医学--asco最新进展her阳性bc相关.pptVIP

ACOSGO Z1041：手术情况 Buzdar A, et al. 2013 ASCO Abstract 502. 组1(n=138) 组2(n=142) 乳腺手术 乳房肿瘤切除术 49(35.5%) 54(38%) 乳房切除术 81(58.9%) 84(59.2%) 未进行 8(5.8%) 4(2.8%) 腋下 仅SLN 39(28.3%) 39(27.5%) ALND+/-SLN 90(65.2%) 98(69.0%) 未进行 9(6.5%) 5(3.5%) ACOSGO Z1041：pCR 乳腺的病理学缓解率 组1 N=138 组2 N=142 p值 乳腺pCR 56.5% 54.2% 0.72 95%CI 47.8-64.9% 45.7-62.6% cN1-3患者中乳腺和腋下的病理学缓解率 组1 N=89 组2 N=90 p值 乳腺和腋下pCR 48.3% 46.7% 0.88 95%CI 37.6-59.2% 36.4-56.9% Buzdar A, et al. 2013 ASCO Abstract 502. ACOSGO Z1041：根据激素受体状态显示的pCR Buzdar A, et al. 2013 ASCO Abstract 502. 荷尔蒙受体状态 组1(n=138) 组2(n=142) pCR 阳性(n=80) 阴性(n=58) 阳性(n=82) 阴性(n=60) 45% 72.4% 37.8% 76.7% ACOSGO Z1041：总结 病理学完全缓解率高 pCR与曲妥珠单抗治疗的开始与时机无关 同时给予蒽环类和曲妥珠单抗不增强pCR 两组心脏事件发生率相似 Buzdar A, et al. 2013 ASCO Abstract 502. Background: The monoclonal antibody trastuzumab (H) has been shown to improve event-free survival (EFS) and pathologic complete response (pCR) in patients with HER2-positive locally advanced or inflammatory breast cancer receiving neoadjuvant chemotherapy with or without one year of trastuzumab in the primary analysis of the NOAH study (Gianni L, Lancet 2010). Updated EFS and overall survival (OS) results are now presented. Methods: In this international, multicenter, open-label, randomized phase III trial patients with locally advanced or inflammatory breast cancer were randomized 1:1 to receive CT1H followed by adjuvant H versus CT alone. A parallel cohort of 99 comparable patients with HER2-negative disease was included and treated with the same chemotherapy regimen. The neoadjuvant chemotherapy regimen included doxorubicin, paclitaxel, cyclophosphamide, methotrexate and 5-fluorouracil. The primary objective was to compare EFS defined as time from randomization to disease recurrence or progression [local, regional, distant or contralateral] or death due to any cause). Results * Conclusions: Present analysis confirms the significant EFS benefit observed in the primary analysis of the NOAH study, and shows a strong trend towards imp