| Autor: |
Conte, Benedetta, Montemurro, Filippo, Levaggi, Alessia, Blondeaux, Eva, Molinelli, Chiara, Cardinali, Barbara, Poggio, Francesca, Buzzatti, Giulia, Bighin, Claudia, Lambertini, Matteo, Del Mastro, Lucia |
| Zdroj: |
Tumori Journal; February 2023, Vol. 109 Issue: 1 p71-78, 8p |
| Abstrakt: |
Objective: Neoadjuvant chemotherapy has become the preferred treatment in HER2-positive early breast cancer. Several trials investigated the neoadjuvant efficacy of dual HER2 blockade with anthracycline-free chemotherapy, whereas few data are available on single-agent trastuzumab and anthracycline-based regimens, which represent the standard of care in the adjuvant setting. This phase II, single-arm trial assessed anthracycline-based chemotherapy and trastuzumab as neoadjuvant treatment for high-risk HER2-positive breast cancer.Methods: Forty-three patients with stage II–III HER2-positive breast cancer were treated with 4 courses of neoadjuvant 5-fluorouracil 600 mg/m2, epirubicin 90 mg/m2, cyclophosphamide 600 mg/m2(FEC ×4) every 21 days, followed by 12 courses of weekly paclitaxel 80 mg/m2and trastuzumab 2 mg/Kg IV (loading dose 4 mg/kg).Results: Pathologic complete response (pCR) was observed in 22 (51%) of 43 patients. After a median follow-up of 6 years, the 5-year disease-free survival and overall survival were 85.8% (95% confidence interval 75.9%–97%) and 89.6% (80.4%–99.8%), respectively. A temporary decrease in left ventricular ejection fraction was observed in two patients. No cardiac death or congestive heart failure occurred. One patient died due to febrile neutropenia.Conclusions: FEC ×4 followed by paclitaxel and trastuzumab was associated with high pCR rates and favorable long-term outcomes. However, this regimen was associated with relevant hematologic toxicity. |
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