De-escalated neoadjuvant therapy with nanoparticle albumin-bound paclitaxel and trastuzumab for low-risk pure HER2 breast cancer
| Autor: | Nayuko Sato, Kosei Kimura, Yuka Asano, Yukihiro Nishida, Shinichiro Kashiwagi, Tsutomu Takashima, Takashi Morimoto, Ayana Ikari, Toshihiro Kobayashi, Satoru Noda, Yukie Tauchi, Hiroya Fujioka, Naofumi Oda, Mitsuhiko Iwamoto, Nobuki Matsunami, Satoru Tanaka, Risa Terasawa, Hirotaka Morishima, Junna Sakane, Kanako Kawaguchi, Toshikatsu Nitta, Norihiro Hokimoto, Shintaro Michishita |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology Adult Cancer Research medicine.medical_specialty Anthracycline Receptor ErbB-2 medicine.medical_treatment Breast Neoplasms Toxicology Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Breast cancer Trastuzumab Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Clinical endpoint Humans Pharmacology (medical) Prospective Studies skin and connective tissue diseases Adverse effect Neoadjuvant therapy Aged Pharmacology Taxane business.industry Middle Aged medicine.disease Neoadjuvant Therapy Regimen 030104 developmental biology Treatment Outcome 030220 oncology & carcinogenesis Female Albumin-Bound Paclitaxel business medicine.drug |
| Zdroj: | Cancer chemotherapy and pharmacology. 83(6) |
| ISSN: | 1432-0843 |
| Popis: | Neoadjuvant trastuzumab combined with anthracycline and taxane is now considered a standard regimen for human epidermal growth factor receptor 2 (HER2)-positive breast cancer. A less toxic, non-anthracycline regimen has been considered as a treatment option for patients with node-negative small tumors. Estrogen receptor-negative and HER2-positive (pure HER2) tumors are more likely to achieve a pathological complete response (pCR). This study evaluates the activity and safety of neoadjuvant nanoparticle albumin-bound paclitaxel (nab-PTX) plus trastuzumab for pure HER2 breast cancer in patients with low risk of relapse. We treated patients with tumors measuring ≤ 3 cm, node-negative, pure HER2 breast cancer using neoadjuvant nab-PTX 260 mg/m2 with trastuzumab every 3 weeks for four cycles. The primary endpoint was the pCR rate. The secondary endpoints included the clinical response rate, disease-free survival, pathologic response rate (defined as pCR or minimal residual invasive disease only in the breast), breast-conserving surgery conversion rate, safety, and disease-free survival. Depending on the pathological findings of surgical specimens, the administration of adjuvant anthracycline could be omitted. Eighteen patients were enrolled. No patient required dose delays or reductions; none showed disease progression, and all patients underwent surgery as scheduled. Of the 18 patients, 66.7% achieved pCR, and the adjuvant anthracycline regimen was omitted for all patients. The incidence of severe adverse events was quite low. This less toxic, anthracycline-free regimen appears to be a significantly effective neoadjuvant therapy for patients with pure HER2 breast cancer at low relapse risk. |
| Databáze: | OpenAIRE |
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