下一代肿瘤不可知靶点即将出现
Next-generation tumor-agnostic targets on the horizon.
肿瘤不可知药物开发将肿瘤学重新聚焦于共享的分子依赖性而非组织来源,从而能够针对跨肿瘤的罕见可操作驱动因素进行高效开发。
英文原题:Predictive Factors of Neoadjuvant Chemotherapy Response in Breast Cancer Validated by Three Anatomopathological Scores: Residual Cancer Burden, Chevallier System, and Tumor-Infiltrating Lymphocytes.
Predictive Factors of Neoadjuvant Chemotherapy Response in Breast Cancer Validated by Three Anatomopathological Scores: Residual Cancer Burden, Chevallier System, and Tumor-Infiltrating Lymphocytes.
RCB 评分与 Chevallier 系统在量化 PST 疗效方面存在强相关性,两者的多数预测因素均通过适当的统计分析得到验证。
引言:本回顾性、观察性描述研究旨在识别乳腺癌患者新辅助治疗反应的预测因素,并使用三种组织病理学评分进行验证,包括残余癌负荷(RCB)评分、Chevallier 分级系统和TIL(肿瘤浸润淋巴细胞)评分。材料与方法:研究纳入 88 例 37 至 78 岁、确诊乳腺癌并拟接受新辅助化疗的女性患者。分析多种个体变量(如年龄、初潮和绝经情况)、乳腺肿瘤及腋窝淋巴结的临床/影像学特征、免疫组化生物标志物(如 ER/PR/HER2 和 Ki67)及组织病理学特征(如亚型和分级),并考察其与依据手术切除标本计算的三种组织病理学评分之间的关系。结果:可能从保乳手术中获益的患者比例,由诊断时的 6% 增至初始全身治疗(PST)后的 20%。年龄低于 49 岁(p=0.01)、绝经前状态(p<0.01)、非特殊型(NST)(p=0.04)、Ki67 高表达(p<0.01)及三阴性乳腺癌(TNBC)(p=0.02)是新辅助治疗反应的正向预测因素;小叶型/混合型癌(p=0.04)、Luminal A 型(p=0.01)、淋巴结阳性(p<0.01)和低分化级别(p=0.01)则是 PST 反应的负向预测因素。结论:RCB 评分与 Chevallier 系统在量化 PST 反应方面高度相关,且通过适当统计分析证实了两者的大多数预测因素。TIL 评分值仅与部分预测因素相关,这很可能是因为该评分需要同时在诊断时活检标本和化疗后切除标本中计算。
INTRODUCTION: The aim of this retrospective, observational, descriptive study was to identify predictors of response to neoadjuvant therapy in breast cancer patients and to validate them using three anatomopathological scores, such as residual cancer burden (RCB) score, Chevallier system, and tumor-infiltrating lymphocytes (TIL) score. MATERIALS AND METHODS: We conducted a study on 88 female patients aged 37 to 78 years with confirmed breast cancer who were indicated for neoadjuvant chemotherapy. We analyzed different individual variables (such as age, menarche, and menopause), clinical/imaging characteristics of the breast tumor and axillary nodes, immunohistochemical biomarkers (such as ER/PR/HER2 and Ki67), and histopathological features (such as subtype and grading) in relation to three anatomopathological scores calculated based on the surgical resection specimen. RESULTS: The percentage of patients who could have benefited from conservative surgery increased from 6% at the time of diagnosis to 20% post-primary systemic therapy (PST). Age under 49 (p = 0.01), premenopausal status (p < 0.01), no special type (NST) (p = 0.04), high Ki67 (p < 0.01), triple-negative breast cancer (TNBC) (p = 0.02) are positive predictive factors of neoadjuvant therapy, while lobular/mixt carcinoma-type (p = 0.04), luminal A (p = 0.01), positive lymph node (p < 0.01), and low differentiation grade (p = 0.01) are negative predictive factors for the response to PST. CONCLUSION: There is a strong correlation between the RCB score and the Chevallier system for quantifying the response to PST, with most predictive factors being confirmed through appropriate statistical analysis for both. TIL score values correlated with only some of the predictors, most likely due to the importance of calculating this score on both biopsy specimens at diagnosis and resection specimens after chemotherapy.
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