白蛋白结合型紫杉醇或多西他赛联合卡铂新辅助治疗HER2阳性乳腺癌疗效比较

Comparison of Efficacy Between Nab-Paclitaxel or Docetaxel Combined with Carboplatin as Neoadjuvant Therapy for HER2-Positive Breast Cancer

目的比较在真实世界临床实践中曲妥珠单抗和帕妥珠单抗(HP)分别配伍白蛋白结合型紫杉醇加卡铂方案与多西他赛加卡铂方案新辅助治疗HER2阳性乳腺癌的疗效。方法回顾性收集2019年6月至2021年12月在河北省共11家三级甲等医院接受HP分别配伍白蛋白结合型紫杉醇加卡铂方案与多西他赛加卡铂方案新辅助治疗并完成后续手术的HER2阳性乳腺癌患者的临床资料,比较两组患者的总体病理完全缓解(tpCR)率。结果共纳入76例患者,其中白蛋白结合型紫杉醇组47例,多西他赛组29例。白蛋白结合型紫杉醇组tpCR率显著高于多西他赛组(72.3%vs.48.3%,χ^(2)=4.463,P=0.035)。亚组分析表明,年龄大于40岁、cN2-3、cTNMⅢ期、激素受体(+)、Ki67>30%患者中,白蛋白结合型紫杉醇组tpCR率高于多西他赛组,差异有统计学意义(P<0.05)。结论在真实世界临床实践中,HP配伍白蛋白结合型紫杉醇加卡铂方案新辅助治疗HER2阳性乳腺癌的疗效优于HP配伍多西他赛加卡铂方案。

Objective To compare the efficacy of trastuzumab plus pertuzumab(HP)combined with either nab-paclitaxel plus carboplatin or docetaxel plus carboplatin as neoadjuvant therapy for HER2-positive breast cancer in real-world clinical practice.Methods Clinical data of HER2-positive breast cancer patients who received neoadjuvant therapy with either HP combined with nab-paclitaxel plus carboplatin or HP combined with docetaxel plus carboplatin and subsequently underwent surgery were retrospectively collected from 11 tertiary grade-A hospitals in Hebei Province from June 2019 to December 2021.The total pathological complete response(tpCR)rates of the two groups were compared.Results A total of 76 patients were included in the study,with 47 in the nab-paclitaxel group and 29 in the docetaxel group.The tpCR rate was significantly higher in the nab-paclitaxel group than that in the docetaxel group(72.3%vs.48.3%,χ^(2)=4.463,P=0.035).Subgroup analysis indicated that patients older than 40 years,with cN2-3,cTNM stageⅢ,hormone receptor-positive status,and Ki67>30%had significantly higher tpCR rates in the nab-paclitaxel group than those in the docetaxel group(P<0.05).Conclusion In real-world clinical practice,the efficacy of HP combined with nab-paclitaxel plus carboplatin as neoadjuvant therapy for HER2-positive breast cancer is superior to that of HP combined with docetaxel plus carboplatin.