Tiwari A, Gogia A, Deo Svs, Shukla N K, Mathur S, Sharma D N
Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Department of Surgical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Indian J Cancer. 2017 Jan-Mar;54(1):343-346. doi: 10.4103/ijc.IJC_152_17.
The neoadjuvant chemotherapy in HER2-positive breast cancer consists of a chemotherapy backbone and HER2-directed therapy. The increase in cardiotoxicity by the use of trastuzumab with an anthracycline-based regimen has led to the use of nonanthracycline-based alternative regimens. The docetaxel, carboplatin, and trastuzumab (TCH) are one such regimen. The efficacy and toxicity of this regimen have not been widely studied in Indian patients.
This retrospective study aims to evaluate the efficacy and toxicity of neoadjuvant TCH regimen in locally advanced and oligometastatic HER2-positive breast cancer in Indian patients.
The hospital records between January 2014 and December 2016 were reviewed to identify patients with locally advanced and oligometastatic HER2-positive breast cancer treated with uniform 3-weekly neoadjuvant chemotherapy protocol-containing docetaxel (75 mg/m2), carboplatin (AUC = 6), and trastuzumab (8 mg/kg loading followed by 6 mg/kg) (TCH). The primary outcome was the pathologic complete response (pCR), which was defined as an absence of invasive and noninvasive cancer in breast or lymphnode.
Thirty-two patients with mean age 46 years met our inclusion criteria, of these 24 patients had locally advanced breast cancer, and eight patients had oligometastatic breast cancer. 13 (40.6%) patients had hormone-positive breast cancer. The objective response rate as assessed clinically was 100%, and pCR rate was 36.3%. The patients with oligometastatic breast cancer also showed a good response to chemotherapy with three patients showing pCR and four patients showing resolution disease at metastatic sites. The patients experienced very few Grade III/IV toxicities, and no patient had clinical congestive heart failure.
The TCH protocol is an efficacious neoadjuvant chemotherapy regimen for locally advanced and oligometastatic breast cancer and is safe and well tolerated in this population.
人表皮生长因子受体2（HER2）阳性乳腺癌的新辅助化疗由化疗主干方案和HER2靶向治疗组成。曲妥珠单抗与基于蒽环类药物的方案联合使用会增加心脏毒性，这促使了非蒽环类替代方案的使用。多西他赛、卡铂和曲妥珠单抗（TCH）方案就是其中之一。该方案的疗效和毒性在印度患者中尚未得到广泛研究。
本回顾性研究旨在评估新辅助TCH方案对印度局部晚期和寡转移HER2阳性乳腺癌患者的疗效和毒性。
回顾2014年1月至2016年12月期间的医院记录，以确定接受统一的每3周一次新辅助化疗方案（包含多西他赛75mg/m²、卡铂AUC = 6和曲妥珠单抗8mg/kg负荷剂量后6mg/kg）（TCH）治疗的局部晚期和寡转移HER2阳性乳腺癌患者。主要结局是病理完全缓解（pCR），定义为乳腺或淋巴结中无浸润性和非浸润性癌。
32例平均年龄46岁的患者符合纳入标准，其中24例为局部晚期乳腺癌，8例为寡转移乳腺癌。13例（40.6%）患者为激素阳性乳腺癌。临床评估的客观缓解率为100%，pCR率为36.3%。寡转移乳腺癌患者对化疗也有良好反应，3例患者达到pCR，4例患者转移部位疾病消退。患者经历的III/IV级毒性很少，且无患者出现临床充血性心力衰竭。
TCH方案是一种有效的局部晚期和寡转移乳腺癌新辅助化疗方案，在该人群中安全且耐受性良好。
