Wonshik Han, Eunhye Kang, Ji Gwang Jung, Hong-Kyu Kim, Han-Byoel Lee, Jisun Kim, Sae Byul Lee, Hee-Chul Shin, Chan Sub Park, Min-Ki Seong, Hyun-Ah Kim, Eun-Kyu Kim, Byung Ho Son
{"title":"使用70基因检测的个性化新辅助策略增加ER+/HER2-乳腺癌的保乳手术","authors":"Wonshik Han, Eunhye Kang, Ji Gwang Jung, Hong-Kyu Kim, Han-Byoel Lee, Jisun Kim, Sae Byul Lee, Hee-Chul Shin, Chan Sub Park, Min-Ki Seong, Hyun-Ah Kim, Eun-Kyu Kim, Byung Ho Son","doi":"10.1038/s41523-025-00772-5","DOIUrl":null,"url":null,"abstract":"<p><p>We investigated whether tailored neoadjuvant therapy (chemotherapy [NCT] or endocrine therapy [NET]) guided by a 70-gene assay could improve breast-conserving surgery (BCS) rates among patients with ER-positive/HER2-negative breast cancer initially deemed ineligible for BCS. Of 130 prospectively enrolled patients (stage II-IIIA, across four Korean centers), 92 were analyzed. Patients classified as high genomic risk received NCT, while low-risk patients underwent NET (letrozole ± leuprolide for premenopausal women) for 16-24 weeks. The primary endpoint-achieving the surgeon-defined target tumor size for BCS-was reached in 69.6% (95% CI: 59.1-78.7%), significantly surpassing the predefined goal of 50.8% (p < 0.05). The actual overall BCS rate was 59.8% (64.7% NCT, 45.8% NET). Pathologic complete response occurred in 2.2%, exclusively in the NCT group. Thus, pretreatment genomic profiling effectively guided therapy selection, substantially increasing BCS eligibility while sparing low-risk patients unnecessary chemotherapy toxicity.</p>","PeriodicalId":19247,"journal":{"name":"NPJ Breast Cancer","volume":"11 1","pages":"57"},"PeriodicalIF":7.6000,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181377/pdf/","citationCount":"0","resultStr":"{\"title\":\"Personalized neoadjuvant strategy using 70-gene assay to increase breast-conserving surgery in ER+/HER2- breast cancer.\",\"authors\":\"Wonshik Han, Eunhye Kang, Ji Gwang Jung, Hong-Kyu Kim, Han-Byoel Lee, Jisun Kim, Sae Byul Lee, Hee-Chul Shin, Chan Sub Park, Min-Ki Seong, Hyun-Ah Kim, Eun-Kyu Kim, Byung Ho Son\",\"doi\":\"10.1038/s41523-025-00772-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We investigated whether tailored neoadjuvant therapy (chemotherapy [NCT] or endocrine therapy [NET]) guided by a 70-gene assay could improve breast-conserving surgery (BCS) rates among patients with ER-positive/HER2-negative breast cancer initially deemed ineligible for BCS. Of 130 prospectively enrolled patients (stage II-IIIA, across four Korean centers), 92 were analyzed. Patients classified as high genomic risk received NCT, while low-risk patients underwent NET (letrozole ± leuprolide for premenopausal women) for 16-24 weeks. The primary endpoint-achieving the surgeon-defined target tumor size for BCS-was reached in 69.6% (95% CI: 59.1-78.7%), significantly surpassing the predefined goal of 50.8% (p < 0.05). The actual overall BCS rate was 59.8% (64.7% NCT, 45.8% NET). Pathologic complete response occurred in 2.2%, exclusively in the NCT group. Thus, pretreatment genomic profiling effectively guided therapy selection, substantially increasing BCS eligibility while sparing low-risk patients unnecessary chemotherapy toxicity.</p>\",\"PeriodicalId\":19247,\"journal\":{\"name\":\"NPJ Breast Cancer\",\"volume\":\"11 1\",\"pages\":\"57\"},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2025-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181377/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"NPJ Breast Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1038/s41523-025-00772-5\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"NPJ Breast Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41523-025-00772-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Personalized neoadjuvant strategy using 70-gene assay to increase breast-conserving surgery in ER+/HER2- breast cancer.
We investigated whether tailored neoadjuvant therapy (chemotherapy [NCT] or endocrine therapy [NET]) guided by a 70-gene assay could improve breast-conserving surgery (BCS) rates among patients with ER-positive/HER2-negative breast cancer initially deemed ineligible for BCS. Of 130 prospectively enrolled patients (stage II-IIIA, across four Korean centers), 92 were analyzed. Patients classified as high genomic risk received NCT, while low-risk patients underwent NET (letrozole ± leuprolide for premenopausal women) for 16-24 weeks. The primary endpoint-achieving the surgeon-defined target tumor size for BCS-was reached in 69.6% (95% CI: 59.1-78.7%), significantly surpassing the predefined goal of 50.8% (p < 0.05). The actual overall BCS rate was 59.8% (64.7% NCT, 45.8% NET). Pathologic complete response occurred in 2.2%, exclusively in the NCT group. Thus, pretreatment genomic profiling effectively guided therapy selection, substantially increasing BCS eligibility while sparing low-risk patients unnecessary chemotherapy toxicity.
期刊介绍：
npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
