Pengaruh Kemoterapi Regimen Antrasiklin Taksan Terhadap Pathologic Complete Response dan Overall Survival Kanker Payudara di RSUP H Adam Malik

Alfi Syahri Ginting, drh.Retno Murwanti, M.P.,Ph.D.;Prof. Dr. apt. Agung Endro Nugroho, S.Si., M.Si.

2024 | Tesis | S2 Mag.Farmasi Klinik

Latar belakang: Kanker payudara merupakan salah dari beberapa kanker dengan tingkat insidensi tertinggi secara akumulatif di dunia dengan jumlah kasus baru sebesar 11,7?n penyebab kematian sebesar 6,9?ri total seluruh jenis kanker pada tahun 2020. Antrasiklin dan taksan merupakan golongan agen kemoterapi yang menjadi pilihan utama digunakan pada berbagai jenis kanker payudara.

Metode penelitian: Penelitian dilakukan secara kohort retrospektif dan dilaksanakan di RSUP H. Adam Malik pada pasien yang menjalani kemoterapi periode 2019-2020. Keluaran penelitian didasarkan pada hasil hasil biopsi bebas dari sel kanker atau pCR (pathologic Complete Response) dengan chi-square dan kesintasan pasien (Overall Survival) dengan metode Kaplan-Meier. Tujuan penelitian ini adalah melihat perbedaan kemoterapi antrasiklin dengan antrasiklin taksan pada kanker payudara

Hasil: Data penderita kanker selama Januari 2019-Desember 2020 terdapat 125 subjek yang menggunakan regimen antrasiklin taksan dan sesuai kriteria inklusi. Terdapat 62 subjek pengguna regimen antrasiklin dan 63 subjek pengguna regimen antrasiklin taksan. Hasil analisa pengamatan 48 bulan menunjukkan estimasi rerata lama hidup regimen antrasiklin 31,290 bulan (CI 95% 27,193-35,387) dengan persentase pCR 69,3?n OS 43,5% sementara regimen antrasiklin taksan memiliki estimasi rerata lama hidup 34,603 bulan (CI 951,236-37,970) dengan persentase pCR 80,9?n OS 44,5%. Analisa risiko menunjukkan regimen antrasiklin memiliki risiko mortalitas 1,165 kali dibandingkan dengan regimen antrasiklin taksan (p=0,524).

Kesimpulan: Regimen antrasiklin dan taksan memiliki overall survival dan pCR yang lebih baik dari regimen antrasiklin tetapi tidak signifikan secara statistik.

Background: Breast cancer had one of the highest cumulative incidence rates among all types of cancer worldwide, representing 11.7% of new cases and 6.9% of deaths in 2020. Anthracyclines and taxanes are chemotherapeutic drugs commonly employed as the first-line treatment for diverse types of breast cancer. 

Method: The study was performed in a retrospective cohort at RSUP H. Adam Malik, involving patients who underwent chemotherapy between 2019 and 2020.   The study findings are derived from the analysis of cancer cell biopsies, specifically pathologic Complete Response (pCR), using chi-square tests, as well as overall survival analysis using Kaplan-Meier methods. This study aims to assess the disparities between anthracycline regime and antracyclicine-taxane regime in the of breast cancer chemotherapy.

Results: During January 2019 to December 2020, a total of 125 cancer patients were identified who met the inclusion criteria and received treatment with the anthracycline regimen. A total of 62 participants were administered the anthracycline regimen, while 63 subjects received the anthracycline-taxane regimen. The analysis of the 48-month observation revealed that anthracycline regime have an estimated lifespan of 31,290 months (95% CI 27,193-35,387) with a pCR rate of 69.3% and an OS rate of 43.5%. On the other hand, anthracycline-taxane regime showed an estimated longevity rate of 34,603 months (95% CI 31,236-37,970) with a pCR rate of 80.9% and an OS rate of 44.5%. The risk analysis indicates that anthracycline regime have a mortality risk that is 1,165 times higher compared to anthracycline-taxane regimes (p=0.524).

Conclusion:The anthracycline plus taxane regimen have higher overall survival rates and pathological complete response (pCR) rates than the anthracycline-only regimen, but the differences are not statistically significant.

Kata Kunci : Kanker Payudara, Antrasiklin, Taksan, Overall Survival, pCR