Zhongguo linchuang yanjiu (Mar 2024)
Influencing factors of pathological complete response in triple-negative breast cancer with neoadjuvant chemotherapy
Abstract
Objective To analyze the clinical and pathological factors affecting pathological complete response (pCR) of triple-negative breast cancer (TNBC) after neoadjuvant chemotherapy (NAC). Methods A retrospective analysis was conducted in 78 TNBC patients treated with NAC and surgery in The First Affiliated Hospital of Xinjiang Medical University from January 2018 to September 2023. The patients were divided into pCR group (n=28) and non-pCR group (n=50) based on whether they had achieved pCR or not. Logistic regression analysis was used to investigate the clinical and pathological factors affecting pCR. The pCR rate and incidence of adverse reactions after NAC between TP regimen (taxane+platinum) and TAC regimen (taxane+anthracycline+cyclophosphamide) were compared. Results The overall pCR rate was 35.9%. There were statistically significant differences between the two groups of patients in tumor diameter, chemotherapy cycle, chemotherapy regimen, paclitaxel type, human epidermal growth factor receptor 2 (HER-2) expression, Ki-67 expression, and androgen receptor (AR) positive expression (P＞0.05). Multivariate logistic regression analysis showed that tumor diameter ≤ 3 cm was an independent favorable factor of pCR(OR=4.191, 95%CI: 1.246-14.094, P=0.021), and AR positive expression was an independent unfavorable factor of pCR (OR=0.124, 95%CI: 0.020-0.784, P=0.027). In addition, the pCR rate of the TP regimen was significantly better than that of the TAC regimen ［54.8%(17/31) vs 28.1%(9/32), χ2=4.636, P=0.031］, and there was no significant difference in the incidence of adverse reactions between two groups (P＞0.05). Conclusion TP or TAC regimen and albumin bound paclitaxel in NAC for TNBC is beneficial for achieving pCR status, but the pCR rate of TP regimen is better than that of TAC regimen, and the incidence of adverse reactions is comparable. The pCR rate is higher for tumor diameter≤3 cm, while low expression of HER-2, Ki-67, or AR indicates a lower pCR rate. AR positive expression is an independent unfavorable factor of pCR.
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