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find Author "吴云秋" 2 results
  • Comparison of efficacy of neoadjuvant chemotherapy in treatment of patients with triple positive breast cancer and HER2 overexpression breast cancer

    ObjectiveTo compare the clinicopathologic characteristics and the difference of efficacy after neoadjuvant chemotherapy (NACT) between the patients with triple positive breast cancer (TPBC) and human epidermal growth factor receptor 2 (HER2) overexpression breast cancer. MethodsThe patients with TPBC and HER2 overexpression breast cancer admitted to the Affiliated Hospital of Southwest Medical University from January 2019 to July 2021 who met the inclusion conditions of this study were retrospectively collected, and the differences of clinicopathologic characteristics and the efficacy after NACT were compared between the patients with TPBC and HER2overexpression breast cancer. Meanwhile the risk factors affecting the efficacy of NACT were analyzed by logistic regression according to the risk factors of pCR based on the statistically significant indicators of univariate analysis and the indicators related to clinical characteristics. The HER2 overexpressing breast cancer was positive HER2, negative estrogen receptor (ER) and progesterone receptor (PR), and the TPBC was positive HER2, ER, and PR. The pathological complete response (pCR) was used to evaluate the efficacy, which was defined as ypT0/isypN0. ResultsA total of 105 patients were enrolled in this study, including 57 patients with TPBC and 48 patients with HER2 overexpression breast cancer, as well as 50 patients with pCR and 55 patients with non-pCR. ① Compared with patients with TPBC, the patients with HER2 overexpression breast cancer had the higher proportions of Miller-Payne system grade 4–5, partial response, pCR, and neutrophil-lymphocyte ratio (NLR) >2.77 (P<0.05). There were no statistical differences in other characteristics such as age, family history of breast cancer, histological grade, T and TNM stages, lymph node metastasis, lymphocyte-monocyte ratio, Ki-67 expression, and surgical method between them (P>0.05). ② The results of logistic multivariate analysis showed that the later T stage, the lower Ki-67 expression, the lower NLR, and the positive ER and PR statuses were not easy to achieve pCR after NACT (P<0.05). ConclusionsAccording to the results of this study, the efficacy of patients with HER2 overexpression breast cancer receiving NACT is more likely to achieve pCR than that of patients with TPBC. Positive hormone receptors (ER and PR), later T stage (stage 3–4), lower Ki-67 expression, and lower NLR (≤2.77) might be a worse efficacy after NACT for patients with breast cancer.

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  • 曲妥珠单抗生物类似药与原研曲妥珠单抗联合帕妥珠单抗治疗HER2阳性乳腺癌患者疗效与安全性的回顾性队列研究

    目的比较HER2阳性乳腺癌患者在新辅助治疗中原研曲妥珠单抗与生物类似药的病理完全缓解(pathologic complete response,pCR)率及不良事件发生率的差异。方法采用回顾性分析法,收集 2021年1月至2022年10月期间在西南医科大学附属医院乳腺外科完成TCbHP方案新辅助治疗及手术治疗的 117例人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER2) 阳性乳腺癌患者的临床病理资料。疗效评价依据实体肿瘤疗效评价标准(RECIST)1.1和 Miller-Payne(MP)系统,采用不良事件通用术语标准5.0进行不良事件发生率统计。结果117例患者中达到总体病理完全缓解(total pathologic complete response,tpCR)者曲妥珠单抗生物类似药汉曲优(HLX02,Zercepac)组占比70.2% (33/47),原研曲妥珠单抗赫赛汀组占比72.9% (51/70),2组比较差异无统计学意义(P=0.755);达到乳腺病理完全缓解(breast pathologic complete response,bpCR)者汉曲优组占比76.6% (36/47),赫赛汀组占比74.3.9% (52/70),2组比较差异无统计学意义(P=0.777)。分子分型为HER2+HR+ (三阳性)组与HER2+HR–(HER2过表达)组患者的tpCR率比较差异有统计学意义(61.6%比88.6%,P=0.002),bpCR率比较差异也有统计学意义(67.1%比88.6%,P=0.009)。在HER2+HR+患者中汉曲优组与赫赛汀组的tpCR率比较差异无统计学意义(66.7%比57.5%,P=0.423),bpCR率比较差异也无统计学意义(75.8%比60.0%,P=0.154);在HER2+HR–患者中汉曲优组与赫赛汀组的的tpCR率比较差异无统计学意义(78.6%比93.3%,P=0.354),bpCR率比较差异也无统计学意义(78.6%比93.3%,P=0.354)。治疗后所有患者均出现了可控的不良事件, 2组患者在心脏、血液系统和肝肾功能方面的不良事件发生率以及 ≥3 级不良事件的发生率均相似,差异均无统计学意义(P>0.05)。结论赫赛汀与其生物类似药汉曲优在新辅助治疗中的疗效和安全性相似,这为 HER2 阳性乳腺癌患者提供了更多的治疗选择。

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