Dose dense versus 3 weekly AC during neoadjuvant chemoimmunotherapy for triple negative breast cancer.

Autor: Bonadio RC; Instituto D'Or de Pesquisa e Ensino (IDOR), São Paulo, Brazil.; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil., de Sousa IM; A.C.Camargo Cancer Center, São Paulo, Brazil., Balint FC; A.C.Camargo Cancer Center, São Paulo, Brazil., Comini ACM; A.C.Camargo Cancer Center, São Paulo, Brazil., Tavares MC; A.C.Camargo Cancer Center, São Paulo, Brazil., Madasi F; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil., Bines J; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil., Ferreira RDP; Serviço de Oncologia, Hospital Moinhos de Vento, Porto Alegre, Brazil., Rosa DD; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; Serviço de Oncologia, Hospital Moinhos de Vento, Porto Alegre, Brazil., Santos CL; Instituto D'Or de Pesquisa e Ensino (IDOR), Recife, Brazil., de Souza ZS; Medical Oncology Department, Hospital Sírio-Libanês, Brasília, Brazil., Assad-Suzuki D; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; Medical Oncology Department, Hospital Sírio-Libanês, Brasília, Brazil., de Araújo JAP; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; Centro de Oncologia-Hospital Beneficência Portuguesa, São Paulo, Brazil., Gagliato DM; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; Centro de Oncologia-Hospital Beneficência Portuguesa, São Paulo, Brazil., Dos Anjos CH; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; Medical Oncology Department, Hospital Sírio-Libanês, São Paulo, Brazil., Zucchetti BM; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; DASA Oncology, Hospital 9 de Julho, São Paulo, Brazil., Ferrari A; DASA Oncology, Hospital Santa Paula, São Paulo, Brazil., de Brito ML; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; DASA Oncology-Clínica AMO, Salvador, Brazil., Cangussu R; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil.; Instituto D'Or de Pesquisa e Ensino (IDOR), Salvador, Brazil., Monteiro MMF; Instituto do Câncer do Ceará, Fortaleza, Brazil., Hoff PM; Instituto D'Or de Pesquisa e Ensino (IDOR), São Paulo, Brazil., Testa L; Instituto D'Or de Pesquisa e Ensino (IDOR), São Paulo, Brazil.; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil., Barroso-Sousa R; Grupo Brasileiro de Estudos em Câncer de Mama (GBECAM), São Paulo, Brazil. romualdo.sousa.ext@dasa.com.br.; DASA Oncology, Brasilia Hospital, DASA, Brasília, Brazil. romualdo.sousa.ext@dasa.com.br.
Jazyk: angličtina
Zdroj: NPJ breast cancer [NPJ Breast Cancer] 2024 Aug 14; Vol. 10 (1), pp. 73. Date of Electronic Publication: 2024 Aug 14.
DOI: 10.1038/s41523-024-00676-w
Abstrakt: Neoadjuvant pembrolizumab plus chemotherapy (P + CT) has emerged as a standard of care for stage II-III triple-negative breast cancer (TNBC). However, the best anthracycline-cyclophosphamide (AC) schedule remains to be determined. While the KEYNOTE-522 regimen employs AC every 3 weeks (q3w AC), previous studies have shown overall survival benefits of dose-dense regimens for early-stage breast cancer. The Neo-Real study (GBECAM-0123) is a real-world data effort evaluating patients with TNBC treated with neoadjuvant P + CT in ten cancer centers since July 2020. The objective of this analysis was to evaluate the effectiveness and safety of dose-dense AC (ddAC) versus q3w AC. Among 333 patients included until November 2023, 311 completed neoadjuvant therapy and 279 underwent surgery with pathology reports available; ddAC was used in 58.2% and q3w AC in 41.8% of the cases. Most patients (69.1%) had stage II TNBC. A pCR was observed in 65.4% with ddAC and 58.7% with q3w AC (P = 0.260), while RCB 0-1 occurred in 82.4% and 73.5%, respectively (P = 0.115). Patients with stage III disease had a numerically higher pCR with ddAC (59% vs 40%, P = 0.155), while pCR rates were similar regardless of AC regimen in stage II disease (66.6% vs 64.5%; P = 0.760). While no significant disparities in drug discontinuation was noted, ddAC showed a trend towards higher rates of grade ≥3 AE (40.5% vs. 30.7%, P = 0.092). The Neo-Real study could not rule out a difference between ddAC and q3w AC during neoadjuvant P + CT. The observation of a potentially higher pCR with ddAC in stage III disease warrants further investigation.
(© 2024. The Author(s).)
Databáze: MEDLINE
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