铂类在三阴性乳腺癌新辅助治疗中的应用进展及疗效预测作用

Platinum in neoadjuvant therapy for triple-negative breast cancer

三阴性乳腺癌(triple-negative breast cancer,TNBC)标准新辅助化疗方案是蒽环序贯紫衫,在此基础上联合铂类能显著提高病理学完全缓解率和远期生存率,但同时会带来治疗相关不良反应。如何精准预测获益人群是目前研究的重点。同源重组修复缺陷(homologous recombination deficiency,HRD)能识别从新辅助含铂方案中获益的患者,特别是BRCA野生型但携带HRD的肿瘤。对于BRCA突变患者,以蒽环为基础的新辅助化疗已足够;而非HRD携带者将不能从铂类药物中获益。

Although adding platinum to taxane-and anthracycline-based neoadjuvant chemotherapy regimens for triple-negative breast cancer(TNBC)patients can significantly improve the pathological complete response(pCR)rate and long-term survival,it is associated with higher treatment-related adverse events(AEs).Current researches focus on the response predictors to select patients who may benefit from platinum-based chemotherapy.Homologous recombination deficiency(HRD)can identify patients who truly need platinum drugs,that is,those with BRCA wild-type but HRD tumors.Results suggest that anthracycline-based chemotherapy is sufficient for BRCA mutation carriers and that non-HRD carriers will not benefit from the added carboplatin.