Impact of neoadjuvant compared to adjuvant chemotherapy on prognosis in patients with hormone-receptor positive / HER2-negative breast cancer: A propensity score matching population-based study

IF 5.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY Breast Pub Date : 2024-05-09 DOI:10.1016/j.breast.2024.103741

Servah Hosseini-Mellner , Åsa Wickberg , Andreas Karakatsanis , Antonis Valachis

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Abstract

Background

The aim of this population-based cohort study was to investigate the impact of neoadjuvant chemotherapy (NACT) compared to adjuvant chemotherapy in prognosis among patients with HR+/HER2 negative breast cancer.

Method

This population-based study utilized data from the research database BCBaSe 3.0, based on the Swedish National Quality breast cancer register, including all patients with breast cancer diagnosis in Sweden between 2008 and 2019. Propensity score matching approach was applied. The outcomes of interest consisted of distant-disease free (DDFS), breast-cancer specific (BCSS), and overall survival (OS).

Results

In total, 14 459 patients were included in the study cohort of whom 2086 received NACT. After 1:1 propensity score matching (PSM), 1539 patients in each study group were available for analyses. No statistically significant difference in survival outcomes were observed between patients treated with NACT compared to those treated with adjuvant chemotherapy (Hazard Ratio (HR) for DDFS: 1.20; 95 % CI: 0.80–1.79; HR for BCSS: 1.16; 95 % CI: 0.54–2.49; HR for OS: 1.14; 95 % CI: 0.64–2.05).

Conclusion

In this population-based cohort study of patients with HR+/HER2-breast cancer, the use of NACT seems to be comparable to adjuvant chemotherapy in terms of prognosis, although non-inferiority cannot be proven by this study design. Until further evidence suggesting a survival benefit in favor of either treatment is available, NACT can be pursued when surgical-de-escalation is intended.

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新辅助化疗与辅助化疗对激素受体阳性/HER2阴性乳腺癌患者预后的影响：倾向评分匹配人群研究。

背景：这项基于人群的队列研究旨在调查新辅助化疗（NACT）与辅助化疗相比对HR+/HER2阴性乳腺癌患者预后的影响：这项基于人群的研究利用了研究数据库BCBaSe 3.0中的数据，该数据库基于瑞典国家优质乳腺癌登记册，包括2008年至2019年期间在瑞典确诊的所有乳腺癌患者。研究采用倾向得分匹配法。研究结果包括无远处转移（DDFS）、乳腺癌特异性（BCSS）和总生存期（OS）：共有 14 459 名患者被纳入研究队列，其中 2086 人接受了 NACT 治疗。经过1:1倾向评分匹配（PSM）后，每个研究组有1539名患者可供分析。与接受辅助化疗的患者相比，接受NACT治疗的患者在生存率方面没有明显的统计学差异（DDFS的危险比（HR）：1.20；95 % CI：0.80-1.79；BCSS的危险比（HR）：1.16；95 % CI：0.80-1.79）：1.16; 95 % CI: 0.54-2.49; OS：结论结论：在这项针对HR+/HER2-乳腺癌患者的人群队列研究中，就预后而言，使用NACT似乎与辅助化疗相当，尽管这项研究设计无法证明其非劣效性。在有更多证据表明任何一种治疗方法对患者的生存都有好处之前，可以在打算手术-升级治疗时使用 NACT。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast 医学-妇产科学

CiteScore

8.70

自引率

2.60%

发文量

165

审稿时长

59 days

期刊介绍： The Breast is an international, multidisciplinary journal for researchers and clinicians, which focuses on translational and clinical research for the advancement of breast cancer prevention, diagnosis and treatment of all stages.