Neoadjuvant Pertuzumab-containing Regimens Improve Pathologic Complete Response Rates in Stage II to III HER-2/neu-positive Breast Cancer: A Retrospective, Single Institution Experience.

Abstract

INTRODUCTION:

Several human epidermal growth factor 2 (HER2)-targeted regimens are used to treat HER2-positive (HER2+) breast cancer (BC). The goal of this study was to retrospectively determine the pathologic complete response (pCR) rate for trastuzumab and pertuzumab (HP)-containing regimens compared with trastuzumab (H)-containing regimens for stage II to III HER2+ BC.

PATIENTS AND METHODS:

Patients (n = 977) with stage II to III HER2+ BC who received neoadjuvant HER2-targeted therapy from 2005 to 2016 and underwent definitive breast and axillary lymph node surgery were identified. pCR was defined as ypT0/is, ypN0. Univariate/multivariate logistic regression and the χ2 test for comparing proportions was used for the statistical analysis.

RESULTS:

The pCR rate was higher for the HP group (n = 170) compared with the H group (n = 807): 59% versus 46% (odds ratio, 1.7; 95% confidence interval, 1.21-2.37; P = .0021). After adjustment for clinically important factors (age, date of diagnosis, stage, tumor grade, nodal status, hormone receptor [HR] status, menopausal status, and chemotherapy backbone) the adjusted odds ratio was 2.25 (95% confidence interval, 1.08-4.73; P = .032). In multivariate analysis, a significant predictor of pCR in both groups included HR status (HR-negative > HR-positive).

CONCLUSION:

These results demonstrate that HP-containing regimens yield higher pCR rates compared with H-containing regimens in patients with stage II to III HER2+ BC in clinical practice regardless of chemotherapy backbone.

• Authors: Rashmi K Murthy, Akshara S Raghavendra, Kenneth R Hess, Takeo Fujii, Bora Lim, Carlos H Barcenas, Hong Zhang, Mariana Chavez-Mac-Gregor, Elizabeth A Mittendorf, Jennifer K Litton, Sharon H Giordano, Alastair M Thompson, Vicente Valero, Stacy L Moulder, Debu Tripathy, Naoto T Ueno
• Journal: Clinical breast cancer (Clin Breast Cancer) Vol. 18 Issue 6 Pg. e1283-e1288 (12 2018) ISSN: 1938-0666 [Electronic] United States
• PMID: 30077429 (Publication Type: Clinical Trial, Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Antibodies, Monoclonal, Humanized
• Biomarkers, Tumor
• ERBB2 protein, human
• Receptor, ErbB-2
• pertuzumab
• Trastuzumab

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biomarkers, Tumor
• Breast Neoplasms (drug therapy, pathology)
• Female
• Follow-Up Studies
• Humans
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Staging
• Prospective Studies
• Receptor, ErbB-2 (metabolism)
• Retrospective Studies
• Trastuzumab (administration & dosage)
• Young Adult