摘要
Abstract
Objective:To explore the clinical efficacy and safety of PD-1 inhibitor Camrelizumab combined with TP protocol for preoperative neoadjuvant chemotherapy(NAC)in elderly patients with triple-negative breast carcinoma(TNBC).Method:A total of 64 patients with TNBC admitted to Cangzhou Central Hospital Affiliated to Hebei Medical University from January 2020 to January 2022 were selected and divided into control group(n=33)and observation group(n=31)according to the accepted treatment protocol.All the enrolled patients were given TP NAC protocol before surgery,and the observation group was given PD-1 inhibitor Camrelizumab on the basis of TP protocol.1 week after NAC was completed,patients in both groups underwent modified radical mastectomy,and continued to receive adjuvant chemotherapy for four cycles after surgery.Ki-67 positivity situation before and after NAC were compared between the observation group and the control group.Operation duration,intraoperative bleeding volume,objective response rate(ORR),disease control rate(DCR),progression free survival(PFS),overall survival(OS)and adverse reactions were recorded and compared between the two groups.Result:The positive rates of Ki-67 in the observation group and the control group after NAC were significantly lower than those before NAC,and among them,there was statistical significance in control group compared with before NAC(P<0.05),but there was no statistical significance in observation group compared with before NAC(P>0.05).The operation duration in the observation group was shorter than that in the control group[(59.08±9.27)min vs.(87.01±9.35)min],and the intraoperative bleeding volume in the observation group was less than that in the control group[(109.35±11.85)mL vs.(174.77±14.67)mL],the differences were statistically significant(P<0.05).ORR(74.2% vs.48.5%)and DCR(90.3% vs.66.7%)in observation group were higher than those in control group(P<0.05).Due to the short follow-up time,OS was not reached in the two groups,PFS in the observation group was not reached,and the median PFS in the control group was 9.70 months[95% CI(9.16,10.24)],the difference between the two groups was statistically significant(P<0.05).There were no significant differences in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion:PD-1 inhibitor Camrelizumab combined with TP protocol has a good clinical effect on preoperative NAC in elderly patients with TNBC,can improve the prognosis of patients,and the safety is relatively controllable.关键词
三阴性乳腺癌/新辅助化疗/PD-1抑制剂/卡瑞利珠单抗/白蛋白结合型紫杉醇/顺铂Key words
Triple-negative breast carcinoma/Neoadjuvant chemotherapy/PD-1 inhibitor/Camrelizumab/Albumin Bound Paclitaxel/Cisplatin
