Abstract P5-20-12: Adjuvant DCH vs TCH for low-risk (node negative); and FECDH vs TCH for high-risk (node positive) HER2+ breast cancer – A retrospective provincial analysis
Notice bibliographique
Résumé
Abstract Background: Chemotherapy plus trastuzumab for early HER2+ breast cancer (BC) is associated with improved survival. Optimal regimens for low-risk (node negative) and high-risk (node positive) HER2+ breast cancers are unknown and choice of regimen varies in real-world clinical practice. Objective: (1) For low-risk breast cancer, to compare DCH (4 cycles) and TCH (6 cycles) in terms of disease free (DFS) and overall survival (OS). (2) For high-risk breast cancer, to compare FECDH (6 cycles) and TCH (6 cycles) in terms of DFS and OS. Methods: All women diagnosed from 2007-2014 with stage I-III, hormone receptor (HR) +/-, HER2+ BC receiving adjuvant chemotherapy plus trastuzumab (n=986) in Alberta, Canada were included. Patients with low-risk (node negative) disease were stratified into DCH (n=104) or TCH (n=360) cohorts for DFS/OS comparison (Kaplan-Meier). Patients with high-risk (node positive) disease were stratified into FECDH (n=145) or TCH (n=314) cohorts. Subgroup analysis of the high-risk cohorts by HR+/HER2+ and HR-/HER2+ for FECDH vs TCH were performed. Chi-square was used to evaluate for difference between cohort variables. Low- Risk Cohort DCH TCH n (104)%n (360)%Age (mean)55.3 53.0 Hormone Status ER+ or PR+8682.727676.7ER and PR-1817.38423.3Grade 121.951.423230.88523.637067.327075.0Surgery lumpectomy525010830.5mastectomy525024669.5 High-Risk Cohort FECDH TCH n (145)%n (314)%Age (mean)50.2 53.6 Hormone Status ER+ or PR+11579.323875.8ER and PR-3020.77624.2Grade 10051.6229206119.631168014678.8Surgery lumpectomy3927.19831.2mastectomy10572.921668.8Node Status N18357.219461.8N24128.37323.2N32114.54715 Results: Median follow-up was 58.1 months in the low-risk cohort and 63.1 months in the high-risk cohort. In the low-risk group, patients receiving TCH had more mastectomy (69.5%) than lumpectomy (30.5%; p<0.001) compared to those receiving DCH (50%; 50%). No significant difference was seen in DFS (p=0.153) or OS (p=0.409) for patients in the DCH (92.3%; 95.2%) vs TCH (95.2%; 96.9%) cohorts. In the high-risk group, no significant difference was seen in DFS (p=0.226) or OS (p=0.164) for FECDH (92.4; 95.2%) or TCH (88.5%; 91.4%) respectively. In subgroup analysis of high-risk HR+/HER2+ BC, patients receiving FECDH demonstrated superior OS (98.3%; p=0.014) and a trend towards superior DFS (94.8%; p=0.069) relative to TCH patients (OS = 91.6%; DFS= 88.7%). Conversely, analysis of high-risk HR-/HER2+ BC, patients demonstrated higher DFS and OS for TCH (88.2%; 90.8%) relative to FECDH (83.3%; 83.3%); although this was non-significant (p=0.516; p=0.298) and likely underpowered. Nodal status was balanced between all groups (p=0.602). Conclusion: In low-risk HER2+ BC, 4 cycles of DCH chemotherapy has high survival with similar outcomes to 6 cycles of TCH. In high-risk HER2+ BC, FECDH has comparable outcomes to TCH consistent with BCIRG-006. This study suggests that women with HR+/HER2+ breast cancer have improved OS with anthracycline containing regimens, such as FECDH. Although non-significant, patients with HR-/HER2+ BC may have some improvement in DFS and OS with TCH, a carboplatin containing regimen. Citation Format: Veitch ZW, Khan OF, Tilley D, Kostaras X, Tang PA, King K, Lupichuk S. Adjuvant DCH vs TCH for low-risk (node negative); and FECDH vs TCH for high-risk (node positive) HER2+ breast cancer – A retrospective provincial analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-20-12.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».