Lancet Oncol:曲妥珠单抗+帕妥珠单抗±紫杉醇降级治疗HER2+/HR-早期乳腺癌

2022-04-20 Nebula MedSci原创

曲妥珠单抗+帕妥珠单抗±紫杉醇治疗12周后获得病理完全缓解的患者可获得很好的生存率

自2012年起,HER2阳性早期乳腺癌的(靶向)治疗策略得到了极大的优化。目前已探索了多种降级新辅助策略,以病理完全缓解作为替代终点来减少化疗的使用。本文汇报了WSG-ADAPT-HER2+/HR-试验的5年生存数据,并分析了病理完全缓解、早期治疗缓解和分子亚型的影响。

WSG-ADAPT-HER2+/HR-试验是一项由研究者发起的、多中心、开放标签、随机的2期研究,招募了年满18岁、组织学确诊、单侧、原发性浸润性、激素受体阴性和HER2阳性、非炎症性早期乳腺癌患者,随机(5:2)分成两组,接受曲妥珠单抗(首剂 8 mg/kg,随后 6 mg/kg·3周)+帕妥珠单抗(首剂 840 mg/kg,随后 420 mg/kg·3周)或曲妥珠单抗+帕妥珠单抗+紫杉醇(80 mg/m2·周)。主要终点是手术时的病理完全缓解率。

2014年3月3日至2015年10月6日期间,共招募了134位患者,随机分至两组:二联组 92位,三联组 42位。中位随访了59.9个月。治疗组间的无侵袭性疾病生存期、无复发生存期、局部无复发生存期、远处无病生存期和总生存期均无显著差异。


两治疗组的无侵袭性疾病生存率、远处无病生存率和总生存率

三联组和二联组的5年生存率分别是98%和87%(风险比[HR] 0.32,p=0.15);无复发生存率分别是98%和89%(HR 0.41, p=0.25);无局部复发生存率分别是100%和95%(HR 0.41, p=0.43);远处无病生存率分别是98%和92%(HR 0.35, p=0.36);总生存率分别是98%和94%(HR 0.41,p=0.43)。病理完全缓解率与无侵袭性疾病生存率提高相关(HR 0.14, p=0.011)。两治疗组各有一例病理完全缓解后的无侵袭性疾病生存事件。


有无病理完全缓解患者的无侵袭性疾病生存率

 

总之,该研究结果显示,曲妥珠单抗+帕妥珠单抗±紫杉醇治疗12周后获得病理完全缓解的患者可获得很好的生存率。省略进一步化疗并不影响病理完全缓解患者的无侵袭性疾病生存期。

 

原始出处:

Nitz Ulrike,Gluz Oleg,Graeser Monika et al. De-escalated neoadjuvant pertuzumab plus trastuzumab therapy with or without weekly paclitaxel in HER2-positive, hormone receptor-negative, early breast cancer (WSG-ADAPT-HER2+/HR-): survival outcomes from a multicentre, open-label, randomised, phase 2 trial.[J] .Lancet Oncol, 2022, https://doi.org/10.1016/S1470-2045(22)00159-0

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    2022-06-02 howi
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    2023-01-16 minlingfeng
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    2022-04-21 学医无涯

    了解一下

    0

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    2022-04-20 小路非

    ***

    0

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    2022-04-20 younei

    lancet上果然牛,感谢梅斯更新及时

    0

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现阶段,由于影像学上的早期治疗反应是预测乳腺癌pCR的一个指标,因此影像学检查在病情评估中至关重要。

European Radiology:全自动乳腺超声(ABUS)成像技术在乳腺病变诊断中的应用

自动乳腺超声(ABUS)可以代替常用的手持式超声(HHUS),实现图像采集的标准化,完全覆盖整个乳腺体积,并将采集任务交给技术人员以减少人为误差。

Radiology:人工智能,为女性乳腺癌筛查“减负”!

现阶段,人工智能(AI)模型的使用可以协助临床缩短乳腺筛查的评估时间。

Cell重大突破:西湖大学蔡尚团队首次证实细菌是乳腺癌转移的重要帮凶

首次证实乳腺癌组织中存在多种独特的 “胞内菌”,并揭示它们在肿瘤转移定植过程中所起的关键作用。这一理念是对传统肿瘤转移理论的重大突破,为深入理解肿瘤转移及临床治疗乳腺癌提供了全新的思路。

重磅!《2022年新版乳腺癌诊疗指南》正式发布

乳腺癌是女性常见的恶性肿瘤之一,发病率位居女性恶性肿瘤的首位,严重危害妇女的身心健康。

Nat Commun:HMMR过表达增加BRCA1相关乳腺癌患病风险

过表达HMMR可促进BRCA1相关乳腺癌的发生发展