优化三阴性乳腺癌（TNBC）的新辅助治疗仍是临床上急需解决的问题。 在这项前瞻性队列研究中，我们调查了阿帕替尼联合剂量密集紫杉醇和卡铂（Apa+ddTCb）与仅使用剂量密集紫杉醇和卡铂方案（ddTCb）进行新辅助治疗的疗效和安全性在TNBC局部晚期新辅助治疗中。 临床I-IIIC期的TNBC患者被纳入接受新辅助Apa+ddTCb治疗的队列。 通过倾向评分匹配，手术后的受试患者与接受新辅助ddTCb治疗的TNBC患者进行配对。 共有25例局部晚期TNBC患者纳入新辅助Apa+ddTCb治疗。 在6个疗程后，总体有效率为88.00％，疾病控制率为100.0％。 23例行手术的患者经配对后与接受新辅助ddTCb治疗的69例TNBC患者相匹配。 Apa+ddTCb组中pCR率（60.9％对30.4％，P =.009）和BCS率（60.9％对30.4％，P =.009）显著提高。 不良事件发生率，尤其是与抗血管生成相关的事件，在Apa+ddTCb组中较高。 进一步的免疫组化分析表明，在Apa+ddTCb组接受新辅助治疗后，VEGF，EGFR，p-VEGFR2和CK17的表达水平显著降低，并且非pCR患者的基线CK17表达水平明显高于pCR患者。 无进展生存期尚未达到。 与ddTCb方案相比，Apa+ddTCb方案在新辅助治疗局部晚期TNBC中取得了改善的疗效和可接受的不良事件，这可能是一种有前景的策略。© 2023 The Authors. 由John Wiley & Sons Ltd代表UICC出版的《国际癌症学》。

Optimizing neoadjuvant therapy for triple-negative breast cancer (TNBC) is still an urgent problem to be solved in the clinic. In this prospective cohort study, we investigated the efficacy and safety of apatinib combined with dose-dense paclitaxel and carboplatin (Apa+ddTCb) vs dose-dense paclitaxel plus carboplatin regimens alone (ddTCb) in neoadjuvant therapy for locally advanced TNBC. TNBC patients with clinical stage I-IIIC were enrolled to receive neoadjuvant Apa+ddTCb therapy. Enrolled patients who underwent surgery were matched with TNBC patients who received neoadjuvant ddTCb therapy by propensity score matching. 25 locally advanced TNBC patients were enrolled for neoadjuvant Apa+ddTCb therapy. The overall clinical ORR achieved 88.00% and DCR achieved 100.0% after 6 cycles. For 23 patients who received surgery, 69 TNBC patients who received neoadjuvant ddTCb therapy were matched. The pCR rate (60.9% vs 30.4%, P = .009) and the BCS rate (60.9% vs 30.4%, P = .009) were significantly improved in the Apa+ddTCb group. The incidence of adverse events, especially those related to antiangiogenic therapy, was higher in the Apa+ddTCb group. Further immunohistochemical analysis suggested that the expression levels of VEGF, EGFR, p-VEGFR2 and CK17 were significantly decreased after receiving neoadjuvant therapy in the Apa+ddTCb group, and the baseline CK17 expression level in non-pCR patients was significantly higher than those in the pCR patients. Progression-free survival was not reached yet. Apa+ddTCb regimen achieved an improved efficacy and acceptable adverse events compared with ddTCb regimen, which might be a promising strategy in the neoadjuvant therapy for locally advanced TNBC.© 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.