Health Sciences University, Dr. Abdurrahman Yurtaslan, Ankara Oncology Education and Research Hospital, Department of Medical Oncology, Ankara, Turkey.
J BUON. 2021 Jul-Aug;26(4):1398-1404.
Recently, neoadjuvant treatment approach has gained importance in locally advanced HER-2 positive breast cancer. Adding pertuzumab increases pathological complete response (pCR). In this study, we aimed to examine the clinicopathologic features that predict the pCR in patients receiving neoadjuvant pertuzumab, trastuzumab, and chemotherapy in locally advanced HER2 positive breast cancer.
Locally advanced HER2 positive breast cancer patients who were followed up in 4 different oncology centers and received 4 cycles of pertuzumab, trastuzumab and taxane were retrospectively evaluated. A total of 58 (92%) patients received anthracycline chemotherapy before combination of dual her-2 blockade and taxanes. Fisher's and chi-square tests were used for nominal variables and numeric data analyses.
A total of 63 female patients were included in the study. Their median age was 46 years (21-75) and 40 (63.5%) patients were premenopausal. Median tumor size was 25 mm (2-70) and there were 22 (34.9%) patients with Stage 3a. pCR was 66% and 75% in the whole group and in the hormone negative group, respectively. Statistically significant increase was found in pCR in patients with grade 3 tumors and cerbB2 with 3+ immunohistochemical staining. No relationship was found between pCR and age at diagnosis, menopausal status, tumor infiltrating lymphocyte, dose-dense anthracycline, Ki67≥40, body mass index (BMI) ≥ 30 kg/m2 and accompanying DCIS.
Four cycles of pertuzumab, trastuzumab and taxane after neoadjuvant anthracycline for locally advanced HER2 breast cancer are associated with increased pCR in patients with grade 3 tumors and high cerbB2 expression.
最近，新辅助治疗方法在局部晚期 HER-2 阳性乳腺癌中变得越来越重要。加入帕妥珠单抗可增加病理完全缓解（pCR）率。本研究旨在探讨局部晚期 HER2 阳性乳腺癌患者接受新辅助帕妥珠单抗、曲妥珠单抗和化疗时预测 pCR 的临床病理特征。
回顾性评估在 4 个不同肿瘤中心接受 4 个周期帕妥珠单抗、曲妥珠单抗和紫杉烷治疗的局部晚期 HER2 阳性乳腺癌患者。共有 58 例（92%）患者在双 HER2 阻断联合紫杉烷治疗前接受了蒽环类化疗。名义变量和数值数据的分析分别采用 Fisher 和卡方检验。
共纳入 63 例女性患者。其中位年龄为 46 岁（21-75 岁），40 例（63.5%）患者为绝经前。中位肿瘤大小为 25mm（2-70mm），22 例（34.9%）患者为 3a 期。整体和激素阴性组的 pCR 率分别为 66%和 75%。在 3 级肿瘤和 cerbB2 免疫组织化学染色 3+的患者中，pCR 显著增加。pCR 与诊断时年龄、绝经状态、肿瘤浸润淋巴细胞、密集蒽环类药物、Ki67≥40、体质量指数（BMI）≥30kg/m2 及伴随的 DCIS 无关。
局部晚期 HER2 阳性乳腺癌患者在新辅助蒽环类治疗后接受 4 个周期的帕妥珠单抗、曲妥珠单抗和紫杉烷治疗与 3 级肿瘤和高 cerbB2 表达患者的 pCR 增加相关。
