Cargando…

Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC

PURPOSE: Neoadjuvant therapy (NAT) is considered the standard of care for patients with HER2-positive breast cancer (BC). However, there is no proven survival benefit of NAT compared to adjuvant therapy for the survival of patients with early-stage HER2-positive BC. This study aimed to compare the p...

Descripción completa

Detalles Bibliográficos
Autores principales: Zheng, Shuyue, Li, Lun, Chen, Ming, Yang, Benlong, Chen, Jiajian, Liu, Guangyu, Shao, Zhimin, Wu, Jiong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9038764/
https://www.ncbi.nlm.nih.gov/pubmed/35429731
http://dx.doi.org/10.1016/j.breast.2022.03.015
_version_ 1784693974876815360
author Zheng, Shuyue
Li, Lun
Chen, Ming
Yang, Benlong
Chen, Jiajian
Liu, Guangyu
Shao, Zhimin
Wu, Jiong
author_facet Zheng, Shuyue
Li, Lun
Chen, Ming
Yang, Benlong
Chen, Jiajian
Liu, Guangyu
Shao, Zhimin
Wu, Jiong
author_sort Zheng, Shuyue
collection PubMed
description PURPOSE: Neoadjuvant therapy (NAT) is considered the standard of care for patients with HER2-positive breast cancer (BC). However, there is no proven survival benefit of NAT compared to adjuvant therapy for the survival of patients with early-stage HER2-positive BC. This study aimed to compare the prognosis of HER2-positive BC patients treated with NAT to that of patients treated with adjuvant therapy. METHODS: This was a single-center real-world retrospective study. This study analyzed the disease-free survival (DFS) and overall survival (OS) of 538 HER2-positive BC patients treated with neoadjuvant therapy and 2684 patients treated with adjuvant therapy at Fudan University Shanghai Cancer Center (FUSCC) between 2012 and 2016. Patients with a clinical tumor size (cT) ≤5 cm or >5 cm were matched using the propensity score matching (PSM) method to prevent selection bias. RESULTS: After PSM, among patients with cT ≤ 5 cm, there was no significant difference in DFS (P = 0.08) or OS (P = 0.11) between the two groups. The analysis of survival outcomes of patients treated with neoadjuvant and adjuvant therapy in the different chemotherapy subgroups yielded consistent results. According to multivariate analysis, lymph node status and response to NAT showed independent prognostic value for OS and DFS. Among patients with cT > 5 cm, the DFS (P = 0.25) and OS (P = 0.57) of patients treated with NAT were similar to those of patients treated with adjuvant therapy after PSM. CONCLUSION: We confirmed the equivalent effects of adjuvant therapy and NAT in HER2-positive BC patients. Neoadjuvant therapy should be used for patients with HER2-positive BC.
format Online
Article
Text
id pubmed-9038764
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-90387642022-04-27 Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC Zheng, Shuyue Li, Lun Chen, Ming Yang, Benlong Chen, Jiajian Liu, Guangyu Shao, Zhimin Wu, Jiong Breast Original Article PURPOSE: Neoadjuvant therapy (NAT) is considered the standard of care for patients with HER2-positive breast cancer (BC). However, there is no proven survival benefit of NAT compared to adjuvant therapy for the survival of patients with early-stage HER2-positive BC. This study aimed to compare the prognosis of HER2-positive BC patients treated with NAT to that of patients treated with adjuvant therapy. METHODS: This was a single-center real-world retrospective study. This study analyzed the disease-free survival (DFS) and overall survival (OS) of 538 HER2-positive BC patients treated with neoadjuvant therapy and 2684 patients treated with adjuvant therapy at Fudan University Shanghai Cancer Center (FUSCC) between 2012 and 2016. Patients with a clinical tumor size (cT) ≤5 cm or >5 cm were matched using the propensity score matching (PSM) method to prevent selection bias. RESULTS: After PSM, among patients with cT ≤ 5 cm, there was no significant difference in DFS (P = 0.08) or OS (P = 0.11) between the two groups. The analysis of survival outcomes of patients treated with neoadjuvant and adjuvant therapy in the different chemotherapy subgroups yielded consistent results. According to multivariate analysis, lymph node status and response to NAT showed independent prognostic value for OS and DFS. Among patients with cT > 5 cm, the DFS (P = 0.25) and OS (P = 0.57) of patients treated with NAT were similar to those of patients treated with adjuvant therapy after PSM. CONCLUSION: We confirmed the equivalent effects of adjuvant therapy and NAT in HER2-positive BC patients. Neoadjuvant therapy should be used for patients with HER2-positive BC. Elsevier 2022-04-08 /pmc/articles/PMC9038764/ /pubmed/35429731 http://dx.doi.org/10.1016/j.breast.2022.03.015 Text en © 2022 Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Zheng, Shuyue
Li, Lun
Chen, Ming
Yang, Benlong
Chen, Jiajian
Liu, Guangyu
Shao, Zhimin
Wu, Jiong
Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC
title Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC
title_full Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC
title_fullStr Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC
title_full_unstemmed Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC
title_short Benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with HER2-positive breast cancer: A retrospective cohort study at FUSCC
title_sort benefits of neoadjuvant therapy compared with adjuvant chemotherapy for the survival of patients with her2-positive breast cancer: a retrospective cohort study at fuscc
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9038764/
https://www.ncbi.nlm.nih.gov/pubmed/35429731
http://dx.doi.org/10.1016/j.breast.2022.03.015
work_keys_str_mv AT zhengshuyue benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc
AT lilun benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc
AT chenming benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc
AT yangbenlong benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc
AT chenjiajian benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc
AT liuguangyu benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc
AT shaozhimin benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc
AT wujiong benefitsofneoadjuvanttherapycomparedwithadjuvantchemotherapyforthesurvivalofpatientswithher2positivebreastcanceraretrospectivecohortstudyatfuscc