Ahmet Necati Sanli, Bilal Turan, Deniz Esin Tekcan Sanli, Isa Karaca, M Kadri Altundag, Fatih Aydogan
{"title":"基于hr阳性/ her2阳性乳腺癌完全、部分和无反应的新辅助反应分层","authors":"Ahmet Necati Sanli, Bilal Turan, Deniz Esin Tekcan Sanli, Isa Karaca, M Kadri Altundag, Fatih Aydogan","doi":"10.1007/s10549-025-07812-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the prognostic relevance of stratified pathological response -complete response (CR), partial response (PR), and no response (NR)- to neoadjuvant chemotherapy (NAC) in patients with hormone receptor-positive and HER2-positive (HR + /HER2 +) breast cancer.</p><p><strong>Methods: </strong>A total of 8277 HR + /HER2 + breast cancer patients treated with NAC between 2010 and 2021 were retrospectively identified from the SEER database. Patients were categorized into CR, PR, and NR groups. Overall survival (OS) and disease-specific survival (DSS) were analyzed using Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>CR, PR, and NR rates were 52.3%, 41.4%, and 6.2%, respectively. Five-year OS rates were 96.3% (CR), 91.1% (PR), and 79.3% (NR), while 10-year DSS rates were 94.0% (CR), 83.4% (PR), and 76.2% (NR) (p < 0.001). In multivariate analysis, PR and NR were associated with significantly increased mortality risk compared to CR (OS HR: 2.16 and 4.20; DSS HR: 2.95 and 5.46; all p < 0.001). Progesterone receptor (PrgR) negativity independently predicted worse OS and DSS, whereas ER status had no significant impact. Additional adverse prognostic factors included advanced age, nodal metastasis, rural residence, and mastectomy. Radiotherapy did not retain significance in multivariate models.</p><p><strong>Conclusion: </strong>Pathological response to NAC is a strong independent prognostic marker in HR + /HER2 + breast cancer. Partial responders represent a clinically distinct group with intermediate outcomes, highlighting the need for response-adapted therapeutic strategies beyond conventional staging systems.</p>","PeriodicalId":9133,"journal":{"name":"Breast Cancer Research and Treatment","volume":" ","pages":"247-264"},"PeriodicalIF":3.0000,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neoadjuvant response stratification based on complete, partial, and no response in HR-positive/HER2-positive breast cancer.\",\"authors\":\"Ahmet Necati Sanli, Bilal Turan, Deniz Esin Tekcan Sanli, Isa Karaca, M Kadri Altundag, Fatih Aydogan\",\"doi\":\"10.1007/s10549-025-07812-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to evaluate the prognostic relevance of stratified pathological response -complete response (CR), partial response (PR), and no response (NR)- to neoadjuvant chemotherapy (NAC) in patients with hormone receptor-positive and HER2-positive (HR + /HER2 +) breast cancer.</p><p><strong>Methods: </strong>A total of 8277 HR + /HER2 + breast cancer patients treated with NAC between 2010 and 2021 were retrospectively identified from the SEER database. Patients were categorized into CR, PR, and NR groups. Overall survival (OS) and disease-specific survival (DSS) were analyzed using Kaplan-Meier and Cox regression models.</p><p><strong>Results: </strong>CR, PR, and NR rates were 52.3%, 41.4%, and 6.2%, respectively. Five-year OS rates were 96.3% (CR), 91.1% (PR), and 79.3% (NR), while 10-year DSS rates were 94.0% (CR), 83.4% (PR), and 76.2% (NR) (p < 0.001). In multivariate analysis, PR and NR were associated with significantly increased mortality risk compared to CR (OS HR: 2.16 and 4.20; DSS HR: 2.95 and 5.46; all p < 0.001). Progesterone receptor (PrgR) negativity independently predicted worse OS and DSS, whereas ER status had no significant impact. Additional adverse prognostic factors included advanced age, nodal metastasis, rural residence, and mastectomy. Radiotherapy did not retain significance in multivariate models.</p><p><strong>Conclusion: </strong>Pathological response to NAC is a strong independent prognostic marker in HR + /HER2 + breast cancer. Partial responders represent a clinically distinct group with intermediate outcomes, highlighting the need for response-adapted therapeutic strategies beyond conventional staging systems.</p>\",\"PeriodicalId\":9133,\"journal\":{\"name\":\"Breast Cancer Research and Treatment\",\"volume\":\" \",\"pages\":\"247-264\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breast Cancer Research and Treatment\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10549-025-07812-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Cancer Research and Treatment","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10549-025-07812-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Neoadjuvant response stratification based on complete, partial, and no response in HR-positive/HER2-positive breast cancer.
Background: This study aimed to evaluate the prognostic relevance of stratified pathological response -complete response (CR), partial response (PR), and no response (NR)- to neoadjuvant chemotherapy (NAC) in patients with hormone receptor-positive and HER2-positive (HR + /HER2 +) breast cancer.
Methods: A total of 8277 HR + /HER2 + breast cancer patients treated with NAC between 2010 and 2021 were retrospectively identified from the SEER database. Patients were categorized into CR, PR, and NR groups. Overall survival (OS) and disease-specific survival (DSS) were analyzed using Kaplan-Meier and Cox regression models.
Results: CR, PR, and NR rates were 52.3%, 41.4%, and 6.2%, respectively. Five-year OS rates were 96.3% (CR), 91.1% (PR), and 79.3% (NR), while 10-year DSS rates were 94.0% (CR), 83.4% (PR), and 76.2% (NR) (p < 0.001). In multivariate analysis, PR and NR were associated with significantly increased mortality risk compared to CR (OS HR: 2.16 and 4.20; DSS HR: 2.95 and 5.46; all p < 0.001). Progesterone receptor (PrgR) negativity independently predicted worse OS and DSS, whereas ER status had no significant impact. Additional adverse prognostic factors included advanced age, nodal metastasis, rural residence, and mastectomy. Radiotherapy did not retain significance in multivariate models.
Conclusion: Pathological response to NAC is a strong independent prognostic marker in HR + /HER2 + breast cancer. Partial responders represent a clinically distinct group with intermediate outcomes, highlighting the need for response-adapted therapeutic strategies beyond conventional staging systems.
期刊介绍：
Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
