Use of Trastuzumab for Neoadjuvant Therapy of HER2+ Breast Cancer – 5-Years of Experience in a Single Clinic
Authors:
Bielčiková Zuazana 1; Petruželka Luboš 1; Chloupková Renata 2
Authors place of work:
Onkologická klinika 1. LF UK a VFN v Praze
1; Institut biostatistiky a analýz, LF MU, Brno
2
Published in the journal:
Klin Onkol 2018; 31(3): 191-199
Category:
Original Articles
doi:
https://doi.org/10.14735/amko2018191
Summary
Background:
Trastuzumab (Herceptin® – H) has been the standard-of-care for patients with HER2+ breast cancer (BC) since 2009 in the Czech Republic. Neoadjuvant application of H increases the number of patients who achieve pathological complete remission (pCR) and improves patients’ outcomes. Aim: This study aimed to assess the effect of neoadjuvant therapy (NAT) with H in patients with early HER2+ BC and to correlate the therapeutic outcome with overall survival (OS). We defined pCR as no invasive carcinoma (ypT0) or in situ residual carcinoma (ypTis) in breast tissue and no invasive carcinoma in axillary lymphatic nodes (ypN0). To correlate pCR with the hormone dependency of BC, we compared the number of patients who achieved pCR between those with hormone-dependent (estrogen receptor (ER) +) BC and those with hormone-negative (ER–) BC.
Results:
We evaluated data from 148 patients with HER2+ BC, most of whom were at stage II. Of these, 50.7% were premenopausal women and 45.9% had ER– BC. Most patients were treated with anthracyclines followed by taxanes and H. pCR was reported in 50% of patients (74/148). ER+ BC regressed more often to ypTis stage (24/35), ER– BC to ypT0ypN0 stage (26/39). The 1-year OS rate of patients who achieved pCR was significantly higher than that of patients who did not (100.0% vs. 95.3%, p = 0.009). Median OS was not achieved in pCR patients group.
Conclusion:
Patients who achieved pCR had a better prognosis than patients who did not.
Key words:
neoadjuvant therapy – trastuzumab – early breast cancer – pathological complete remission – prognosis
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Submitted: 14. 9. 2017
Accepted: 15. 2. 2018
Zdroje
1. Haque R, Ahmed SA, Inzhakova G et al. Impact of breast cancer subtypes and treatment on survival: an analysis spanning two decades. Cancer Epidemiol Biomarkers Prev 2012; 21 (10): 1848–1855. doi: 10.1158/1055-9965.EPI-12-0474.
2. Rastogi P, Anderson SJ, Bear HD et al. Preoperative chemotherapy: updates of National surgical adjuvant breast and bowel project protocols B-18 and B-27. J Clin Oncol 2008; 26 (5): 778–785. doi: 10.1200/JCO.2007. 15.0235.
3. Gralow JR, Burstein HJ, Wood W et al. Preoperative therapy in invasive breast cancer: pathologic assessment and systemic therapy issues in operable disease. J Clin Oncol 2008; 26 (5): 814–819. doi: 10.1200/JCO.2007.15.3510.
4. Killelea BK, Yang VQ, Mougalian S et al. Neoadjuvant chemotherapy for breast cancer increases the rate of breast conservation: results from the National cancer database. J Am Coll Surg 2015; 220 (6): 1063–1069. doi: 10.1016/j.jamcollsurg.2015.02.011.
5. Bonadonna G, Valagussa P, Brambilla C et al. Primary chemotherapy in operable breast cancer: eight-year experience at the Milan Cancer Institute. J Clin Oncol 1998; 16 (1): 93–100. doi: 10.1200/JCO.1998.16.1.93.
6. Vecchio FM, Valentini V, Minsky BD et al. The relationship of pathologic tumor regression grade (TRG) and outcomes after preoperative therapy in rectal cancer. Int J Radiat Oncol Biol Phys 2005; 62 (3): 752–760. doi: 10.1016/j.ijrobp.2004.11.017.
7. Kuroi K, Toi M, Tsuda H et al. Unargued issues on the pathological assessment of response in primary systemic therapy for breast cancer. Biomed Pharmacother 2005; 59 (Suppl 2): 387–392.
8. Ogston KN, Miller ID, Payne S et al. A new histological grading system to assess response of breast cancers to primary chemotherapy: prognostic significance and survival. Breast 2003; 12 (5): 320–327.
9. Liedtke C, Mazouni C, Hess KR et al. Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol 2008; 26 (8): 1275–1281. doi: 10.1200/JCO.2007.14.4147.
10. Cortazar P, Zhang L, Untch M et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 2014; 384 (9938): 164–172. doi: 10.1016/S0140-6736 (13) 624 22-8.
11. von Minckwitz G, Untch M, Blohmer JU et al. Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. J Clin Oncol 2012; 30 (15): 1796–1804. doi: 10.1200/JCO.2011.38.8595.
12. Untch M, Fasching PA, Konecny GE et al. Pathologic complete response after neoadjuvant chemotherapy plus trastuzumab predicts favorable survival in human epidermal growth factor receptor 2 – overexpressing breast cancer: results from the TECHNO trial of the AGO and GBG study groups. J Clin Oncol 2011; 29 (25): 3351–3357. doi: 10.1200/JCO.2010.31.4930.
13. Ahluwalia MS, Daw HA. Neoadjuvant therapy with trastuzumab, paclitaxel and epirubicin for HER-2-positive operable breast cancer. J Clin Oncol 2005; 23 (30): 7760–7761. doi: 10.1200/JCO.2005.03.0213.
14. Dawood S, Gonzalez-Angulo AM, Peintinger F et al. Efficacy and safety of neoadjuvant trastuzumab combined with paclitaxel and epirubicin: A retrospective review of the M. D. Anderson experience. Cancer 2007; 110 (6): 1195–1200. doi: 10.1002/cncr.22895.
15. Coudert BP, Largillier R, Arnould L et al. Multicenter phase II trial of neo-adjuvant therapy with trastuzumab, docetaxel, and carboplatin for human epidermal growth factor receptor-2-overexpressing stage II or III breast cancer: Results of the GETN (A) -1 trial. J Clin Oncol 2007; 25 (19): 2678–2684. doi: 10.1200/JCO.2006.09.9994.
16. Limentani SA, Brufsky AM, Erban JK et al. Phase II study of neoadjuvant docetaxel, vinorelbine, and trastuzumab followed by surgery and adjuvant doxorubicin plus cyclophosphamide in women with human epidermal growth factor receptor 2-overexpressing locally advanced breast cancer. J Clin Oncol 2007; 25 (10): 1232–1238. doi: 10.1200/JCO.2005.05.3306.
17. Buzdar AU, Valero V, Ibrahim NK et al. Neoadjuvant therapy with paclitaxel followed by 5-fluorouracil, epirubicin, and cyclophosphamide chemotherapy and concurrent trastuzumab in human epidermal growth factor receptor 2-positive operable breast cancer: An update of the initial randomized study population and data of additional patients treated with the same regimen. Clin Cancer Res 2007; 13 (1): 228–233. doi: 10.1158/1078-0432.CCR-06-1345.
18. Lazaridis G, Pentheroudakis G, Pavlidis N. Integrating trastuzumab in the neoadjuvant treatment of primary breast cancer: Accumulating evidence of efficacy, synergy and safety. Crit Rev Oncol Hematol 2008; 66 (1): 31–41. doi: 10.1016/j.critrevonc.2007.07.002.
19. Gianni L, Semiglazov V, Manikhas GM et al. Neoadjuvant trastuzumab in locally advanced breast cancer (NOAH): Antitumour and safety analysis. J Clin Oncol 2007; 25: 532–539. doi: 10.1200/JCO.2006.08.9987.
20. Peintinger F, Buzdar AU, Kuerer HM et al. Hormone receptor status and pathologic response of HER2-positive breast cancer treated with neoadjuvant chemotherapy and trastuzumab. Ann Oncol 2009; 19 (12): 2020–2025. doi: 10.1093/annonc/mdn427.
21. Petrelli F, Fausto K, Borgonovo M et al. Neoadjuvant chemotherapy and concomitant trastuzumab in breast cancer: a pooled analysis of two randomized trials. Anticancer Drugs 2011; 22 (2): 128–135.
22. Kakarala M, Wicha MS. Implications of the cancer stem-cell hypothesis for breast cancer prevention and therapy. J Clin Oncol 2008; 26 (17): 2813–2820. doi: 10.1200/JCO.2008.16.3931.
23. Korkaya H, Paulson A, Iovino F et al. HER2 regulates the mammary stem/progenitor cell population driving tumorigenesis and invasion. Oncogene 2008; 27 (47): 6120–6130. doi: 10.1038/onc.2008.207.
24. de Azambuja E, Holmes AP, Piccart-Gebhart M et al. Lapatinib with trastuzumab for HER2-positive early breast cancer (NeoALTTO): survival outcomes of a randomised, open-label, multicentre, phase 3 trial and their association with pathological complete response. Lancet Oncol 2014; 15 (10): 1137–1146. doi: 10.1016/S1470-2045 (14) 70 320-1.
25. Gianni L, Pienkowski T, Im YH et al. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial. Lancet Oncol 2012; 13 (1): 25–32. doi: 10.1016/S1470-2045 (11) 70336-9.
26. Schneeweiss A, Chia S, Hickish T et al. Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase II cardiac safety study (TRYPHAENA). Ann Oncol 2013; 24 (9): 2278–2284. doi: 10.1093/annonc/mdt182.
27. Broglio KR, Quintana M, Foster M, et al. Association of pathologic complete response to neoadjuvant therapy in HER2-positive breast cancer with long-term outcomes: A meta-analysis. JAMA Oncol 2016; 2 (6): 751–760. doi: 10.1001/jamaoncol.2015.6113.
28. Buzdar AU, Ibrahim NK, Francis D et al. Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol 2005; 23 (16): 3676–3685. doi: 10.1200/JCO.2005.07.032.
29. Gianni L, Eiermann W, Semiglazov V et al. Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet 2010; 375 (9712): 377–384. doi: 10.1016/S0140-6736 (09) 61 964-4.
30. Seidman A, Hudis C, Pierri MK et al. Cardiac dysfunction in the trastuzumab clinical trials experience. J Clin Oncol 2002; 20 (5): 1215–1221. doi: 10.1200/JCO.2002.20.5. 1215.
31. Guarneri V, Lenihan DJ, Valero V et al. Long-term cardiac tolerability of trastuzumab in metastatic breast cancer: the M.D. Anderson cancer center experience. J Clin Oncol 2006; 24 (25): 4107–4115. doi: 10.1200/JCO.2005.04. 9551.
32. Romond EH, Jeong JH, Rastogi P et al. Seven-year follow-up assessment of cardiac function in NSABP B-31, a randomized trial comparing doxorubicin and cyclophosphamide followed by paclitaxel (ACP) with ACP plus trastuzumab as adjuvant therapy for patients with node-positive, human epidermal growth factor receptor 2–positive breast cancer. J Clin Oncol 2012; 30 (31): 3792–3799. doi: 10.1200/JCO.2011.40.0010.
33. Cortayer P, Zhang L, Untch M et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 2014; 384 (9938): 163–172. doi: 10.1016/S0140-6736 (13) 624 22-8.
34. Fujii S, Yamashita S, Yamaguchi T et al. Pathological complete response of HER2-positive breast cancer to trastuzumab and chemotherapy can be predicted by HSD17B4 methylation. Oncotarget 2017; 8 (12): 19039–19048. doi: 10.18632/oncotarget.15118.
35. Fujii T, Kogawa T, Wu J et al. Nomogram to predict pathologic complete response in HER2-positive breast cancer treated with neoadjuvant systemic therapy. Br J Cancer 2017; 116 (4): 509–514. doi: 10.1038/bjc.2016.444.
36. Guiu S, Mouret Reynier MA, Toure M et al. Predictive factors of response in HER2-positive breast cancer treated by neoadjuvant therapy. J Oncol 2013; 854121. doi: 10.1155/2013/854121.
37. Cudós AG, Morales S, Alvarez AN et al. Pathological complete response in HER2 positive breast cancer treated with trastuzumab and chemotherapy: Predictive factors report. J Clin Oncol 2017; 35 (Suppl 15): e12133. doi: 10.1200/JCO.2017.35.15_suppl.e12 133.
38. Valachis A, Mauri D, Polyzos NP et al. Trastuzumab combined to neoadjuvant chemotherapy in patients with HER2-positive breast cancer: a systematic review and meta-analysis. Breast 2011; 20 (6): 485–490. doi: 10.1016/j.breast.2011.06.009.
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