紫杉醇联合卡铂密集方案新辅助治疗三阴性乳腺癌的疗效及远期生存

目的评价PC(紫杉醇+卡铂)密集方案新辅助治疗三阴性乳腺癌的疗效和远期生存, 探索三阴性乳腺癌新辅助化疗的优化方案。方法 2008年1月至2018年9月中国医学科学院肿瘤医院病理确诊为三阴性乳腺癌(临床分期T1～4N0～3M0)、接受PC密集方案新辅助化疗及手术的患者, 采用倾向性评分方法对PC密集方案组和3周方案组患者进行1∶1最近邻匹配, 比较两组的疗效、安全性及远期生存。结果纳入三阴性乳腺癌患者100例, 密集方案组和3周方案组各50例。密集方案组和3周方案组的客观有效率(ORR)均为90.0%(45/50)。密集方案组3～4级中性粒细胞减少的发生率低于3周方案组(分别为32.7%和68.0%, P=0.001), 但肝功能异常的发生率高于3周方案组(分别为57.1%和32.0%, P=0.012)。病理学完全缓解(pCR)率分别为34.0%(17/50)和38.0%(19/50), 差异无统计学意义(P=0.677)。中位随访55个月, 密集方案组和3周方案组的5年无复发生存率分别为83.5%和75.2%, 5年总生存率分别为87.9%和84.5%, 差异均无统计学意义(P值分...

Efficacy and survival outcomes of dose-dense carboplatin plus paclitaxel as neoadjuvant chemotherapy for triple-negative breast cancer

Objective To evaluate the efficacy and survival outcomes of dose-dense(biweekly)carboplatin plus paclitaxel(PC)as neoadjuvant chemotherapy(NAC)in triple-negative breast cancer(TNBC),and to explore an optimal neoadjuvant chemotherapy regimen for TNBC.Methods Patients diagnosed as TNBC(cT1-4N0-3M0)in Cancer Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1∶1 matched using propensity score matching(PSM)to compare the efficacy,safety and survival outcomes.Results One hundred of TNBC patients were enrolled(50 patients were divided in dose-dense group,50 patients in standard group).The objective response rate(ORR)of dose-dense group and standard group were both 90.0%(45/50).The grade 3-4 neutropenia in dose-dense group was less than that of standard group(32.7%vs.68.0%,P=0.001),while the rate of ALT/AST elevation in dose-dense group was higher than that of standard group(57.1%vs.32.0%,P=0.012).The pathological complete response(pCR)rates were 34.0%(17/50)in dose-dense group and 38.0%(19/50)in standard group,without statistically significance(P=0.677).The median follow-up time was 55 months(3-150 months).The 5-year recurrence-free survival(RFS)in dose-dense group and standard group were 83.5%and 75.2%,respectively the 5-year overall survival(OS)in dose-dense and standard group were 87.9%and 84.5%the difference were not statistically significant(P=0.322 and 0.647,respectively).Patients with residual disease(tumor size≥1 cm or lymph node positive)had poor prognosis,the 5-year RFS and OS were 59.3%and 68.5%,respectively.Conclusions Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile.Since dose-dense regimen can shorten the duration of therapy,it can be an alternative in TNBC.