新医学2024，Vol.55Issue(1)：12-18,7.DOI:10.3969/j.issn.0253-9802.2024.01.003
含铂新辅助免疫治疗用于三阴性乳腺癌的临床探究
Clinical efficacy and safety of platinum-containing neoadjuvant immunotherapy for triple-negative breast cancer
摘要
Abstract
Objective To evaluate the clinical efficacy and safety of platinum-containing neoadjuvant immunotherapy for triple-negative breast cancer.Methods Sixty-four patients with PD-L1 positive triple-negative breast cancer were enrolled and randomly divided into the control(n=32)and observation groups(n=32).In the control group,preoperative chemotherapy regimen of albumin-bound paclitaxel plus cisplatin(TP)was given,while the observation group received platinum-containing neoadjuvant immunotherapy--combined with programmed death receptor-1(PD-1)inhibitor carrilizumab on the basis of TP chemotherapy regimen of control group.At 4 weeks post-neoadjuvant chemotherapy,whether modified radical surgery or breast-conserving surgery was chosen based on surgical indications,and whether axillary lymph node dissection was performed according to intraoperative sentinel lymph node biopsy results.The objective response rate,disease control rate,pathological complete response rate,breast conservation rate,axillary lymph node exemption rate,T lymphocyte subset levels,hypoxia-inducible factor-1alevels,vascular endothelial growth factor levels,and the incidence of adverse reactions were compared between two groups.Results After 6 cycles of neoadjuvant chemotherapy,the objective remission rate,pathological complete remission rate,and elevated level of CD4+T lymphocytes in the observation group were higher than those in the control group(all P＜0.05).The levels of hypoxia-inducible factor-1a and vascular endothelial growth factor in the observation group were lower than those in the control group(all P＜0.05).Although the disease control rate,breast conservation rate and exemption rate of axillary lymph node dissection were relatively high in the observation group,the difference was not significant when compared with that in the control group(P＞0.05).There was no significant difference in the incidence of adverse reactions between two groups(P＞0.05).Conclusion Platinum-containing neoadjuvant immunotherapy is efficacious and safe for triple-negative breast cancer,which reduces the tumor load and improves clinical prognosis of the patients.关键词
三阴性乳腺癌/程序性死亡受体-1抑制剂/新辅助免疫治疗/保乳术/腋窝淋巴结清扫/病理学完全缓解Key words
Triple-negative breast cancer/Programmed death receptor-1 inhibitor/Neoadjuvant immunotherapy/Breast-conserving surgery/Axillary lymph node dissection/Pathologic complete response引用本文复制引用
殷雨来,张银旭,任悦,张辉,张晓宇..含铂新辅助免疫治疗用于三阴性乳腺癌的临床探究[J].新医学,2024,55(1):12-18,7.基金项目
河北省医学科学研究课题(20220400) （20220400）
