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1. Background
Addition of trastuzumab and pertuzumab to neoadjuvant chemotherapy in human epidermal growth factor receptor 2(HER-2) positive patients is the current clinical standard today. In studies on neoadjuvant chemotherapy, the primary endpoint is pathological complete response (pCR). More real-life data are needed to answer whether the presence of anthracycline in the chemotherapy regimen enhances complete response with neoadjuvant dual HER-2 blockade, and whether cardiotoxicity increases with dual HER-2 blockade after anthracycline.
2. Methods
52 patients with HER-2 positive breast cancer who received neoadjuvant chemotherapy were retrospectively evaluated. Three centers participated in the study (İzmir Kent Hospital, Manisa Celal Bayar University, Ege University). The effects of chemotherapy regimen and several other factors such as age, stage, menopause status, lymph node positivity, hormone receptor positivity on pCR were evaluated. Also presence of cardiotoxicity was evaluated.
3. Results
The mean age of diagnosis was 46 ± 9 (range: 26-67), and 50% (26) of the patients were postmenopausal. The pCR rate was 71.2% (37) in the entire study group.
In terms of pCR, there was no significant difference between those who use an anthracycline containing and non-anthracycline containing regimens (71.4% vs 70%, p=1.000), those with negative and positive hormone receptors (64.7% vs 74.3%, p=0.525), those with Ki67 levels of %20 or less and those over 20% (60% vs 73.8%, p=0.447), premenopausal and postmenopausal ones (76.9% vs 65.4%, p=0.054).
4. Conclusions
As a result of the data we obtained, it was concluded that adding anthracycline regimen to dual HER-2 blockade in the neoadjuvant period did not bring additional benefits in terms of pCR. Additional studies are needed on whether the use of anthracycline-containing regimen contributes additionally in patients who will use the neoadjuvant pertuzumab-trastuzumab combination.
Keywords
Neoadjuvant, pertuzumab, HER-2 blockade, chemotherapy regimen
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
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Complete author information
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No community comments so far
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License:
This work is licensed under a CC BY 4.0 License. Read Full License
The most recent version of this article is available here.
1. Background
Addition of trastuzumab and pertuzumab to neoadjuvant chemotherapy in human epidermal growth factor receptor 2(HER-2) positive patients is the current clinical standard today. In studies on neoadjuvant chemotherapy, the primary endpoint is pathological complete response (pCR). More real-life data are needed to answer whether the presence of anthracycline in the chemotherapy regimen enhances complete response with neoadjuvant dual HER-2 blockade, and whether cardiotoxicity increases with dual HER-2 blockade after anthracycline.
2. Methods
52 patients with HER-2 positive breast cancer who received neoadjuvant chemotherapy were retrospectively evaluated. Three centers participated in the study (İzmir Kent Hospital, Manisa Celal Bayar University, Ege University). The effects of chemotherapy regimen and several other factors such as age, stage, menopause status, lymph node positivity, hormone receptor positivity on pCR were evaluated. Also presence of cardiotoxicity was evaluated.
3. Results
The mean age of diagnosis was 46 ± 9 (range: 26-67), and 50% (26) of the patients were postmenopausal. The pCR rate was 71.2% (37) in the entire study group.
In terms of pCR, there was no significant difference between those who use an anthracycline containing and non-anthracycline containing regimens (71.4% vs 70%, p=1.000), those with negative and positive hormone receptors (64.7% vs 74.3%, p=0.525), those with Ki67 levels of %20 or less and those over 20% (60% vs 73.8%, p=0.447), premenopausal and postmenopausal ones (76.9% vs 65.4%, p=0.054).
4. Conclusions
As a result of the data we obtained, it was concluded that adding anthracycline regimen to dual HER-2 blockade in the neoadjuvant period did not bring additional benefits in terms of pCR. Additional studies are needed on whether the use of anthracycline-containing regimen contributes additionally in patients who will use the neoadjuvant pertuzumab-trastuzumab combination.
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