Imidazofurin

Targeted axillary dissection (TAD) was developed to reduce axillary morbidity in breast cancer by avoiding axillary lymph node dissection (ALND). Morbidity after TAD is expected to align with morbidity after sentinel lymph node biopsy; however, patient populations differ. As long-term morbidity after TAD is unknown, this study examined presence and severity of pain following TAD staging after neoadjuvant treatment.

A self-reported, validated questionnaire was sent to patients treated for cN1-3 breast cancer with TAD after neoadjuvant chemotherapy (NACT), with or without completion ALND, between Jan 1, 2017, and Aug 31, 2021. Data collection started in Jan 2025. The primary outcome was presence and severity of pain. Descriptive statistics were used, and a multivariable logistic regression analysis identified factors associated with reporting pain.

Questionnaire response rates were 59% for TAD alone and 50% for TAD with ALND. Median follow-up was 4.6 years. Overall, 59.5% reported pain, with more patients in the TAD with ALND group affected (67% versus 52%, p < .01). Severe pain was reported by 11.3%, with no difference between groups. Axillary surgery type was associated with reporting pain (OR 0.54 for the TAD only group, 95% CI 0.35-0.83, p = <0.01).

TAD alone reduces the odds of reporting pain by approximately 50%, yet persistent pain is common, affecting half of the patients staged with TAD alone. Two-thirds of those with completion ALND reports persistent pain at long-term follow-up. Long-term morbidity after axillary staging after NACT require deeper understanding and should be considered in clinical decision-making.

China has advanced both domestic innovation and the introduction of imported targeted anticancer drugs (TADs). However, characteristics of these TADs remain unclear. In this cross‐sectional study, we identified TADs approved in China from 2017 to 2024. Trend in number, target distributions, endpoint evidence, clinical benefit (via European Society for Medical Oncology–Magnitude of Clinical Benefit Scale [ESMO‐MCBS]), and the price were analyzed. Of the approved 143 TADs (315 indications), 64 (44.8%) (145 indications [46.0%]) were domestically developed and 79 (55.2%) (170 indications [54.0%]) were imported, with annual growth rates of 31.0% for domestic TADs (incidence rate ratio 1.310, 95% CI; 1.158–1.482; P  < 0.001) vs. 9.8% for imported TADs (1.098, 95% CI; 0.992–1.215; P  = 0.071). A total of 52 drug targets were identified (23 domestic; 47 imported). Imported TAD indications more often reported overall survival (OS) than domestic drugs (44.1% vs. 29.0%; P  = 0.006), but domestic TAD indications showed better OS (hazard ratio 0.69, 95% CI 0.66–0.71 vs. 0.73, 95% CI 0.71–0.76). Domestic TAD indications were predominantly rated as having intermediate clinical benefit (57.9% vs. 35.9% for imported), while high benefit was less frequent (22.1% vs. 35.3%) and low benefit slightly less common (20.0% vs. 28.8%). Median monthly treatment prices were consistently higher for imported than domestic TADs across all drug categories. In conclusion, both domestic and imported TADs continued to increase. Domestic TAD targets were highly concentrated. Fewer than half of domestic and imported TAD indications reported OS, and less than 40% in either group achieved high‐grade clinical benefit. Imported TADs had higher monthly treatment prices than domestic TADs.