Efficacy analysis of neoadjuvant chemotherapy with or without anthracyclines in female patients with HER2-positive breast cancer in China: a nationwide, multicenter, 10-year retrospective study (CSBrS-012)
机构：[1]Xi An Jiao Tong Univ, Dept Breast Surg, Affiliated Hosp 1, 277 West Yanta Rd, Xian 710061, Shaanxi, Peoples R China[2]First Hosp Jilin Univ, Dept Breast Surg, 71 Xinmin St, Changchun 130021, Jilin, Peoples R China[3]Zhengzhou Univ, Affiliated Canc Hosp, Henan Breast Canc Ctr, Dept Breast Dis, Zhengzhou, Henan, Peoples R China河南省肿瘤医院[4]Henan Canc Hosp, Zhengzhou, Henan, Peoples R China河南省肿瘤医院[5]Fourth Mil Med Univ, Xijing Hosp, Dept Thyroid Breast & Vasc Surg, Xian, Shaanxi, Peoples R China[6]China Med Univ, Surg Oncol Dept, Shengjing Hosp, Shenyang, Liaoning, Peoples R China中国医科大学附属盛京医院中国医科大学盛京医院[7]Chinese Acad Sci, Zhejiang Canc Hosp, Inst Basic Med & Canc IBMC, Canc Hosp,Univ Chinese Acad Sci,Dept Breast Surg, Hangzhou, Zhejiang, Peoples R China浙江省肿瘤医院[8]Hebei Med Univ, Hosp 4, Dept Surg, Shijiazhuang, Hebei, Peoples R China河北医科大学第四医院[9]Jilin Canc Hosp, Dept Breast Surg 4, Changchun, Jilin, Peoples R China[10]Harbin Med Univ, Affiliated Hosp 2, Dept Breast Surg, Harbin, Heilongjiang, Peoples R China[11]Guizhou Med Univ, Affiliated Wudang Hosp, Dept Breast Surg, Guiyang, Guizhou, Peoples R China[12]Shandong Univ, Hosp 2, Cheeloo Coll Med, Dept Breast Surg, Jinan, Shandong, Peoples R China[13]Peking Univ First Hosp, Breast Dis Ctr, Beijing, Peoples R China[14]Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Breast Surg, Hangzhou, Zhejiang, Peoples R China浙江大学医学院附属第一医院[15]Chinese Peoples Liberat Army Gen Hosp, Med Ctr 1, Dept Gen Surg, Beijing, Peoples R China[16]Capital Med Univ, Beijing Chaoyang Hosp, Dept Breast Surg, Beijing, Peoples R China北京朝阳医院[17]Dalian Med Univ, Affiliated Hosp 2, Dept Breast Surg, Dalian, Liaoning, Peoples R China[18]Shandong Univ, Dept Breast & Thyroid Surg, Shandong Prov Hosp, Jinan, Shandong, Peoples R China[19]Inner Mongolia Autonomous Reg Peoples Hosp, Dept Thyroid Breast Hernia Surg, Hohhot, Inner Mongolia, Peoples R China[20]Fudan Univ, Dept Breast Surg, Obstet & Gynecol Hosp, Shanghai, Peoples R China[21]Lanzhou Univ Second Hosp, Dept Gen Surg, Lanzhou, Gansu, Peoples R China[22]China Med Univ, Dept Breast Surg, Hosp 1, Shenyang, Liaoning, Peoples R China
Background:In the era of targeted therapy, whether patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer are exempted from anthracycline usage in the neoadjuvant setting is controversial. Objectives:Our objective was to retrospectively analyze the differences in pathological complete remission (pCR) rates between the anthracycline group and the nonanthracycline group. Design:The CSBrS-012 study (2010-2020) included female primary breast cancer patients with neoadjuvant chemotherapy (NAC) who underwent standard breast and axillary surgery post-NAC. Methods:A logistic proportional hazard model was applied to estimate the association of covariates with pCR. Propensity score matching (PSM) was performed to balance the differences in baseline characteristics, and subgroup analyses were performed using the Cochran-Mantel-Haenszel test. Results:A total of 2507 patients were enrolled: the anthracycline group (n = 1581, 63%) and the nonanthracycline group (n = 926, 37%). A pCR was recorded in 17.1% (271/1581) of patients in the anthracycline group and in 29.3% (271/926) in the nonanthracycline group, and the difference in the pCR rate between the two groups was statistically significant [odds ratio (OR) = 2.00, 95% confidence interval (CI) (1.65-2.43); p < 0.001). In the subsequent subgroup analysis, substantial differences in pCR rates between the anthracycline and nonanthracycline groups were detected in the nontargeted [OR = 1.91, 95% CI (1.13-3.23); p = 0.015] and dual-HER2-targeted populations [OR = 0.55, 95% CI (0.33-0.92); p = 0.021) before PSM, whereas differences vanished after PSM. The pCR rates between the anthracycline and nonanthracycline groups did not differ for the single target population, either before or after PSM. Conclusion:In the presence of trastuzumab and/or pertuzumab, the pCR rate of patients with HER2-positive breast cancer receiving anthracycline was not superior to that of patients receiving nonanthracycline. Thus, our study further provides clinical evidence for exempting anthracycline treatment in HER2-positive breast cancer in the era of targeted therapy.
基金：
Institutional Foundation of The First Affiliated Hospital of Xi'an Jiaotong University [CSBrS-012]; [2022YQPY08]
第一作者机构：[1]Xi An Jiao Tong Univ, Dept Breast Surg, Affiliated Hosp 1, 277 West Yanta Rd, Xian 710061, Shaanxi, Peoples R China
通讯作者：
推荐引用方式(GB/T 7714)：
Chen Heyan,Maimaitiaili Amina,Liu Zhenzhen,et al.Efficacy analysis of neoadjuvant chemotherapy with or without anthracyclines in female patients with HER2-positive breast cancer in China: a nationwide, multicenter, 10-year retrospective study (CSBrS-012)[J].THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY.2023,15:doi:10.1177/17588359231156146.
APA：
Chen, Heyan,Maimaitiaili, Amina,Liu, Zhenzhen,Ling, Rui,Zhao, Yi...&Zhang, Huimin.(2023).Efficacy analysis of neoadjuvant chemotherapy with or without anthracyclines in female patients with HER2-positive breast cancer in China: a nationwide, multicenter, 10-year retrospective study (CSBrS-012).THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY,15,
MLA：
Chen, Heyan,et al."Efficacy analysis of neoadjuvant chemotherapy with or without anthracyclines in female patients with HER2-positive breast cancer in China: a nationwide, multicenter, 10-year retrospective study (CSBrS-012)".THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY 15.(2023)
