新辅助派姆单抗联合化疗 (P  CT) 已成为 II-III 期三阴性乳腺癌 (TNBC) 的标准治疗方法。然而，最佳的蒽环类-环磷酰胺 (AC) 方案仍有待确定。虽然 KEYNOTE-522 方案每 3 周使用一次 AC (q3w AC)，但之前的研究表明剂量密集方案对早期乳腺癌具有总体生存获益。 Neo-Real 研究 (GBECAM-0123) 是一项真实世界数据工作，评估自 2020 年 7 月以来在十个癌症中心接受新辅助 P   CT 治疗的 TNBC 患者。该分析的目的是评估剂量密集治疗的有效性和安全性AC (ddAC) 与 q3w AC。截至 2023 年 11 月，在纳入的 333 名患者中，311 名患者完成了新辅助治疗，279 名患者接受了手术并提供了病理报告； 58.2% 的病例使用了 ddAC，41.8% 的病例使用了 q3w AC。大多数患者（69.1%）患有 II 期 TNBC。 ddAC 的 pCR 率为 65.4%，q3w AC 的 pCR 率为 58.7%（P = 0.260），而 RCB 0-1 的发生率分别为 82.4% 和 73.5%（P = 0.115）。 III 期疾病患者使用 ddAC 后的 pCR 数值较高（59% vs 40%，P = 0.155），而无论 II 期疾病采用何种 AC 方案，pCR 率均相似（66.6% vs 64.5%；P = 0.760）。虽然停药方面没有显着差异，但 ddAC 显示 ≥3 级 AE 发生率较高的趋势（40.5% 对比 30.7%，P = 0.092）。 Neo-Real 研究不能排除新辅助 P  CT 期间 ddAC 和 q3w AC 之间的差异。在 III 期疾病中观察到 ddAC 可能具有更高的 pCR，值得进一步研究。© 2024。作者。

Neoadjuvant pembrolizumab plus chemotherapy (P + CT) has emerged as a standard of care for stage II-III triple-negative breast cancer (TNBC). However, the best anthracycline-cyclophosphamide (AC) schedule remains to be determined. While the KEYNOTE-522 regimen employs AC every 3 weeks (q3w AC), previous studies have shown overall survival benefits of dose-dense regimens for early-stage breast cancer. The Neo-Real study (GBECAM-0123) is a real-world data effort evaluating patients with TNBC treated with neoadjuvant P + CT in ten cancer centers since July 2020. The objective of this analysis was to evaluate the effectiveness and safety of dose-dense AC (ddAC) versus q3w AC. Among 333 patients included until November 2023, 311 completed neoadjuvant therapy and 279 underwent surgery with pathology reports available; ddAC was used in 58.2% and q3w AC in 41.8% of the cases. Most patients (69.1%) had stage II TNBC. A pCR was observed in 65.4% with ddAC and 58.7% with q3w AC (P = 0.260), while RCB 0-1 occurred in 82.4% and 73.5%, respectively (P = 0.115). Patients with stage III disease had a numerically higher pCR with ddAC (59% vs 40%, P = 0.155), while pCR rates were similar regardless of AC regimen in stage II disease (66.6% vs 64.5%; P = 0.760). While no significant disparities in drug discontinuation was noted, ddAC showed a trend towards higher rates of grade ≥3 AE (40.5% vs. 30.7%, P = 0.092). The Neo-Real study could not rule out a difference between ddAC and q3w AC during neoadjuvant P + CT. The observation of a potentially higher pCR with ddAC in stage III disease warrants further investigation.© 2024. The Author(s).