无蒽环类药物和含蒽环类药物的新辅助化疗免疫疗法对三阴性乳腺癌的疗效比较。

IF 5 2区医学 Q2 Medicine

Translational Oncology Pub Date : 2024-11-01 DOI:10.1016/j.tranon.2024.102171

Yuhan Wei , Qiao Li , Hongnan Mo , Yalong Qi , Hewei Ge , Xiaoying Sun , Ying Fan , Pin Zhang , Jiayu Wang , Yang Luo , Jing Wang , Fei Ma

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引用次数: 0

摘要

背景：选择合适的化疗骨干药物联合新辅助免疫疗法治疗三阴性乳腺癌（TNBC）仍不明确。在此，我们旨在评估不含蒽环类药物和含蒽环类药物的方案与新辅助免疫疗法联用的疗效和安全性：这项回顾性研究纳入了2020年11月至2023年11月期间在三个研究中心接受新辅助免疫治疗联合各种化疗方案的87例TBNC患者。研究的首要目标是病理完全反应（pCR），次要目标包括总反应率、无事件生存期（EFS）和不良反应发生率。研究还进行了亚组分析，以确定哪些患者可从不同的治疗策略中获得实质性益处：结果：与免疫疗法相结合，无蒽环类药物治疗方案的pCR率（55.1% vs. 51.4%；Odds比，1.16；95%置信区间[CI]，0.49-2.74；P = 0.73）和EFS（危险比，0.66；95% CI，0.18-2.45；P = 0.53）与含蒽环类药物治疗方案相当。亚组分析显示，与含蒽环类药物方案相比，肿瘤分期（p = 0.017）和淋巴结分期（p = 0.011）对不含蒽环类药物方案的 pCR 率的预测能力存在矛盾。具体而言，在无淋巴结转移的患者中，不含蒽环类药物方案的 pCR 率明显高于含蒽环类药物方案（p = 0.021）。汇总分析进一步证实了总体分析和亚组分析的结果。大多数不良反应为1-2级，未观察到新的不良反应：结论：不含蒽环类药物的新辅助化疗方案可作为TNBC患者（尤其是无淋巴结转移的患者）有效、安全的免疫治疗替代方案。

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Comparative efficacy of anthracycline-free and anthracycline-containing neoadjuvant chemoimmunotherapy regimens for triple-negative breast cancer

Background

The selection of appropriate chemotherapy backbone agents in combination with neoadjuvant immunotherapy for triple-negative breast cancer (TNBC) remains unclear. Herein, we aimed to evaluate the efficacy and safety of anthracycline-free and anthracycline-containing regimens coupled with neoadjuvant immunotherapy.

Method

This retrospective study included 87 patients with TBNC who received neoadjuvant immunotherapy combined with various chemotherapy regimens at three research centers from November 2020 to November 2023. The primary objective was pathological complete response (pCR), while secondary objectives included overall response rates, event-free survival (EFS), and the incidence of adverse events. A subgroup analysis was performed to delineate patients who may substantially benefit from distinct therapeutic strategies.

Results

Coupled with immunotherapy, anthracycline-free regimens achieved comparable pCR rates (55.1 % vs. 51.4 %; Odds ratio, 1.16; 95 % confidence interval [CI], 0.49–2.74; p = 0.73) and EFS (Hazard ratio, 0.66; 95 % CI, 0.18–2.45; p = 0.53) to anthracycline-containing regimens. According to subgroup analyses, the tumor stage (p = 0.017) and lymph node stage (p = 0.011) exhibit contradictory predictive power for the pCR rate of anthracycline-free regimens when compared with that of anthracycline-containing regimens. Specifically, anthracycline-free regimens yielded significantly higher pCR rates in patients without lymph node metastasis than anthracycline-containing regimens (p = 0.021). Pooled analyses further confirmed the results of both total and subgroup analyses. Most adverse events were grades 1–2, and no new adverse reactions were observed.

Conclusion

Anthracycline-free neoadjuvant chemotherapy regimens could serve as an effective and safe alternative immunotherapy partner for patients with TNBC, particularly in those without lymph node metastasis.

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来源期刊

Translational Oncology ONCOLOGY-

CiteScore

8.40

自引率

2.00%

发文量

314

审稿时长

54 days

期刊介绍： Translational Oncology publishes the results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of oncology patients. Translational Oncology will publish laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer. Peer reviewed manuscript types include Original Reports, Reviews and Editorials.