Pathologic Complete Response to Neoadjuvant Chemotherapy Plus Trastuzumab Predicts for Improved Survival in Women With HER2-positive Breast Cancer

Author(s):  
M.M. Kim ◽  
P. Allen ◽  
A. Gonzalez-Angulo ◽  
W.A. Woodward ◽  
F. Meric-Bernstam ◽  
...  
2016 ◽  
Vol 11 (4) ◽  
pp. 863
Author(s):  
Quan Liang ◽  
Qiang Fu ◽  
Wei Li ◽  
Jiacong You ◽  
Zhanchao Zhao

<p>The aim of this study was to compare the efficacy and safety of trastuzumab versus the combination of trastuzumab and lapatinib added to neoadjuvant chemotherapy for HER2 positive breast cancer. PubMed, MEDLINE, The Cochrane Library, Web of Science and nearly 5 years of the important international conference on oncology records were searched for randomized clinical trials that compared lapatinib plus trastuzumab and neoadjuvant chemotherapy (NAC) with trastuzumab in combination with NAC and that included pathologic complete response rate as the primary outcome. Finally, 6 clinical randomized controlled trials were included. Meta-analysis shows that pathological complete response rate was significantly increased in trastu-zumab plus lapatinib group than single use trastuzumab group (53.4%, 40.4%, RR = 1.75, 95% CI 1.38 ~ 2.23, p&lt;0.001). In conclusion, the combination of trastuzumab and lapatinib added to neoadjuvant chemotherapy in HER2 positive breast cancer is more effective.</p><p> </p>


2017 ◽  
Vol 164 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Mette S. van Ramshorst ◽  
Claudette E. Loo ◽  
Emilie J. Groen ◽  
Gonneke H. Winter-Warnars ◽  
Jelle Wesseling ◽  
...  

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12080-e12080
Author(s):  
Mohammed Oukkal ◽  
Souad Challal ◽  
Nawel Abed Benmelha ◽  
Nabil Benachenhou ◽  
Mohcen Wahib Boubnider ◽  
...  

e12080 Background: Evaluation of the histological response after neoadjuvant chemotherapy with Docetaxel-carboplatin and bio similar Trastuzumab (CANMAB 150mg) in Her2 positive breast cancer. The primary end point was pathologic complete response (pCR) rate, determined from surgical specimens. Methods: Between March 2017 and June 2018, we treated 39 patients with Her2-positive breast cancer satge II (61,5%), III (38,5%), with a neoadjuvant schedule of docetaxel (75 mg/m2), carboplatin (AUC 6) and biosimilar trastuzumab (CANMAB 150mg: 8 mg/kg loading dose then 6 mg/kg) every 3 weeks. Patients were diagnosed at a mean age of 48 years; 52,28% had hormone receptor-positive tumors and 87,17% of patients were node positive. All pts received 6 cycles of chemotherapy followed by surgery and one year of biosimilar trastuzumab. Results: We report the preliminary results of a prospective study on the use of the biosimilar trastuzumab combined with preoperative chemotherapy in Her2 positive breast cancer. Thirty nine patients (100%) completed six cycles of therapy. Surgery was breast conservative in 6 (15,38%) of 39 patients. Fifteen of the Thirty one patients (48%) achieved a pCR, Twelve of the twenty six node-positive patients (46,15%) experienced nodal conversion. There was a significantly lower response in HR-positive patients compared to HR-negative ones (26,7 vs 73,33%). No case of congestive heart failure was observed. Conclusions: The use of biosimilar trastuzumab with docetaxel and carboplatin achieved promising efficacy, with a good pCR rate (48%) in stage II or III Her2-positive breast cancer.


Breast Care ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. 388-393
Author(s):  
Xinguang Wang ◽  
Yingjian He ◽  
Zhaoqing Fan ◽  
Tianfeng Wang ◽  
Yuntao Xie ◽  
...  

Background: We sought to investigate the incremental benefit of trastuzumab in patients with HER2-positive breast cancer who achieved a pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT). Methods: The data of HER2-positive invasive breast cancer patients treated with NACT and achieving pCR were obtained from the institutional database. Patients were categorized according to trastuzumab administration. The Kaplan-Meier method and log-rank estimates were used to test the association between trastuzumab administration and survival. Univariate and multivariate Cox regressions were used to obtain hazard ratios. Results: Of 223 patients, 83 (37.2%) were treated with NACT without trastuzumab and 140 (62.8%) were treated with NACT plus trastuzumab for 1 year. After a median follow-up of 67 months, the trastuzumab group showed improved relapse-free survival compared with the no-trastuzumab group (95.7 vs. 87.8%, hazard ratio = 0.31, p = 0.028). No significant difference in distant disease-free survival or overall survival was observed (p = 0.250 and 0.432, respectively). Multivariate analysis identified endocrine therapy and trastuzumab administration to be associated with decreased risk of relapse (p = 0.018 and 0.030, respectively). Conclusion: The administration of trastuzumab should be considered standard treatment for HER2-positive patients who have achieved pCR after NACT alone.


2021 ◽  
Vol 13 ◽  
pp. 175883592110090
Author(s):  
Hong-Fei Gao ◽  
Zhiyong Wu ◽  
Ying Lin ◽  
Xiang-Yang Song ◽  
Yin Cao ◽  
...  

Background: Although dual blockade HER2-based neoadjuvant chemotherapy is associated with excellent outcomes for human epidermal growth factor receptor 2 (HER2)-positive breast cancer, pertuzumab is not available to all patients due to cost. The optimal neoadjuvant chemotherapy for HER2-positive breast cancer in the presence of a single HER2 blockade is unknown. This study aimed to compare the efficacy and safety of epirubicin/cyclophosphamide followed by docetaxel/trastuzumab (EC-TH) with docetaxel/carboplatin/trastuzumab (TCH) neoadjuvant setting for HER2-positive breast cancer under the single HER2 blockade. Methods: Patients with stage II-IIIC HER2-positive breast cancer were randomly assigned to either eight cycles of EC-TH every 3 weeks during all chemotherapy cycles, or six cycles of TCH every 3 weeks. The primary endpoint was pathological complete response (pCR) (defined as the absence of invasive tumor cells in breast and axilla, ypT0/is ypN0). Results: From May 2017 to November 2019, 140 patients were randomly assigned, and 135 patients were ultimately found evaluable for the primary endpoint. The pCR was recorded in 25 of 67 patients [37.3%; 95% confidence interval (CI), 25.8–50.0] in the EC-TH group and in 38 of 68 patients (55.9%, 95% CI, 43.3–67.9) in the TCH group ( p = 0.032). The most common adverse events (AEs) were neutropenia in 24 of 67 (35.8%) patients in the EC-TH group versus 27 of 68 (39.7%) in the TCH group ( p = 0.642), anemia in 33 of 67 (49.3%) patients in the EC-TH group versus 34 of 68 (50.0%) in the TCH group ( p = 0.931), and thrombocytopenia in five of 67 (7.5%) patients in the EC-TH group versus 17 of 68 (25.0%) in the TCH group ( p = 0.006). Conclusion: For patients receiving the single HER2 blockade trastuzumab for HER2-positive breast cancer, TCH regimen might be a preferred neoadjuvant therapy. Trial registration: This trial was registered with ClinicalTrials.gov identifier: NCT03140553) on 2 May 2017.


Author(s):  
Agnieszka Irena Jagiełło-Gruszfeld ◽  
Magdalena Rosinska ◽  
Malgorzata Meluch ◽  
Katarzyna Pogoda ◽  
Anna Niwińska ◽  
...  

Neoadjuvant systemic therapy has now become the the standard in early breast cancer management. Chemotherapy in combination with trastuzumab +/- pertuzumab targeted therapy can improve rates of pathologic complete response (pCR) in patients with HER2-positive breast cancer. Achieving a pCR is considered a good prognostic factor, in particular in patients with more aggressive breast cancer subtypes such as TNBC or HER2 positive cancers. Furthermore, most studies demonstrate that chemotherapy in combination with trastuzumab and pertuzumab is well tolerated. The retrospective analysis presented here concentrates on neoadjuvant therapy with the TCbH-P regimen, with a particular emphasis on patients over 60 years of age. We analysed the factors affecting the achievement of pCR and presented adverse effects of the applied therapies, which opened a discussion about optimizing the therapy of older patients with HER-2 positive breast cancer.


Sign in / Sign up

Export Citation Format

Share Document