Efficacy And Prognosis Of Docetaxel And Albumin-Paclitaxel Neoadjuvant Therapy For HER-2 Negative Operable Breast Cancer

Background and Purpose: As one of the most common female malignant tumors,breast cancer seriously threatens the life safety of women all over the world.With the continuous progress of medical level,the cognition of breast cancer is constantly improved.The concept that breast cancer is a systemic disease is gradually recognized,and more and more treatment methods are available for breast cancer patients to choose.Neoadjuvant chemotherapy for breast cancer refers to systemic chemotherapy before surgical treatment for breast cancer patients without distant metastasis.Its main purpose is to shrink the tumor,enable inoperable patients to undergo surgery,and enable patients unable to preserve breast milk,because it can provide timely and personalized chemotherapy sensitivity information,which is conducive to the customization of follow-up treatment strategies.Is currently the standard treatment strategy for breast cancer.At present,the most commonly used neoadjuvant chemotherapy regimen for HER-2 negative breast cancer are cyclophosphamide,anthracycline,combined taxus(TAC)and cyclophosphamide + anthracycline sequential taxus(AC-T).Taxoid drugs are commonly used in neoadjuvant chemotherapy for breast cancer.Docetaxel and albupaclitaxel,two common taxoid drugs in clinical practice,have different efficacy and prognosis in operable breast cancer with negative HER-2.Based on this,we targeted to explore the efficacy of docetaxel and albuminpaclitaxel in neoadjuvant chemotherapy for breast cancer and the influence on prognosis.Method: In this study,580 patients with HER-2 negative and operable female breast cancer admitted to our hospital were retrospectively analyzed.These patients were first admitted from January 2015 to December 2019.All patients were selected docetaxel and albumin-paclitaxel on the basis of TAC and AC-T,respectively.Based on this,the subjects were divided into four groups,namely,TAC(docetaxel)group,TAC(albumin-paclitaxel)group,AC-T(docetaxel)group and AC-T(albumin-paclitaxel)group.To observe the difference of efficacy and prognosis between docetaxel and albuminpacel in different regiments of neoadjuvant chemotherapy for HER-2 negative operable breast cancer,and to compare the incidence of adverse reactions between the two drugs in different regiments of chemotherapy.Results:(1)In the TAC group,the objective response rate(ORR)of the TAC(Docetaxel)group was 80.1%,and the ORR of the TAC(albuminpaclitaxel)group was 85.7%.There was no statistically significant difference in ORR between the two groups.In the AC-T regimen group,the ORR of the AC-T(docetaxel)group was 79.5% and that of the AC-T(albumin-paclitaxel)group was 85.0%,and there was no statistically significant difference in ORR between the two groups.(2)In the TAC regimen group,the p CR rate of the TAC(Docetaxel)group was 21.8%and that of the TAC(albumin-paclitaxel)group was 32.5%,and there was a statistically significant difference in the p CR rate between the two groups.In the AC-T regimen group,the p CR rate of the AC-T(docetaxel)group was 20.5%,and that of the AC-T(albumin-paclitaxel)group was 32.3%,and the difference in p CR rate between the two groups was statistically significant.(3)In terms of pathological indicators after neoadjuvant chemotherapy in the TAC regimen group,there was a statistically significant difference in the ratio of lymphocyte infiltration and positive lymph nodes after neoadjuvant chemotherapy between the TAC(docetaxel)group and the TAC(albumin-paclitaxel)group.In terms of pathological indicators after neoadjuvant chemotherapy in the AC-T regimen group,there was a statistically significant difference in the rate of positive lymph nodes after neoadjuvant chemotherapy between the AC-T(docetaxel)group and the AC-T(albumin-paclitaxel)group.(4)In the TAC regimen group,the 3-year disease-free survival rate was 87.8% in the TAC(Docetaxel)group and 91.2% in the TAC(albuminpaclitaxel)group.The 3-year survival rate was 96.1% in the TAC(docetaxel)group and 97.6% in the TAC(albumin-paclitaxel)group.In the AC-T regimen group,the 3-year disease-free survival rate was 89.1% in the AC-T(Docetaxel)group and 89.4% in the AC-T(albumin-paclitaxel)group.The 3-year survival rate was 96.9% in the AC-T(Docetaxel)group and 98.4% in the AC-T(albumin-paclitaxel)group.(5)In the TAC group,the incidence of neutropenia,sensory neuropathy,muscle,joint,bone pain,fatigue and abnormal liver function in the TAC group was significantly higher than that in the TAC group.In addition,hair loss,electrocardiogram abnormalities and gastrointestinal reactions occurred during treatment with both drugs,but there was no statistical difference in incidence between the two drugs.In the AC-T group,the incidence of neutropenia,sensory neuropathy,muscle,joint,bone pain,fatigue,and liver dysfunction was significantly higher in the AC-T group than in the docetaxel group.Similarly,hair loss,electrocardiogram abnormalities and gastrointestinal reactions occurred during the treatment of both drugs,but there was no statistical difference in incidence between the two drugs.Conclusion: For women with HER-2 negative operable breast cancer,albuminpaclitaxel achieved a better p CR rate regardless of TAC neoadjuvant chemotherapy regimen or AC-T neoadjuvant chemotherapy regimen,and the results of this study also indicated that p CR rate could translate into a better survival prognosis.However,in this study,the incidence of adverse reactions was higher with albumin paclitaxel.