Arvind M Shinde1, Jing Zhai2, Kim Wai Yu3, Paul Frankel4, John H Yim5, Thehang Luu1, Laura Kruper5, Courtney Vito5, Sally Shaw6, Nayana L Vora6, Michele Kirschenbaum7, George Somlo8. 1. Department of Medical Oncology and Therapeutic Research, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA. 2. Department of Pathology, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA. 3. Department of Clinical Pharmacy, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA. 4. Department of Information Sciences, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA. 5. Department of General Oncologic Surgery, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA. 6. Department of Diagnostic Radiology, City of Hope, 1500 East Duarte Rd., Duarte, CA, 91010 USA. 7. Office of Clinical Trials, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA. 8. Department of Medical Oncology and Therapeutic Research, City of Hope, 1500 East Duarte Rd., Duarte, CA 91010, USA. Electronic address: GSomlo@coh.org.
Abstract
BACKGROUND: Pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) is considered a surrogate for improved survival. Platinum-containing NCT, particularly in patients with HER2+ and triple-negative breast cancers (TNBC) may increase pCR rates. METHODS: Tumor characteristics, pCR rates (no invasive disease in breast and lymph nodes), toxicities, and survival in patients who received carboplatin, a taxane, and trastuzumab (HER2+ disease) between April 2009 and December 2011, were reviewed. RESULTS: Thirty eight patients (39 tumors) completed a median of 4 cycles of NCT. Eighteen of 39 (46%) tumors were HER2+, 8/18 (44%) responded with pCR; 13/18 HER2+ tumors were HR+ (72%) and 4/13 (31%) had a pCR. Ten of 39 (26%) tumors were TNBC; 6/10 (60%) had a pCR. At a median of 25-months no recurrences were observed in patients with pCR. CONCLUSIONS: Prospective studies of anthracycline-free platinum-containing NCT are warranted in LABC patients with HER2+ and TNBC.
BACKGROUND: Pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) is considered a surrogate for improved survival. Platinum-containing NCT, particularly in patients with HER2+ and triple-negative breast cancers (TNBC) may increase pCR rates. METHODS:Tumor characteristics, pCR rates (no invasive disease in breast and lymph nodes), toxicities, and survival in patients who received carboplatin, a taxane, and trastuzumab (HER2+ disease) between April 2009 and December 2011, were reviewed. RESULTS: Thirty eight patients (39 tumors) completed a median of 4 cycles of NCT. Eighteen of 39 (46%) tumors were HER2+, 8/18 (44%) responded with pCR; 13/18 HER2+ tumors were HR+ (72%) and 4/13 (31%) had a pCR. Ten of 39 (26%) tumors were TNBC; 6/10 (60%) had a pCR. At a median of 25-months no recurrences were observed in patients with pCR. CONCLUSIONS: Prospective studies of anthracycline-free platinum-containing NCT are warranted in LABC patients with HER2+ and TNBC.
Keywords:
Carboplatin; Human epidermal growth factor receptor 2 (HER2); Inflammatory breast cancer; Locally advanced breast cancer (LABC); Pathologic complete response (pCR); Triple-negative breast cancer (TNBC)
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