J Clin Oncol:辅助紫杉醇和曲妥珠单抗试验治疗结节阴性、人表皮生长因子受体2阳性乳腺癌的七年随访分析

2020-06-14 MedSci原创 MedSci原创

紫杉醇和曲妥珠单抗辅助试验旨在解决人类小表皮生长因子受体2(HER2)阳性乳腺癌患者的治疗问题。辅助紫杉醇和曲妥珠单抗试验的主要分析表明,3年无病生存期(DFS)为98.7%。在这项计划中的二级分析中

紫杉醇和曲妥珠单抗辅助试验旨在解决人类小表皮生长因子受体2(HER2)阳性乳腺癌患者的治疗问题。辅助紫杉醇和曲妥珠单抗试验的主要分析表明,3年无病生存期(DFS)为98.7%。在这项计划中的二级分析中,我们报告了更长期的结果和探索性结果,以确定HER2阳性小肿瘤的生物学特性以及可能易导致紫杉醇诱导的周围神经病变(TIPN)的遗传因素。

在这项II期研究中,HER2阳性的乳腺癌患者,肿瘤3cm或更小,阴性结节,接受紫杉醇(80mg/m2)与曲妥珠单抗治疗12周,随后接受曲妥珠单抗治疗9个月。主要终点是DFS。还分析了无复发间隔(RFI)、乳腺癌特异性生存和总生存(OS)。在探索性分析中,通过PAM50(Prosigna)进行内在亚型,并在nCounter分析系统上对存档组织进行复发风险评分的计算。对TIPN进行基因分型调查。

2007年10月至2010年9月,共有410名患者入组。经过6.5年的中位随访,共发生23例DFS事件。7年DFS为93%(95% CI,90.4~96.2),其中4例(1.0%)远处复发,7年OS为95%(95% CI,92.4~97.7),7年RFI为97.5%(95% CI,95.9~99.1)。PAM50分析(n = 278)显示,大多数肿瘤为HER2富集型(66%),其次是腔隙B(14%)、腔隙A(13%)和基底样(8%)。基因分型(n = 230)发现一个单核苷酸多态性,rs3012437,与2级或更高的TIPN患者的TIPN风险增加有关(10.4%)。

总之,随着随访时间的延长,辅助紫杉醇和曲妥珠单抗与优良的长期结局相关。小HER2阳性肿瘤中PAM50固有亚型的分布与之前报道的较大肿瘤相似。

原始出处:

Sara M TolaneyHao Guo, et al., Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Clin Oncol. 2019 Aug 1;37(22):1868-1875.

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    2021-01-17 minlingfeng
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    2020-06-15 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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