Pathologic Complete Response Rates in Young Women With BRCA1-Positive Breast Cancers After Neoadjuvant Chemotherapy
Pathologic Complete Response Rates in Young Women With BRCA1-Positive Breast Cancers After Neoadjuvant Chemotherapy
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DOI：
10.1200/jco.2008.20.7019
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发表时间：
2010-01-20
影响因子：
45.3
通讯作者：
Narod, Steven
中科院分区：
文献类型：
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作者：
Byrski, Tomasz;Gronwald, Jacek;Narod, Steven
PurposeTo estimate the rate of psychological complete response（pCR）to neoadjuvant chemotherapy in BRCA1 mutation carriers according to chemotherapy regimen.Patients and MethodsFrom a registry of 6，903 patients，we identified 102 women who carried a BRCA1 founder mutation and who had been treated for breast cancer with neoadjuvant chemotherapy.使用标准criterions.ResultsTwenty-four（24%）的102 BRCA 1突变携带者经历了pCR的病理完全反应进行了评价。不同治疗的缓解率差异很大：环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF）治疗的14名妇女中有1名（7%）达到pCR，多柔比星和多西他赛（AT）治疗的25名妇女中有2名（8%）达到pCR;在51名接受多柔比星和环磷酰胺（AC）或氟尿嘧啶、多柔比星和环磷酰胺（FAC）治疗的妇女中，12例接受顺铂治疗的妇女中有10例（83%）pCR。结论在接受AT或CMF治疗的乳腺癌和BRCA 1突变的妇女中观察到低pCR率。顺铂治疗后，pCR率较高。AC或FAC与PCR的中间率相关。AC和铂类治疗的相对获益需要通过对该队列和其他队列的随访来证实。
PurposeTo estimate the rate of pathologic complete response (pCR) to neoadjuvant chemotherapy in BRCA1 mutation carriers according to chemotherapy regimen.Patients and MethodsFrom a registry of 6,903 patients, we identified 102 women who carried a BRCA1 founder mutation and who had been treated for breast cancer with neoadjuvant chemotherapy. Pathologic complete response was evaluated using standard criteria.ResultsTwenty-four (24%) of the 102 BRCA1 mutation carriers experienced a pCR. The response rate varied widely with treatment: a pCR was observed in one (7%) of 14 women treated with cyclophosphamide, methotrexate, and fluorouracil (CMF); in two (8%) of 25 women treated with doxorubicin and docetaxel (AT); in 11 (22%) of 51 women treated with doxorubicin and cyclophosphamide (AC) or fluorouracil, doxorubicin, and cyclophosphamide (FAC), and in 10 (83%) of 12 women treated with cisplatin.ConclusionA low rate of pCR was observed in women with breast cancer and a BRCA1 mutation who were treated with AT or CMF. A high rate of pCR was seen after treatment with cisplatin. An intermediate rate of PCR was associated with AC or FAC. The relative benefits of AC and platinum therapy need to be confirmed through follow-up of this and other cohorts.