AUTHOR=Yu Xingfei , Wang Chen , Zheng Yabing , Miao Beibei , Hu Jiejie , Shao Xiying , Sheng Liming , Lin Juan , Ding Yuqin , Xuan Haojun , Ding Yingying , Gong Lijie , Feng Weiliang , Qin Chengdong , Chen Daobao , Yu Yang , Yang Hongjian TITLE=Preoperative Systemic Therapy Versus Upfront Surgery in HER2-Positive Breast Cancer in the Real World JOURNAL=Frontiers in Oncology VOLUME=11 YEAR=2021 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.704842 DOI=10.3389/fonc.2021.704842 ISSN=2234-943X ABSTRACT=Purpose

To compare survival in different strategies, preoperative systemic treatment versus upfront surgery, in HER2-positive early breast cancer patients in the real world.

Methods

According to the actual upfront treatment, eligible patients from 2012 to 2015 were classified as preoperative systemic treatment or upfront surgery group prospectively. The primary endpoint is disease-free survival; the second endpoint is overall survival. All the outcomes were examined in the propensity score matching model and inverse probability of treatment weighting model.

Results

Included in the analysis were 1,067 patients (215 in the preoperative systemic treatment group, 852 in the upfront surgery group). In the propensity score matching model (matching at 1:1 ratio), the disease-free survival of the preoperative systemic treatment group was significantly higher than that of the upfront surgery group (hazard ratio, 0.572, 95%CI, 0.371–0.881, P, 0.012). In the inverse probability of treatment weighting model, there was no significant difference in disease-free survival between the two groups (hazard ratio, 0.946, 95%CI, 0.763–1.172, P, 0.609). For overall survival, there was no significant difference between the two groups.

Conclusion

The HER2-positive patients who accepted preoperative systemic treatment had better disease-free survival than those who underwent upfront surgery by real-world statistic methods.

Clinical Trial Registration

Clinicaltrials.gov, identifier NCT04249440.