The survival benefit of adjuvant trastuzumab with or without chemotherapy in the management of small (T1mic, T1a, T1b, T1c), node negative HER2+ breast cancer.

IF 6.5 2区医学 Q1 ONCOLOGY NPJ Breast Cancer Pub Date : 2024-06-19 DOI:10.1038/s41523-024-00652-4

Kai C C Johnson, Ai Ni, Dionisia Quiroga, Ashley C Pariser, Preeti K Sudheendra, Nicole O Williams, Sagar D Sardesai, Mathew Cherian, Daniel G Stover, Margaret Gatti-Mays, Bhuvaneswari Ramaswamy, Maryam Lustberg, Sachin Jhawar, Roman Skoracki, Robert Wesolowski

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Abstract

There is limited data regarding the added benefit of adjuvant systemic therapy in the management of small, node-negative, HER2+ breast cancer. In a multi-institutional retrospective analysis using the American Society of Clinical Oncology CancerLinQ database, we compared survival outcomes among T1a-c N0 HER2+ patients diagnosed between 2010 to 2021 who received locoregional therapy alone or in combination with adjuvant trastuzumab (+/- chemotherapy). Primary outcomes were invasive disease-free survival (iDFS) and overall survival (OS). Of the 1,184 patients, 436 received locoregional therapy alone. We found a statistically significant improvement in iDFS (HR 0.73, P = 0.003) and OS (HR 0.63, P = 0.023) on univariate analysis with adjuvant trastuzumab with or without chemotherapy which remained statistically significant on multivariate analysis. Three-arm univariate analysis found that iDFS was significantly improved with trastuzumab monotherapy (P = 0.003) and combination therapy (P = 0.027) compared to observation. Subgroup data suggests that T1b/c tumors derive the greatest benefit.

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曲妥珠单抗辅助化疗或不辅助化疗在治疗小型（T1mic、T1a、T1b、T1c）、结节阴性 HER2+ 乳腺癌中的生存获益。

在治疗小结节阴性 HER2+ 乳腺癌方面，有关辅助性全身治疗的额外益处的数据非常有限。在一项利用美国临床肿瘤学会 CancerLinQ 数据库进行的多机构回顾性分析中，我们比较了 2010 年至 2021 年期间确诊的 T1a-c N0 HER2+ 患者中单独或联合曲妥珠单抗（+/- 化疗）辅助局部治疗的生存结果。主要结果为侵袭性无病生存期（iDFS）和总生存期（OS）。在1184名患者中，有436人单独接受了局部治疗。我们发现，在单变量分析中，曲妥珠单抗辅助化疗或不辅助化疗可显著提高iDFS（HR 0.73，P = 0.003）和OS（HR 0.63，P = 0.023），而在多变量分析中，这两项指标仍具有统计学意义。三臂单变量分析发现，与观察组相比，曲妥珠单抗单药治疗（P = 0.003）和联合治疗（P = 0.027）可显著改善iDFS。亚组数据表明，T1b/c肿瘤获益最大。

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来源期刊

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.