Clinical and Genetic Predictive Models for the Prediction of Pathological Complete Response to Optimize the Effectiveness for Trastuzumab Based Chemotherapy.
Clinical and Genetic Predictive Models for the Prediction of Pathological Complete Response to Optimize the Effectiveness for Trastuzumab Based Chemotherapy.
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用于预测病理完全缓解以优化基于曲妥珠单抗的化疗效果的临床和遗传预测模型
DOI：
10.3389/fonc.2021.592393
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发表时间：
2021
影响因子：
4.7
通讯作者：
Wu J
中科院分区：
文献类型：
--
作者：
Li L;Chen M;Zheng S;Li H;Chi W;Xiu B;Zhang Q;Hou J;Wang J;Wu J
研究背景曲妥珠单抗对HER2+乳腺癌患者有很好的疗效，但仍有20%的患者治疗无效。我们进行了一项回顾性队列研究，以优化HER2+乳腺癌患者的新辅助化疗和曲妥珠单抗治疗。方法对600例患者进行分析，找出病理完全应答者的临床特征，建立临床预测模型。还对现有的RNA序列数据进行了综述，以开发用于聚合酶链式反应的遗传模型。结果PCR率为39.8%，且PCR值与较好的无病生存率和总生存率相关。ER阴性和PR阴性、HER2 IHC评分高、Ki-67高和曲妥珠单抗的使用与PCR值的改善相关。每周用紫杉醇和卡铂的PCR率最高(46.70%)，最低的是蒽环素+紫杉烷方案(11.11%)。分析了四个已发表的GEO数据集，并建立了用于PCR的10基因模型和免疫签名。非聚合酶链式反应阳性患者为ER+PR+，免疫标志物和基因模式评分较低。激素受体状态和免疫标志是PCR值的独立预测因素。结论激素受体状态和10基因模型可独立预测PCR值，可用于患者选择和药物疗效优化。
Background Trastuzumab shows excellent benefits for HER2+ breast cancer patients, although 20% treated remain unresponsive. We conducted a retrospective cohort study to optimize neoadjuvant chemotherapy and trastuzumab treatment in HER2+ breast cancer patients. Methods Six hundred patients were analyzed to identify clinical characteristics of those not achieving a pathological complete response (pCR) to develop a clinical predictive model. Available RNA sequence data was also reviewed to develop a genetic model for pCR. Results The pCR rate was 39.8% and pCR was associated with superior disease free survival and overall survival. ER negativity and PR negativity, higher HER2 IHC scores, higher Ki-67, and trastuzumab use were associated with improved pCR. Weekly paclitaxel and carboplatin had the highest pCR rate (46.70%) and the anthracycline+taxanes regimen had the lowest rate (11.11%). Four published GEO datasets were analyzed and a 10-gene model and immune signature for pCR were developed. Non-pCR patients were ER+PR+ and had a lower immune signature and gene model score. Hormone receptor status and immune signatures were independent predictive factors of pCR. Conclusion Hormone receptor status and a 10-gene model could predict pCR independently and may be applied for patient selection and drug effectiveness optimization.
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DOI：
10.1007/s00432-019-03083-y
发表时间：
2020-02-01
影响因子：
3.6
作者：
LeVasseur, Nathalie;Sun, J.;Chia, S.
通讯作者：
Chia, S.
影响因子：
8.2
作者：
Gu CL;Zhu HX;Deng L;Meng XQ;Li K;Xu W;Zhao L;Liu YQ;Zhu ZP;Huang HM
通讯作者：
Huang HM
影响因子：
50.5
作者：
Lesurf, R.;Griffith, O. L.;Mardis, E. R.
通讯作者：
Mardis, E. R.
影响因子：
45.3
作者：
Fernandez-Martinez, Aranzazu;Krop, Ian E.;Carey, Lisa A.
通讯作者：
Carey, Lisa A.
影响因子：
3.8
作者：
McGuire A;Kalinina O;Holian E;Curran C;Malone CA;McLaughlin R;Lowery A;Brown JAL;Kerin MJ
通讯作者：
Kerin MJ