紫杉醇联合卡铂密集方案新辅助治疗三阴性乳腺癌的疗效及远期生存

Objective To evaluate the efficacy and survival outcomes of dose-dense ( biweekly) carboplatin plus paclitaxel ( PC) as neoadjuvant chemotherapy ( NAC) in triple-negative breast cancer (TNBC), and to explore an optimal neoadjuvant chemotherapy regimen for TNBC. Methods Patients diagnosed as TNBC( cT1-4N0-3M0) in Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Between January 2008 and September 2018 who received dose-dense PC and standard 3-weekly PC as NAC were 1 : 1 matched using propensity score matching (PSM) to compare the efficacy, safety and survival outcomes. Results One hundred of TNBC patients were enrolled ( 50 patients were divided in dose-dense group, 50 patients in standard group). The objective response rate (ORR) of dose-dense group and standard group were both 90.0% (45 / 50). The grade 3-4 neutropenia in dose-dense group was less than that of standard group (32.7% vs. 68.0%, P= 0.001), while the rate of ALT/ AST elevation in dose-dense group was higher than that of standard group (57.1% vs. 32.0%, P = 0.012). The pathological complete response (pCR) rates were 34.0% (17 / 50) in dose-dense group and 38.0% (19 / 50) in standard group, without statistically significance ( P = 0. 677). The median follow-up time was 55 months ( 3-150 months). The 5-year recurrence-free survival (RFS) in dose-dense group and standard group were 83.5% and 75.2%, respectively the 5-year overall survival (OS) in dose-dense and standard group were 87.9% and 84.5% the difference were not statistically significant (P = 0.322 and 0.647, respectively). Patients with residual disease (tumor size≥1 cm or lymph node positive) had poor prognosis, the 5-year RFS and OS were 59. 3% and 68. 5%, respectively. Conclusions Dose-dense PC has similar efficacy with standard 3-weekly PC and has a good safety profile. Since dose-dense regimen can shorten the duration of therapy, it can be an alternative in TNBC.