Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer
Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer
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DOI：
10.1200/jco.2007.14.4147
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发表时间：
2008-03-10
影响因子：
45.3
通讯作者：
Pusztai, Lajos
中科院分区：
文献类型：
--
作者：
Liedtke, Cornelia;Mazouni, Chafika;Pusztai, Lajos
目的三阴性乳腺癌(TNBC)的定义是雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER-2)表达缺失。在这项研究中，我们比较了TNBC患者和非TNBC患者对新辅助化疗的反应和生存率。我们纳入了从1985年到2004年在M.D.安德森癌症中心接受新辅助化疗的1,118名I-III期乳腺癌患者，他们的完整受体信息是可用的。比较TNBC患者和非TNBC患者的临床和病理参数、病理完全应答率(PCR)、生存期测量和器官特异性复发率。与非TNBC患者相比，TNBC患者的PCR率显著升高(22%比11%；P=.034)，但三年无进展生存率(P<；.0001)和三年总生存率(OS)降低(P<；.0001)。TNBC与内脏转移风险增加(P=.0005)、骨复发风险降低(P=.027)和复发后生存期缩短(P<；.0001)相关。仅在前3年，TNBC的复发率和死亡率较高。如果实现了聚合酶链式反应，TNBC和非TNBC患者的存活率相似(P=0.24)。与之形成鲜明对比的是，有TNBC的残留病患者的预后较非TNBC患者差(P<；0.0001)。结论有TNBC的患者较无TNBC的患者有更高的PCR率，且有PCR者具有良好的生存。然而，新辅助化疗后的RD患者如果有TNBC与非TNBC的患者相比，他们的生存率显著下降，尤其是在前3年。
PurposeTriple-negative breast cancer (TNBC) is defined by the lack of estrogen receptor (ER), progesterone receptor ( PR), and human epidermal growth factor receptor 2 (HER-2) expression. In this study, we compared response to neoadjuvant chemotherapy and survival between patients with TNBC and non-TNBC.Patients and MethodsAnalysis of a prospectively collected clinical database was performed. We included 1,118 patients who received neoadjuvant chemotherapy at M. D. Anderson Cancer Center for stage I-III breast cancer from 1985 to 2004 and for whom complete receptor information were available. Clinical and pathologic parameters, pathologic complete response rates (pCR), survival measurements, and organ-specific relapse rates were compared between patients with TNBC and non-TNBC.ResultsTwo hundred fifty-five patients (23%) had TNBC. Patients with TNBC compared with non- TNBC had significantly higher pCR rates (22% v 11%; P = .034), but decreased 3-year progression-free survival rates (P < .0001) and 3-year overall survival (OS) rates (P < .0001). TNBC was associated with increased risk for visceral metastases (P = .0005), lower risk for bone recurrence (P = .027), and shorter postrecurrence survival (P < .0001). Recurrence and death rates were higher for TNBC only in the first 3 years. If pCR was achieved, patients with TNBC and non-TNBC had similar survival (P = .24). In contrast, patients with residual disease (RD) had worse OS if they had TNBC compared with non-TNBC (P < .0001).ConclusionPatients with TNBC have increased pCR rates compared with non-TNBC, and those with pCR have excellent survival. However, patients with RD after neoadjuvant chemotherapy have significantly worse survival if they have TNBC compared with non-TNBC, particularly in the first 3 years.