Targeted Therapy Breakthrough: Apatinib Enhances Neoadjuvant Chemotherapy in Triple- Negative Breast Cancer

Abstract

Abstract Objective To investigate the clinical efficacy, prognosis, and safety of apatinib combined with doxorubicin + cyclophosphamide (AC) followed by paclitaxel (T) neoadjuvant chemotherapy regimen in patients with triple-negative breast cancer (TNBC). Methods A retrospective analysis was conducted on 70 patients with TNBC treated at Cangzhou Central Hospital from July 2016 to January 2020. The patients were divided into a control group (n = 34) and an observation group (n = 36) based on the treatment regimen received. The control group received neoadjuvant chemotherapy with the AC-T sequential regimen, whereas the observation group received apatinib in addition to the control group's regimen. The occurrence of adverse reactions during chemotherapy was recorded. Fasting venous blood samples were collected from both groups of patients after neoadjuvant chemotherapy completion to measure the levels of vascular endothelial growth factor (VEGF), thymidine kinase 1 (TK1), carcinoembryonic antigen (CEA), and the objective response rate (ORR) was recorded. At 4 weeks after completing neoadjuvant chemotherapy, patients underwent breast-conserving surgery or modified radical mastectomy as decided by a treatment group physician in the Thyroid Breast and Thoracic Surgery Department of Cangzhou Central Hospital, with axillary lymph node dissection determined according to sentinel lymph node biopsy results. Surgical procedures and pathological complete response (pCR) were documented. Then, a 3-year follow-up was conducted from the start of treatment to record and analyze the 3-year disease-free survival rate and 3-year overall survival rate. Results After completing neoadjuvant chemotherapy, the observation group showed significantly higher pCR rate, breast-conserving rate, 3-year disease-free survival rate, and 3-year overall survival rate compared to the control group (P < 0.05). The observation group also demonstrated a significant decrease in VEGF and CEA levels compared to the control group (P < 0.05). No grade III or above adverse reactions were observed in both groups during chemotherapy, and adverse reactions such as nausea and vomiting, diarrhea, leukopenia, and proteinuria were mainly recorded. In the observation group, there were 3 cases of nausea and vomiting, 5 cases of diarrhea, 7 cases of leukopenia, and 9 cases of proteinuria. In the control group, there were 4 cases of nausea and vomiting, 4 cases of diarrhea, 5 cases of leukopenia, and 6 cases of proteinuria. There was no significant difference in the occurrence of adverse reactions between the two groups (P > 0.05). Conclusion Apatinib combined with the AC-T sequential neoadjuvant chemotherapy regimen shows good clinical efficacy, significant prognosis, and manageable safety in patients with TNBC.