Introduction: Data are lacking on the optimal neoadjuvant systemic treatment (NST) for women with hormone receptor-positive (HR+) human epidermal growth factor receptor 2-positive (HER2+) breast cancer if they are unfit to receive the combination of chemotherapy and anti-HER2 therapy. The aim of this study was to determine whether the rates of ypT0 and ypN0 differ between patients treated with neoadjuvant endocrine therapy (NET) versus NET combined with anti-HER2 therapy (NET+aHER2).Materials and Methods: Data from the Netherlands Cancer Registry were analysed to identify women diagnosed with primary HR+/HER2+ breast cancer between 2008 and 2019, treated with either NET or NET+aHER2. The ypT0 and ypN0 rates were analysed (using uni- and multivariable logistic regression analyses, as applicable) in relation to the characteristics of the patient, the tumour, and the treatment.Results: Of the 190 patients identified (median age 77), 150 had been treated with NET and 40 with NET+aHER2. Patients with clinically node-positive disease (cN+) were significantly more likely to have been treated with NET+aHER2 (p= 0.029). The ypT0 rate was significantly higher after NET+aHER2, with 10.0% (4/40) versus 1.3% (2/150) following NET (p= 0.019). The ypN0 rate was significantly higher after NET+aHER2, with 25.0% (6/24) versus 5.5% (3/55) following NET in the cN+ patients (p= 0.020) and 81.3% (13/16) versus 55.8% (53/95) after NET in the cN- patients (p= 0.047). In the cN- patients, the ypN0 status was independently associated with age (p= 0.008) and the administration of NET+aHER2 (p= 0.016).Conclusions: The rates of ypT0 and ypN0 in women with HR+/HER2+ breast cancer treated with NST was significantly higher following NET+aHER2 than after NET.
引言：对于不适合接受化疗联合抗HER2治疗的激素受体阳性（HR+）人表皮生长因子受体2阳性（HER2+）乳腺癌女性患者，目前缺乏关于其最佳新辅助全身治疗（NST）方案的数据。本研究旨在比较接受新辅助内分泌治疗（NET）与NET联合抗HER2治疗（NET+aHER2）的患者在病理完全缓解（ypT0）和淋巴结阴性（ypN0）率方面的差异。 材料与方法：通过分析荷兰癌症登记处的数据，筛选出2008年至2019年间确诊为原发性HR+/HER2+乳腺癌并接受NET或NET+aHER2治疗的女性患者。采用单变量及多变量逻辑回归分析方法，评估患者特征、肿瘤特征及治疗方案与ypT0和ypN0率之间的相关性。 结果：在纳入的190例患者（中位年龄77岁）中，150例接受NET治疗，40例接受NET+aHER2治疗。临床淋巴结阳性（cN+）患者接受NET+aHER2治疗的比例显著更高（p=0.029）。NET+aHER2组的ypT0率显著高于NET组（10.0% [4/40] vs. 1.3% [2/150]，p=0.019）。在cN+患者中，NET+aHER2组的ypN0率显著更高（25.0% [6/24] vs. NET组5.5% [3/55]，p=0.020）；在cN-患者中，NET+aHER2组的ypN0率亦显著高于NET组（81.3% [13/16] vs. 55.8% [53/95]，p=0.047）。多变量分析显示，在cN-患者中，ypN0状态与年龄（p=0.008）及接受NET+aHER2治疗（p=0.016）独立相关。 结论：对于接受NST的HR+/HER2+乳腺癌女性患者，NET联合抗HER2治疗组的ypT0和ypN0率均显著高于单纯NET治疗组。
肿瘤(癌症)患者之家