TCbHP方案新辅助治疗人表皮生长因子受体2阳性乳腺癌的效果和安全性  

Efficacy and safety of neoadjuvant therapy with TCbHP regimen for human epidermal growth factor receptor 2-positive breast cancer

作　　者：徐东宏[1] 吴向东 张世博 杜永涛 胡崇珠[1] 王恩庆[1] Xu Donghong;Wu Xiangdong;Zhang Shibo;Du Yongtao;Hu Chongzhu;Wang Enqing(Department of Breast Surgery 1,Baoding No.1 Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院乳腺外一科,保定071000

出　　处：《肿瘤研究与临床》2024年第8期590-593,共4页Cancer Research and Clinic

基　　金：保定市科技计划(2141ZF242)。

摘　　要：目的探讨曲妥珠单抗和帕妥珠单抗联合紫杉类药物和铂类药物(TCbHP)方案新辅助治疗人表皮生长因子受体2(HER2)阳性乳腺癌的效果及安全性。方法回顾性病例系列研究。回顾性分析2019年6月至2021年12月河北省11家三级甲等医院接受21 d TCbHP方案新辅助治疗并完成后续手术的HER2阳性乳腺癌患者的临床资料,统计分析总体病理完全缓解(tpCR)率、≥3级不良反应发生率和既定方案完成率。结果共纳入78例患者,均为女性,中位年龄[M(Q_(1),Q_(3))]54.0岁(48.5岁,57.5岁)。tpCR率为64.1%(50/78)。亚组分析显示,HER2免疫组织化学法(IHC)+++组tpCR率高于HER2 IHC++且荧光原位杂交阳性组[68.6%(48/70)比25.0%(2/8)],差异有统计学意义(χ^(2)=4.18,P=0.041);激素受体阴性组tpCR率高于激素受体阳性组[81.8%(27/33)比51.1%(23/45)],差异有统计学意义(χ^(2)=7.80,P=0.005);使用白蛋白结合型紫杉醇组tpCR率高于多西他赛组[72.3%(34/47)比48.3%(14/29)],差异有统计学意义(χ^(2)=4.46,P=0.035)。78例患者≥3级不良反应发生率为12.8%(10/78),既定方案完成率为92.3%(72/78)。结论TCbHP方案新辅助治疗HER2阳性乳腺癌患者效果确切,安全性及耐受性良好。ObjectiveTo investigate the efficacy and safety of neoadjuvant therapy with trastuzumab and pertuzumab combined with taxane and platinum drugs(TCbHP)regimen for human epidermal growth factor receptor 2(HER2)-positive breast cancer.MethodsA retrospective case series study was conducted.The clinical data of HER2-positive breast cancer patients who received neoadjuvant therapy with 21-day TCbHP regimen and completed subsequent surgery in 11 tertiary-level hospitals in Hebei Province from June 2019 to December 2021 were retrospectively analyzed,and the total pathological complete remission(tpCR)rate,the incidence of grade≥3 adverse events,and the completion rate of the established regimen were statistically analyzed.ResultsA total of 78 female patients were included and the median age[M(Q_(1),Q_(3))]was 54.0 years(48.5 years,57.5 years).The tpCR rate was 64.1%(50/78).Subgroup analysis showed that the tpCR rate in the HER2 immunohistochemistry(IHC)+++group was higher than that in the HER2 IHC++and fluorescence in situ hybridization-positive group[68.6%(48/70)vs.25.0%(2/8)],and the difference was statistically significant(χ^(2)=4.18,P=0.041);the tpCR rate in the hormone-receptor negative group was higher than that in the hormone-receptor positive group[81.8%(27/33)vs.51.1%(23/45)],and the difference was statistically significant(χ^(2)=7.80,P=0.005);the tpCR rate in the albumin-bound paclitaxel group was higher than that in the docetaxel group[72.3%(34/47)vs.48.3%(14/29)],and the difference was statistically significant(χ^(2)=4.46,P=0.035).The incidence of≥grade 3 adverse reactions was 12.8%(10/78)in 78 patients,and the completion rate of the established regimen was 92.3%(72/78).ConclusionsNeoadjuvant therapy with TCbHP regimen for HER2-positive breast cancer shows a definite efficacy,good safety and tolerance.

关 键 词：乳腺肿瘤 人表皮生长因子受体2 新辅助治疗 治疗结果 不良反应 

分 类 号：R737.9[医药卫生—肿瘤]