Naslov Učinkovitost neoadjuvantne terapije kod karcinoma dojke luminalnog B imunofenotipa Naslov (engleski) Efficacy of neoadjuvant therapy in the treatment of luminal B subtype of breast cancer Autor Ana Bjeliš Mentor Branka Petrić Miše (mentor)Član povjerenstva Doris Rušić (predsjednik povjerenstva)Član povjerenstva Sandra Zekić Tomaš (član povjerenstva)Član povjerenstva Dinka Šundov (član povjerenstva)Ustanova koja je dodijelila Sveučilište u Splitu Datum i država obrane 2024-07-11, Hrvatska Znanstveno / umjetničko BIOMEDICINA I ZDRAVSTVO Sažetak Ciljevi: Neoadjuvantna terapija (NAT) se daje sustavno u ranim fazama liječenja kako bi se kontrolirala veličina tumora i smanjio rizik od postoperativnih metastaza. Neoadjuvantna kemoterapija je manje učinkovita kod luminalnog raka dojke nego kod drugih podtipova. Istraživali smo patološke karakteristike luminalnih B karcinoma dojke u vrijeme postavljanja dijagnoze i nakon NAT-a, te kliničke karakteristike i ishode bolesnika liječenih NAT-om na Klinici za onkologiju i radioterapiju KBC-a Split.
Ispitanici i metode: Retrospektivno su prikupljeni i obrađeni podaci iz povijesti bolesti 41 bolesnice s luminalnim B karcinoma dojke liječenih NAT-om u razdoblju od 1. siječnja 2018. do 1. lipnja 2021. godine. Podaci su uključivali dob, spol, menopauzalni status bolesnica i stadij bolesti u trenutku dijagnoze, status ER, PR, HER2 i Ki67, RCB, EFS i OS.
Rezultati: Medijan životne dobi bolesnika s luminalnim B karcinomom dojke u trenutku dijagnoze bio je 62 godine. U istraživanju je uključeno 40 bolesnica i 1 bolesnik. Dvije trećine dijagnosticiranih bolesnica je bilo u menopauzi. Kod većine, bolest je dijagnosticirana u stadiju IIA (46,3%), IIB (24,4%) i IIIC (14,6%). ER su bili pozitivni u ≥ 80% tumorskih stanica u 90% bolesnika, a PR su bili pozitivni u ≤ 20% tumorskih stanica u 27% bolesnika. Niska razina HER2 (HER2 1+ i HER2 2+) primijećena je u 61% pacijenata s luminalnim B podtipom. Ki67 bio je iznad 20% u 93% bolesnika. Većina (80% bolesnika) je primilo neoadjuvantnu kemoterapiju (ACdd-T protokol). Medijan trajanja NAT-a bio je 5,5 mjeseci. Nakon operacije, učinak NAT-a procijenjen je pomoću RCB. Potpuni patološki odgovor (RCB 0) zabilježen je u samo 3 bolesnika (7%). Imali su HER2-low podtip raka dojke i liječeni su neoadjuvantnom kemoterapijom. Četiri bolesnika (10%) imalo je RCB 1, 20 bolesnika (49%) RCB 2 i 14 bolesnika (34%) RCB 3. Nakon 41,5 mjeseci medijana praćenja, 1 bolesnik razvio je lokalni recidiv, 1 bolesnik lokoregionalni recidiv, a 5 bolesnika diseminiranu bolest. Na kraju analize, 33 bolesnika (78%) je živo bez bolesti, 4 bolesnika (10%) je živo s bolešću, 5 bolesnika (12%) je umrlo je zbog raka dojke. Posljedično, EFS i OS za ovu ispitivanu populaciju još nisu dosegnuti.
Zaključak: Rezultati naše analize su u skladu s podacima mnogih kliničkih izvješća s luminalnim B podtipom raka dojke liječenim NAT-om. Potrebno je dulje praćenje kako bi se definirao utjecaj NAT-a na preživljavanje.
Sažetak (engleski) Objectives: Neoadjuvant therapy (NAT) is given systemically in the early stages of treatment to control the tumor size and reduce the risk of postoperative metastasis. Neoadjuvant chemotherapy is less effective in luminal breast cancer than in other subtypes. We investigated the pathological characteristics of luminal B breast cancers at the time of diagnosis and after NAT, and clinical characteristics and outcomes of patients treated with NAT treated in Department of Oncology and Radiotherapy of University hospital of Split.
Patients and Methods: Data from the medical history of 41 patients with luminal B subtype of breast cancer treated with NAT in the period from January 1, 2018 to June 1, 2021, were retrospectively collected and processed. Data included age, gender, menopausal status of patients and stage of disease at diagnosis, status of ER, PR, HER2 and Ki67, RCB, EFS and OS.
Results: The median age of patients with luminal B subtype of breast cancer at the time of diagnosis was 62 years. Forty female patients and 1 male patient were included in the study. Two thirds of the diagnosed patients were postmenopausal. Majority of patients were diagnosed with stage IIA (46.3%), IIB (24.4%) and IIIC (14.6%). ER were positive in ≥ 80% of tumor cells in 90% of patients, and PR were positive in ≤ 20% of tumor cells in 27% of patients. HER2-low level (HER2 1+ and HER2 2+) was observed in 61% of patients with luminal B subtype. Ki67 was above 20% in 93% of patients. Majority of patients (80%) received neoadjuvant chemotherapy (ACdd-T protocol). Median duration of NAT was 5.5 months. After surgery, effect of NAT was evaluated through RCB. Complete pathological response (RCB 0) was recorded in only 3 patients (7%). They had HER2-low subtype of breast cancer and were treated with neoadjuvant chemotherapy. Four patients (10%) had RCB 1, 20 patients (49%) RCB 2 and 14 patients (34%) RCB 3. After 41.5 months of median of follow-up, 1 patient developed local recurrence, 1 patient locoregional recurrence, and 5 patients disseminated disease. At the end of the analysis, 33 patients (78%) were alive without disease, 4 patients (10%) were alive with the disease, 5 patients (12%) died due to breast cancer. Consequently, EFS and OS for this study population has not been reached yet.
Conclusion: Our analysis showed results consistent with data from many clinical reports with luminal B breast cancer treated with NAT. Longer follow-up is needed to define the survival impact of NAT.
Ključne riječi
karcinom dojke
neoadjuvantna terapija
Ključne riječi (engleski)
breast cancer
neoadjuvant therapy
Jezik hrvatski URN:NBN urn:nbn:hr:171:670217 Studijski program Naziv: Medicina Vrsta resursa Tekst Način izrade datoteke Izvorno digitalna Prava pristupa Otvoreni pristup Uvjeti korištenja Datum i vrijeme pohrane 2024-07-09 07:02:38
