摘要
目的探究曲妥珠单抗和帕托珠单抗联合化疗对人表皮生长因子受体2(HER2)阳性乳腺癌新辅助治疗的效果。方法回顾性分析2019年1月至2021年12月在北京大学深圳医院进行新辅助治疗的49例HER2阳性乳腺癌患者的临床资料。根据治疗方式分为2线,2组分别使用TCbHP或EC序贯THP双靶联合化疗方案,所有患者均完成新辅助及手术治疗,对新辅助化疗后获病理完全缓解(PCR)与未完全缓解(非PCR)的两组患者的临床病理指标进行比较。结果入组患者年龄(45.22±9.17)岁。25例患者接受TCbHP方案,24例患者接受EC序贯THP方案,其中32例(65.3%)患者化疗后病理评估为PCR。TCbHP方案组PCR率为76.0%(19/25),高于EC序贯THP方案组的54.2%(13/24),但差异无统计学意义(P>0.05)。新辅助化疗后PCR组患者相关临床指标中,雌激素受体(ER)、孕激素受体(PR)阳性比例低于非PCR组患者(均P<0.05),两组患者间年龄、肿瘤分期、Ki67、分子分型以及化疗方案间差异均无统计学意义(均P>0.05);TCbHP方案组和EC序贯THP方案组患者的ER和分子分型之间的差异有统计学意义(均P<0.05)。化疗相关不良反应中,TCbHP方案组患者出现血小板减少及肾功能损伤的比例高于EC序贯THP方案组患者(均P<0.05),其他不良反应两组差异均无统计学意义(均P>0.05)。结论双靶药物联合化疗对HER2阳性乳腺癌新辅助治疗的效果较好,TCbHP方案与EC序贯THP方案PCR比率相似,但前者血小板减少及肾功能损伤不良反应较高,两种方案均有较好的心脏安全性。
ObjectiveTo evaluate the efficacy and safety of trastuzumab and pertuzumab combined with chemotherapy in neoadjuvant therapy for human epidermal growth factor receptor 2(HER2)positive breast cancer.MethodsA retrospective study was performed on cases of HER2-positive breast cancer treated with neoadjuvant therapy at Peking University Shenzhen Hospital from January 2019 to December 2021.The patients were divided into two groups to receive either the TCbHP regimen or the EC-THP regimen for neoadjuvant chemotherapy,respectively.All patients underwent neoadjuvant and surgical treatment.The clinicopathological parameters were compared between patients with pathological complete response(pCR)and those with non-complete response(non-PCR)after neoadjuvant chemotherapy.ResultsThe mean age of the patients was(45.22±9.17)years.Twenty-five patients received the TCbHP regimen and 24 received the EC-THP regimen.The overall pCR rate was 65.3%(32/49).The pCR rate was 76.0%(19/25)among patients receiving the TCbHP regimen and 54.2%(13/24)among those receiving the EC-THP regimen(P>0.05).The proportion of patients with positive ER and PR status in the PCR group was lower than that of the non-PCR group after neoadjuvant chemotherapy(P<0.05 for both),though there was no significant difference in age,tumor stage,Ki67 index,molecular type,or chemotherapy regimens between the two groups(P>0.05 for all).There were significant differences in ER status and molecular type between the TCbHP regimen group and EC-THP regimen group(P<0.05 for both).Compared with the EC-THP group,the incidence of thrombocytopenia and renal injury was higher in the TCbHP group(P<0.05 for both),but there was no significant difference in the incidence of other adverse events between the two groups(P>0.05 for all).ConclusionBoth the TCbHP and EC-THP regimens may be useful neoadjuvant treatments for HER2-positive breast cancer.The pCR rate to the TCbHP regimen was higher than that to the EC-THP regimen.The incidence of thrombocytopenia and renal injury is higher in the TCbHP regimen.Both regimens have very good cardiac safety.
作者
崔军威
刘荫华
刘晓岭
胡艺冰
胡慧
Cui Junwei;Liu Yinhua;Liu Xiaoling;Hu Yibing;Hu Hui(Department of Breast Surgery,Peking University Shenzhen Hospital,Shenzhen 518036,China;Breast Disease Center,Peking University First Hospital,Beijing 100034,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2022年第11期1062-1067,共6页
Chinese Journal of Clinicians(Electronic Edition)
基金
吴阶平医学基金会临床科研专项资助(320.6750.2021-10-96)
广东省医学科学技术研究项目(A2020288)
作者简介
通信作者:胡慧,Email:sapphiretjmu@163.com;通信作者:胡艺冰,Email:hufay@126.com
