-negative, primary IBC, who received ICIs plus first line chemotherapy from January 2015 to April 2023. A sample size of 42 patients allowed to detect an increase in 6-months real-world progression-free survival (rwPFS) rate from 40 % with only chemotherapy to 60 % with ICI and chemotherapy.

Results

41 patients from eight international IBC referral centers were included (61 % with primary, de novo mTN-IBC, 61 % with visceral disease). All received ICIs plus first line chemotherapy and 24 % underwent breast surgery and/or locoregional radiotherapy. After a median follow-up of 19.3 months, the 6-months rwPFS rate was 30 % (95 % Confidence Interval [CI], 17–45 %), the median rwPFS was 3.3 months (95 % CI: 2.2–5.4), the median overall survival was 15.7 months (95 % CI: 6.8–16.3).

Conclusions

This one-sample analysis showed a poor outcome of patients with mTN-IBC, despite the treatment with ICI, in contrast with the expected benefit based on preclinical evidence of immune-vulnerability of IBC. These results suggest the need to further investigate the role of immunotherapy in this aggressive and rare type of breast cancer presentation.

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来源期刊

European Journal of Cancer 医学-肿瘤学

CiteScore

11.50

自引率

4.80%

发文量

953

审稿时长

23 days

期刊介绍： The European Journal of Cancer (EJC) serves as a comprehensive platform integrating preclinical, digital, translational, and clinical research across the spectrum of cancer. From epidemiology, carcinogenesis, and biology to groundbreaking innovations in cancer treatment and patient care, the journal covers a wide array of topics. We publish original research, reviews, previews, editorial comments, and correspondence, fostering dialogue and advancement in the fight against cancer. Join us in our mission to drive progress and improve outcomes in cancer research and patient care.