新辅助化疗联合双靶治疗HER-2阳性乳腺癌的有效性比较  

Efficacy comparation of different neoadjuvant chemotherapies combined with trastuzumab and pertuzumab in HER-2 positive breast cancer

作　　者：闵婕 李心心 王欣 Jie Min;Xinxin Li;Xin Wang(The First Department of Breast Cancer,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Tianjin’s Clinical Research Center for Cancer,Key Laboratory of Breast Cancer Prevention and Therapy(Ministry of Education),Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院乳腺一科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,乳腺癌防治教育部重点实验室,天津市“肿瘤防治”重点实验室,天津市300060

出　　处：《中国肿瘤临床》2023年第22期1142-1146,共5页Chinese Journal of Clinical Oncology

基　　金：天津市医学重点学科(专科)建设项目(编号:TJYXZDXK-009A)资助。

摘　　要：目的:比较多西他赛+卡铂+曲妥珠单抗+帕妥珠单抗(TCbHP)、多西他赛+曲妥珠单抗+帕妥珠单抗(THP)与蒽环类+环磷酰胺序贯紫杉类+曲妥珠单抗+帕妥珠单抗(AC-THP)作为新辅助治疗方案对HER-2阳性激素受体(hormone receptor,HR)阳性和HER-2阳性HR阴性乳腺癌患者的有效性。方法:回顾性分析2019年6月至2022年12月于天津医科大学肿瘤医院就诊的408例HER-2阳性且行标准新辅助治疗的乳腺癌患者的临床病理资料,根据HR状态分为HER-2阳性HR阳性组211例、HER-2阳性HR阴性组197例。根据不同新辅助治疗方案进一步分为TCbHP、THP和AC-THP组,分别比较各组患者行各治疗方案的病理学完全缓解(pathological complete response,pCR)率。结果:HER-2阳性HR阳性乳腺癌患者中,TCbHP、THP和AC-THP组的pCR率分别为43.1%(69/160)、36.0%(9/25)和38.5%(10/26),各组间比较差异无统计学意义(χ^(2)=0.580,P=0.748);HER-2阳性HR阴性患者中,TCbHP、THP和AC-THP组的pCR率分别为85.5%(94/110)、57.3%(43/75)和66.7%(8/12),TCbHP组与THP组比较差异具有统计学意义(χ^(2)=19.967,P<0.001)。结论:TCbHP、THP和AC-THP新辅助治疗方案对HER-2阳性HR阳性乳腺癌患者的疗效相似,TCbHP作为新辅助治疗对HER-2阳性HR阴性乳腺癌疗效更优。Objective:To compare the efficacy of taxane+carboplatin combined with trastuzumab and pertuzumab(TCbHP),taxane combined with trastuzumab and pertuzumab(THP)and anthracycline+cyclophosphamide followed by taxane+trastuzumab+pertuzumab(ACTHP)as neoadjuvant therapy strategies for breast cancer patients with human epidermal growth factor receptor-2(HER-2)positive hormone receptor(HR)positive and HER-2 positive HR negative cancers,respectively.Methods:We retrospectively analyzed clinicopathological data of 408 HER-2 positive breast cancer patients receiving standard neoadjuvant therapy from Tianjin Medical University Cancer Institute&Hospital from June 2019 to December 2022.Stratified by HR,211 of 408 were HER-2 positive HR positive,and 197 of 408 were HER-2 positive HR negative.Participants were further assigned into a TCbHP group,a THP group,and an AC-THP group according to their differing neoadjuvant regimens,and their pathologic complete response(pCR)rates were compared.Results:Among the HER-2 positive HR positive patients,the respective pCR rates of the TCbHP,THP,and AC-THP groups were 43.1%(69/160),36.0%(9/25),and 38.5%(10/26)with no statistical significance(χ^(2)=0.580,P=0.748).Among the HER-2 positive HR negative patients,the respective pCR rates of the TCbHP,THP,and ACTHP groups were 85.5%(94/110),57.3%(43/75),and 66.7%(8/12)with a statistically significant difference between the TCbHP and THP groups(χ^(2)=19.967,P<0.001).Conclusions:TCbHP,THP,and AC-THP as neoadjuvant regimens exerted similar efficacy in treating HER-2 positive HR positive breast cancer.TCbHP exhibited superior efficacy in HER-2 positive HR negative breast cancer.

关 键 词：乳腺癌 人表皮生长因子受体-2阳性 新辅助治疗 靶向治疗 有效性 

分 类 号：R737.9[医药卫生—肿瘤]