原发性转移性乳腺癌患者与复发性her2阴性、激素受体阳性晚期乳腺癌患者的特点和预后

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Pub Date : 2025-02-05 DOI:10.1016/j.breast.2025.104412

Christina B. Walter , Andreas D. Hartkopf , Alexander Hein , Peter A. Fasching , Hans-Christian Kolberg , Peyman Hadji , Hans Tesch , Lothar Häberle , Johannes Ettl , Diana Lüftner , Markus Wallwiener , Volkmar Müller , Matthias W. Beckmann , Laura L. Michel , Erik Belleville , Hanna Huebner , Sabrina Uhrig , Chloë Goossens , Pauline Wimberger , Carsten Hielscher , Carlo Fremd

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引用次数: 0

摘要

背景：一线转移性乳腺癌（MBC）患者包括原发性乳腺癌（rMBC）后的新发转移（dnMBC）或复发性疾病患者。该分析旨在探讨dnMBC与rMBC的总体预后价值，特别是根据年龄和转移部位的亚组，以及其他一线，激素受体（HR）阳性，her2阴性（HRpos/HER2neg）人群的预后临床病理参数。方法在前瞻性PRAEGNANT MBC登记（NCT02338167）中，确定了508名接受晚期疾病一线治疗的HRpos/ her2阴性患者。根据转移状态（dnMBC、初诊5年内rMBC （rMBC <；5年）、5年以上rMBC （rMBC≥5年））评估临床病理参数（年龄、体重指数、运动状态、肿瘤分级、转移部位及治疗）。采用Cox回归分析来研究转移状态是否影响无进展生存期（PFS）和总生存期（OS）。结果180例（35.4%）患者存在新发转移性疾病，而132例（26.0%）患者rMBC≥5年，196例（38.6%）患者rMBC≥5年。dnMBC患者预后最好。相对于dnMBC， rMBC≥5年的PFS风险比为1.75 (95%CI: 1.31-2.34)， rMBC≥5年的PFS风险比为1.25 （95%CI: 0.94-1.65）。亚组特异性差异未观察到。结论hrpos / her2阴性的一线MBC患者既往未接受治疗，预后较好。这种差异在所有检查的临床病理参数中都是相似的。因此，将MBC分类作为临床试验的分层因素可能是有益的。

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Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer

Background

Patients with first-line metastatic breast cancer (MBC) comprise patients with de novo metastases (dnMBC) or recurrent disease after primary breast cancer (rMBC). This analysis aimed to explore the prognostic value of dnMBC versus rMBC overall and particularly in subgroups according to age and metastasis site, in addition to other prognostic clinicopathological parameters in a first-line, hormone receptor (HR)-positive, HER2-negative (HRpos/HER2neg) population.

Methods

Within the prospective PRAEGNANT MBC registry (NCT02338167), 508 HRpos/HER2neg patients, receiving first-line treatment for advanced disease, were identified. Clinicopathological parameters (age, body mass index, performance status, tumor grading, metastasis site and therapy) were assessed according to metastatic status (dnMBC, rMBC within 5 years of primary diagnosis (rMBC <5 years), rMBC after more than 5 years (rMBC ≥5 years)). Cox regression analyses were performed to investigate whether metastatic status influences progression-free survival (PFS) and overall survival (OS).

Results

De novo metastatic disease was present in 180 patients (35.4 %), whereas 132 patients (26.0 %) had rMBC <5 years and 196 patients (38.6 %) had rMBC ≥5 years. Patients with dnMBC had the most favorable prognosis. Relative to dnMBC, hazard ratios for PFS were 1.75 (95%CI: 1.31–2.34) in rMBC<5 years and 1.25 (95%CI: 0.94–1.65) for rMBC ≥5 years. Subgroup-specific differences were not observed.

Conclusion

HRpos/HER2neg first-line MBC patients have a more favorable prognosis if the disease was previously not treated. This difference was similar across all examined clinicopathological parameters. It may therefore be beneficial to incorporate MBC categories as a stratification factor in clinical trials.

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.