Comparison of efficacy and safety of Pirarubicin and Epirubicin in neoadjuvant chemotherapy of triple negative breast cancer

YIN Chenyan; TANG Jie

doi:10.13506/j.cnki.jpr.2025.01.014

Abstract：Objective To compare the efficacy and safety of Pirarubicin and Epirubicin in neoadjuvant chemotherapy for triple-negative breast cancer.Methods A retrospective analysis was conducted on the clinical data of triple-negative breast cancer patients who received complete neoadjuvant chemotherapy followed by surgery at Jiangsu Province Hospital of Chinese Medicine from January 2019 to September 2023.Patients were divided into two groups based on the drug used:the Pirarubicin group(n=91)and the Epirubicin group(n=95).The pathological complete response(pCR)rate,objective remis-sion rate(ORR),Ki-67 index reduction,Miller-Payne grading,and incidence of adverse events were compared between the two groups.Results The overall ORR in the Pirarubicin group was significantly higher than that in the Epirubicin group(89.0％VS 77.9％,P=0.042).In the subgroups with I～Ⅱ stage tumors(91.4％VS 78.5％,P=0.048),tumors＞2 cm(92.5％VS 78.5％,P=0.012),and patients with lymph node metastasis(90.0％VS 76.3％,P=0.028),the ORR was also higher in the Pirarubicin group,respectively,with statistically significant differences.Additionally,the incidence of bone mar-row suppression was higher in the Pirarubicin group(27.5％VS 12.6％,P=0.011),while gastrointestinal reactions(16.5％VS 29.5％,P=0.036)and hair loss(19.8％VS 32.6％,P=0.047)were lower compared to the Epirubicin group.Conclusion Pirarubicin can improve the ORR in neoadjuvant chemotherapy for triple-negative breast cancer compared to Epirubicin,and it reduces the incidence of gastrointestinal reactions and hair loss.However,it is associated with a higher rate of bone marrow suppression.