JAMA Oncol: "The most toxic" breast cancer survival rate increases! Precision Assisted Treatment "Fudan Program" appears in the Journal of the American Medical Association - Oncology

About 15 to 20 percent of breast cancer is triple-negative breast cancer (TNBC), which has long been considered the most difficult and "toxic" type of breast cancer.
Compared with other breast cancer subtypes, TNBC is more invasive, and because estrogen, progesterone, HER2 three major subjects are negative, hormones or targeted drugs are not effective, systemic treatment is still mainly chemotherapy, easy to relapse, metastasis.
, for early TNBC patients, the standard option for postoperative ancillary therapy is cyclocyclycer and yew.
, however, the five-year survival rate of the standard program hovers around 80%, with cyclocyclyctic drugs and cardiac toxicity.
how to break through this bottleneck and improve TNBC's efficacy based on molecular parting is a difficult problem that fudan University's affiliated oncology hospital team has been leading for years.
on August 13th, local time, the results of the PATTERN trial 3, launched by Chinese researchers, were published in jamA Oncology, the Journal of the American Medical Association, proving that the yew alcohol-carbab scheme has an advantage over the standard scheme in terms of multiple survival indicators.
the thesis is Professor Zhai Zhimin and Professor Yu Koda of Fudan University's Affiliated Oncology Hospital.
the first time that the carcatin-containing program is superior to the cyclocyclycertin/yewane option for early TNBC patients," the team said in the paper.
" proposed the carablatin scheme because TNBC usually has the characteristics of ogenomic recombinant repair defects, genome instability, some patients have BRCA pathogenesies abnormalities, and platinum drugs may be effective in these mechanisms.
studies have shown that platinum-containing options are effective in TNBC's new complementary or advanced treatments, but their value in complementary treatments has not been proven.
10 years ago, after the team proposed innovative treatment strategies, the trial was conducted at nine clinical centers in China, including 647 surgically available TNBC patients between July 2001 and April 2016. Groups received traditional standard chemotherapy CEF-T (cyclophosphamide and table-soft stars, fluorouracils, 322 people) or PCb (yew alcohol and carptonin, 325 people).
follow-up period was 62 months.
results showed that patients receiving the PCb program had a higher five-year disease-free survival rate (86.5 percent vs. 80.3 percent) and a significant 35 percent lower risk of lesions or death than those on the CF-T program.
the PCb group had a higher risk of disease-free survival over a five-year period (92.6% vs. 87.9%), and a significant 41% reduction in the risk of distant lesions or death.
the PCb group had a higher five-year relapse rate (91.2% vs. 84.4%) and a significant 46% reduction in the risk of recurrence.
the PCb group had a higher five-year total survival rate (93.4% vs. 89.8%) and a 29% lower risk of death within five years.
the current differences are not significant enough, the paper notes that a fuller assessment of the overall lifetime of efficacy will require longer-term follow-up.
subgroup analysis, patients with certain characteristics were more sensitive to PCb programmes and benefited more from survival: younger (50 years old) and more invasive patients with tumors.
In patients with BRCA1/2 mutations, the risk of lesions or death was reduced by 56%; the statistical differences were not significant, and the researchers identified two potential causes: (1) the small sample size of patients with BRCA1/2 mutations was not sufficient to produce statistical effectiveness, and (2) even in patients with BRCA1/2 negatives, the gene variants associated with ERCA1/2 were sensitive to carabtin if they carried the same recombinant repair-related gene variants.
further analysis also showed a 61% reduction in the risk of lesions or death in patients with gene mutations associated with recombinant repair.
is consistent with the known safety of the drug in question in terms of safety. The
team concluded the paper by noting that these findings suggest that the yew alcohol-carptonine option is one of the effective complementary chemotherapy options for surgically available TNBC patients, and that in the era of molecular division, it is worth further exploring TNBC subgroup patients who are sensitive to the program, and that biomarker testing is important for selecting patients who are suitable for the program.
This is another important positive result under the "Three Negative Breast Cancer Precision Treatment Strategy" led by the team of Fudan University Affiliated Oncology Hospital, and we look forward to further validation of this program to bring better and more appropriate treatment options to patients.
.