11089 Background: Neoadjuvant therapy for breast cancer constitutes an excellent test to evaluate the sensitivity to chemotherapeutic agents and/or new biological agents against specific targets as trastuzumab and Her2. Furthermore, pathologic complete response (pCR) is a surrogate marker for disease-free and overall survival. Methods: The objective was to determine the efficacy in terms of pCR rates and the safety profile of the doublets plus trastuzumab schedule administered for the neoadjuvant setting of locally advanced breast cancer patients. A total of 20 patients with histologically confirmed locally invasive Her2-positive breast carcinoma were included. The median age was 43. Mean tumour size was 5.1 cm. Treatment consisted of a first sequence with epirubicin 90 mg/m2 and cyclophophamide 600 mg/m2 for 3 cycles, and a second sequence with paclitaxel 150 mg/m2 and gemcitabine 2500 mg/m2 for six cycles. All drugs were administered on day 1, every two weeks with prophylactic growth factor supports. Weekly trastuzumab was administered at a dose of 2mg/kg (4 mg/kg loading dose), concomitantly with paclitaxel and gemcitabine. Subsequently, patients underwent surgery and received radiotherapy and/or adjuvant hormonal therapy according to institutional practice Results: Objective clinical response was achieved in all patients. 10 (50%) pCR were obtained. With a median follow up of 18.2 months (3–38), 17 patients (85%) are alive without disease progression, and 3 (15%) showed recurrence and 1 of whom died. Treatment was well tolerated, 1 patient experienced 1 episode of grade 4 neutropenia and 2 patients had grade 3 neutropenia. 1 patient discontinued the treatment due to hypersensitivity reaction to paclitaxel. Asymptomatic decrease in cardiac ejection fraction with subsequent normalization was seen in 1 case. Conclusions: Despite of the small number of patients, results have shown a high pCR rate in this group of breast cancer patients with poor prognostic. The schedule seems to be feasible and tolerable and further studies with the doublet sequences plus trastuzumab are warranted on the neoadjuvant Her2 positive breast cancer patients No significant financial relationships to disclose.
Predictors of Long-Term Disease Control and Survival for HER2-Positive Advanced Breast Cancer Patients Treated With Pertuzumab, Trastuzumab, and Docetaxel
