Impact of the addition of carboplatin to anthracycline‐taxane‐based neoadjuvant chemotherapy on survival in BRCA1/2 ‐mutated triple‐negative breast cancer
Impact of the addition of carboplatin to anthracycline‐taxane‐based neoadjuvant chemotherapy on survival in BRCA1/2 ‐mutated triple‐negative breast cancer
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在基于蒽环类紫杉烷类药物的新辅助化疗中添加卡铂对 BRCA1/2 突变三阴性乳腺癌生存的影响
DOI：
10.1002/ijc.33234
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发表时间：
2020
影响因子：
6.4
通讯作者：
Xie Yuntao
中科院分区：
文献类型：
--
作者：
Zhang Juan;Yao Lu;Liu Yiqiang;Ouyang Tao;Li Jinfeng;Wang Tianfeng;Fan Zhaoqing;Fan Tie;Lin Benyao;Xie Yuntao
在标准新辅助化疗中加入卡铂是否能提高BRCA 1/2突变的三阴性乳腺癌（TNBC）的生存率尚不清楚。在这项回顾性研究中，我们旨在探索基于蒽环紫杉烷（A-T）或基于蒽环紫杉烷/卡铂（A-TP）的新辅助化疗在BRCA 1/2突变TNBC中的疗效。共1585例可手术的原发性乳腺癌患者接受新辅助A-T（n = 886）或A-TP方案（n = 699）治疗，所有受试者均检测BRCA 1和BRCA 2生殖细胞突变。估计病理完全缓解（pCR）、无复发生存期（RFS）、无远处复发生存期（DRFS）和总生存期（OS）。在整个队列中，102例患者（6.4%）携带致病性BRCA 1/2生殖系突变。中位随访81个月后，在整个队列中，A-T和A-TP组之间的生存率无显著差异。然而，在288例TNBC患者中，BRCA 1/2突变携带者接受A-TP方案治疗时的生存率显著高于A-T方案（5年RFS：82.6% vs 47.9%;P= 0.024; 5年DRFS：88.5% vs 46.9%;P= 0.010; 5年OS：88.2% vs 49.9%;P= 0.036）。多变量分析显示，A-TP方案是RFS和DRFS的显著有利因素，在BRCA 1/2突变的TNBC中，与A-T方案相比，显示出更好的OS趋势（RFS：校正风险比[HR]，0.24; 95%置信区间[CI]，0.06 - 0.91，P = .035; DRFS：HR，0.17; 95% CI，0.03 - 0.80;P= .025; OS：HR，0.29; 95% CI，0.06 - 1.49;P= 0.14）。我们的研究表明，当卡铂添加到标准的基于A-T的新辅助化疗中时，BRCA 1/2突变的TNBC患者获得生存益处。
Whether adding carboplatin to standard neoadjuvant chemotherapy improves survival inBRCA1/2‐mutated triple‐negative breast cancer (TNBC) is unknown. In this retrospective study, we aimed to explore the efficacy of anthracycline‐taxane (A‐T)‐based or anthracycline‐taxane/carboplatin (A‐TP)‐based neoadjuvant chemotherapy inBRCA1/2‐mutated TNBC. A total of 1585 operable primary breast cancer patients were treated with either neoadjuvant A‐T (n = 886) or A‐TP regimen (n = 699).BRCA1andBRCA2germline mutations were determined in all subjects. Pathological complete response (pCR), recurrence‐free survival (RFS), distant recurrence‐free survival (DRFS) and overall survival (OS) were estimated. Of the entire cohort, 102 patients (6.4%) carried a pathogenicBRCA1/2germline mutation. After a median follow‐up of 81 months, no significant differences in survival between the A‐T and A‐TP arms were found in the entire cohort. However, among 288 TNBC patients,BRCA1/2mutation carriers had significantly better survival when treated with the A‐TP regimen than with the A‐T regimen (5‐year RFS: 82.6% vs 47.9%;P= .024; 5‐year DRFS: 88.5% vs 46.9%;P= .010; 5‐year OS: 88.2% vs 49.9%;P= .036). Multivariate analyses revealed that the A‐TP regimen was a significantly favourable factor for RFS and DRFS and showed a trend towards better OS when compared with the A‐T regimen inBRCA1/2‐mutated TNBC (RFS: adjusted hazard ratio [HR], 0.24; 95% confidence interval [CI], 0.06‐0.91,P= .035; DRFS: HR, 0.17; 95% CI, 0.03‐0.80;P= .025; OS: HR, 0.29; 95% CI, 0.06‐1.49;P= .14). Our study suggested thatBRCA1/2‐mutated TNBC patients gain a survival benefit when carboplatin is added to standard A‐T‐based neoadjuvant chemotherapy.