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.
ObjectiveTo investigate the expression of epidermal growth factor receptor (EGFR) in triple-negative breast cancer (TNBC) and its relation with clinicopathologic features. MethodsA computer search of PubMed, Web of Science, CNKI, Wanfang Data, and VIP databases were conducted to select clinical studies on EGFR expression in the TNBC according to the inclusion and exclusion criteria, and the search period was from database establishment to January 2022. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature before conducting meta-analysis using RevMan 5.4 software. ResultsA total of 28 studies including 7 956 patients were included. The results of meta-analysis showed that the positive rate of EGFR expression in the TNBC patients was higher than that in the non-TNBC patients [OR=5.16, 95%CI (4.04, 6.58), P<0.000 01], and the proportions of patients with axillary lymph node metastasis [OR=3.11, 95%CI (1.56, 6.19), P=0.001] and with tumor diameter >2 cm [OR=2.09, 95%CI (1.18, 3.72), P=0.01] in the patients with EGFR positive were higher than those the patients with EGFR negative, no correlation was found that the proportion of patients with histological WHO classification 3 between the patients with EGFR positive expression and EGFR negative expression (P=0.07). ConclusionFrom the results of this meta-analysis, EGFR expression might be associated with the occurrence, development, and metastasis of patients with TNBC.
Objective To systematically evaluate the efficacy and safety of dose-dense neoadjuvant chemotherapy (ddNACT) and conventional neoadjuvant chemotherapy (cNACT) for locally advanced breast cancer (LABC). Methods PubMed, Embase, Web of Science, CNKI, Wanfang Data, and VIP databases were searched for randomized controlled trials (RCT) comparing ddNACT regimen with cNACT regimen for breast cancer. The time limit for retrieval was from establishment to March 1st, 2021. Two reviewers independently screened literatures, extracted data and assessed risk bias of included studies; then, meta-analysis was performed by using Stata 15.0 software. Results A total of 13 RCTs were included, including 3 258 patients, of which 1 625 patients received ddNACT and 1 633 patients received cNACT. The results of meta-analysis showed that the ddNACT regimen could improve the pathological complete response rate (pCR, P<0.001), objective response rate (ORR, P<0.001), and disease free survival (DFS, P=0.037) as compared with the cNACT regimen, there was no significant difference in the overall survival (OS) between the two groups (P=0.098). The incidences of grade 3 or 4 oral stomatitis (P=0.005) and neurotoxicity (P<0.001) were higher and the incidence of grade 3 or 4 neutropenia was lower (P=0.025) in the patients with ddNACT regimen, there were no significant differences in grade 3 or 4 thrombocytopenia (P=0.152), grade 3 or 4 anemia (P=0.123), chemotherapy completion rate (P=0.161) and breast conservative surgery rate (P=0.186) between the two groups. Patients with hormone receptor (HR) negative (HR–) were more likely to get pCR after neoadjuvant chemotherapy (P<0.001). ConclusionsCurrent evidence shows that the use of anthracycline/taxane-based ddNACT regimen in LABC patients can improve the pCR, ORR, and DFS as compared with cNACT regimen. The pCR after neoadjuvant chemotherapy in the patients with HR– is higher than that with HR+. Prophylactic use of granulocyte-colony stimulating factor could significantly reduce the incidence of neutropenia, and most patients are tolerant to ddNACT regimen, 2 regimens have similar chemotherapy completion rates.