A Randomized Controlled Study Of Individual Neoadjuvant Chemotherapy Of Breast Cancer Guided By Drug-sensitive Gene Detection

Objectives Breast cancer is a malignant cancer common in women.The chemotherapeutic drugs and regimens selected according to experience and the national comprehensive cancer network(NCCN)guidelines are not very effective.This study aims on exploring the feasibility and clinical significance of individualized neoadjuvant chemotherapy for patients with breast cancer guided by gene single nucleotide polymorphism(SNP)analysis.Methods In this study,187 female patients with breast cancer from January 2011 to February 2018 in Tangshan People's Hospital affiliated to North China University of Technology were selected.The patients were randomly divided into the trial group(95cases)and the control group(92 cases).For the patients in the trial group,the gene SNPs in peripheral blood from the breast cancer patients were detected by generation sequencing technology,and the predicted sensitive chemotherapy regimens were selected according to the SNPs.For the patients in the control group,the chemotherapy regimen was selected according to the National Comprehensive Cancer Network(NCCN)Guidelines.The therapeutic effect and toxicity of chemotherapy were compared between the two groups.Results The rate of pathologic complete remission(pCR)of the breast cancer patients treated according to the gene SNPs in the trial group was significantly higher than that in the control group(37.2% vs 18.0%,P<0.05),the difference with statistical significance;In the trial group,the pathological response rates of patients with breast cancer of luminal A,luminal B,Her-2 positive and triple-negative breast cancer(TNBC)were all higher than those of the control group,In the gene SNPs group,the pathological response rates of patients with breast cancer of luminal A,luminal B,Her 2 positive and triple-negative breast cancer(TNBC)were all higher than those of the control group,but the pathological response rates of patients with breast cancer of Her 2 positive in test group was significantly higher than that in the control group(78.1% vs 52.2%,P<0.05);The incidence of liver injury in the trial group was markedly lower than that in the control group(17.89% vs 30.43%,P<0.05),the difference with statistical significance;The incidence of grade 3-4 neutropenia in blood was significantly lower than that in control group(31.58% vs 50.0%,P<0.05),the difference with statistical significance.Conclusions Individualized neoadjuvant chemotherapy guided by gene SNPs could significantly increase the rate of pCR of breast cancer patients,as well as markedly reduce side effects of chemotherapy such as liver injury and neutropenia.This study has certain clinical application value for breast cancer patients.Figure 1;Table 11;Reference 126...