病理学完全缓解替代无复发生存用于三阴性乳腺癌患者新辅助化疗后

　　2016年5月14日，美国《肿瘤标靶》杂志在线发表了复旦大学附属肿瘤医院和复旦大学上海医学院（李俊杰、陈胜、陈灿明、狄根红、柳光宇、吴炅、邵志敏）的回顾性分析研究报告，发现病理学完全缓解（pCR）可以替代无复发生存（RFS）用于三阴性乳腺癌患者新辅助化疗后。

Oncotarget. 2016 May 14. [Epub ahead of print]

Pathological complete response as a surrogate for relapse-free survival in patients with triple negative breast cancer after neoadjuvant chemotherapy.

Li J, Chen S, Chen C, Di G, Liu G, Wu J, Shao Z.

Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China; Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

We retrospective analyzed triple negative breast cancer (TNBC) patients who received either taxane-based or anthracycline-based neoadjuvant chemotherapy, evaluated whether pathological complete response (pCR) is a surrogate endpoint for relapse free survival (RFS) in TNBC and explored which subgroup of patients benefits more from superior treatment regimen. 186 patients received taxane-based (Group A) or anthracycline-based (Group B) neoadjuvant chemotherapy, median follow-up was 48.1 months. 42 patients received total pCR (ypT0/is ypN0), 34 in Group A and 8 in Group B, p < 0.001. Patients who achieved pCR had an increased RFS when compared with non-pCR patients, p = 0.043. Patients in Group A had a better RFS, p = 0.025, after adjusting for tumor size and clinical lymph node status before neoadjuvant therapy. Only patients sensitive to neoadjuvant chemotherapy exhibited RFS benefit from taxane-based treatment, and those who were treatment insensitive had similar RFS between both groups. Our analysis showed Taxane-based regimen had higher pCR rate and could predict improved RFS in TNBC, and the prognostic value was greater in treatment sensitive patients. This retrospective analysis supports the use of pCR as a surrogate endpoint for RFS in TNBC.

KEYWORDS: breast cancer; neoadjuvant; pathological complete response; triple negative

PMID: 27191991

DOI: 10.18632/oncotarget.9369