Neoadjuvant chemotherapy with or without anthracyclines in combination with single HER2-targeted therapy in HER2-positive breast cancer.

Autor: Gupta A; All India Institute of Medical Sciences (AIIMS), New Delhi, India., Gogia A; All India Institute of Medical Sciences (AIIMS), New Delhi, India. Electronic address: ajaygogia@gmail.com., Deo S; All India Institute of Medical Sciences (AIIMS), New Delhi, India., Sharma DN; All India Institute of Medical Sciences (AIIMS), New Delhi, India., Mathur S; All India Institute of Medical Sciences (AIIMS), New Delhi, India., Sagiraju HKR; National Cancer Institute, Jhajjar, Haryana, India.
Jazyk: angličtina
Zdroj: Cancer treatment and research communications [Cancer Treat Res Commun] 2023; Vol. 36, pp. 100741. Date of Electronic Publication: 2023 Jul 09.
DOI: 10.1016/j.ctarc.2023.100741
Abstrakt: Background: Neoadjuvant chemotherapy (NACT) with human epidermal growth factor receptor 2 (HER2) blockade is the preferred approach for treating early and locally advanced HER2-positive breast cancer. There is a lack of robust data comparing pathological complete response (pCR) and survival outcomes in anthracycline-free and anthracycline-containing regimens with single HER2-targeted therapy.
Objectives: The present study retrospectively evaluated pCR between two groups: Single HER2-targeted therapy with and without anthracycline.
Methods: A total of 215 HER2-positive female breast cancer patients were analyzed who received eitheranthracycline-containing EC-TH (epirubicin and cyclophosphamide, followed by docetaxel and trastuzumab)oranthracycline-free TCH [docetaxel, carboplatin and trastuzumab]. Univariate and multivariate analyses identified prognostic factors for survival and pCR.Kaplan Meier survival curvesdetermined disease-free survival(DFS) and overall survival (OS).
Results: Baseline characteristics were comparable in both treatment groups. The pCR rate was 30.8% in the anthracycline-containing EC-TH group and 40.9% in the anthracycline-free TCH group; p = 0.140. Disease-free survival at 3 years (65.8% vs. 58.4%) and 5 years (49.2% vs. 55.2%) was similar between EC-TH and TCH groups, respectively (log-rank p = 0.550). Three-year (95.5% vs. 92.5%) and five-year (84.4% vs. 80.8%) OSwere also comparable between both groups (log-rank p = 0.485). The anthracycline-containing EC-TH group had a higher incidence of febrile neutropenia (6.4%. vs. 3.6%) and cardiac adverse events (7.7% vs. 4.4%) than the anthracycline-free TCH group.
Conclusion: Neoadjuvant anthracycline-free chemotherapy has similar pCR and survival outcomeswith favourable cardiac and non-cardiac adverse effect profiles compared with anthracycline-containing chemotherapy.
Competing Interests: Declaration of Competing Interest The authors declare that they do not have any conflict of interest.
(Copyright © 2023. Published by Elsevier Ltd.)
Databáze: MEDLINE
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