Rashmi K Murthy1, Akshara S Raghavendra2, Kenneth R Hess3, Takeo Fujii2, Bora Lim2, Carlos H Barcenas2, Hong Zhang4, Mariana Chavez-Mac-Gregor5, Elizabeth A Mittendorf6, Jennifer K Litton2, Sharon H Giordano5, Alastair M Thompson6, Vicente Valero2, Stacy L Moulder2, Debu Tripathy2, Naoto T Ueno2. 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.
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.
Authors: Benjamin James Hall; Ajay Ashok Bhojwani; Helen Wong; Andrea Law; Helen Flint; Eliyaz Ahmed; Helen Innes; Joanne Cliff; Zaf Malik; Julie Elizabeth O'Hagan; Allison Hall; Rajaram Sripadam; Shaun Tolan; Zulfiqar Ali; Clare Hart; Douglas Errington; Farida Alam; Rosa Giuliani; Shaveta Mehta; Sheena Khanduri; Nicky Thorp; Richard Jackson; Silvia Cicconi; Carlo Palmieri Journal: Breast J Date: 2022-06-30 Impact factor: 2.269