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Clin Breast Cancer. 2018 Dec;18(6):e1283-e1288. doi: 10.1016/j.clbc.2018.07.008. Epub 2018 Jul 10.

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.

Author information

1
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: rmurthy1@mdanderson.org.
2
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
3
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX.
4
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX; Division of Cancer Prevention, Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX.
5
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
6
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.

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.

KEYWORDS:

Chemotherapy; Neoadjuvant; Pathologic complete response; Pertuzumab; Trastuzumab

PMID:
30077429
DOI:
10.1016/j.clbc.2018.07.008
[Indexed for MEDLINE]

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