Shinde Arvind M, Zhai Jing, Yu Kim Wai, Frankel Paul, Yim John H, Luu Thehang, Kruper Laura, Vito Courtney, Shaw Sally, Vora Nayana L, Kirschenbaum Michele, Somlo George
Department of Medical Oncology and Therapeutic Research, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA.
Department of Pathology, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA.
Breast. 2015 Feb;24(1):18-23. doi: 10.1016/j.breast.2014.10.008. Epub 2014 Nov 20.
Pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) is considered a surrogate for improved survival. Platinum-containing NCT, particularly in patients with HER2+ and triple-negative breast cancers (TNBC) may increase pCR rates.
Tumor characteristics, pCR rates (no invasive disease in breast and lymph nodes), toxicities, and survival in patients who received carboplatin, a taxane, and trastuzumab (HER2+ disease) between April 2009 and December 2011, were reviewed.
Thirty eight patients (39 tumors) completed a median of 4 cycles of NCT. Eighteen of 39 (46%) tumors were HER2+, 8/18 (44%) responded with pCR; 13/18 HER2+ tumors were HR+ (72%) and 4/13 (31%) had a pCR. Ten of 39 (26%) tumors were TNBC; 6/10 (60%) had a pCR. At a median of 25-months no recurrences were observed in patients with pCR.
Prospective studies of anthracycline-free platinum-containing NCT are warranted in LABC patients with HER2+ and TNBC.
新辅助化疗（NCT）后的病理完全缓解（pCR）被认为是生存改善的替代指标。含铂新辅助化疗，特别是在人表皮生长因子受体2（HER2）阳性和三阴性乳腺癌（TNBC）患者中，可能会提高pCR率。
回顾了2009年4月至2011年12月期间接受卡铂、紫杉烷和曲妥珠单抗（HER2阳性疾病）治疗的患者的肿瘤特征、pCR率（乳腺和淋巴结无浸润性疾病）、毒性和生存率。
38例患者（39个肿瘤）完成了中位4周期的新辅助化疗。39个肿瘤中有18个（46%）为HER2阳性，18个中的8个（44%）达到pCR；18个HER2阳性肿瘤中有13个（72%）为激素受体（HR）阳性，其中4个（31%）达到pCR。39个肿瘤中有10个（26%）为TNBC；10个中的6个（60%）达到pCR。在中位25个月时，pCR患者未观察到复发。
对于HER2阳性和TNBC的局部晚期乳腺癌（LABC）患者，有必要进行不含蒽环类药物的含铂新辅助化疗的前瞻性研究。
