197P - The efficacy of preoperative breast cancer chemotherapy without anti-HER2-targeted treatment: Single center experience in setting of no reimbursement in Poland (2011-2015)

Abstract

BackgroundTargeted anti-HER2 therapy is a keystone in radical breast cancer therapy. In Poland preoperative use of trastuzumab was not reimbursed until 2016 and pertuzumab is still not covered. Moreover, adjuvant use of trastuzumab was not covered for patients with stage IIIB-C breast cancer. The aim of the study was to analyse of the subset of patients with HER2-positive breast cancer who were treated preoperatively in s center in Poland without use of anti-HER2 medications to analyse their prognosis compared to other breast cancer subtypes. MethodsWe reviewed the records of patients enrolled to the prospective study of prediction of chemotherapy response (MILESTONE-BreastPred). All patients were enrolled between 2011—2015, with intent of preoperative breast cancer chemotherapy, mainly by AC-P or TAC regimens. In the whole group PET/CT was used as an method of staging. ResultsTable197PTableSubtypeHER2-positiveTNBCLUM B HER2-negativePnumer of patients11987160median age4742.746.6n.s.% G366.486.147.40.001% N+74.860.967.5n.s.% CSIII56.242.938.80.048% de novo CSIV11.93.58.1n.s.% inoperable after chemotherapy [%]17.710.310n.s.% pCR32.6539.7420.140.005% 5-year PFS47.270.668.30.001median PFS [mo]56.7NR92.90.001 ConclusionsHER2-positive breast cancer in Polish population is at presentation more advanced than other subtypes, and despite relatively high pCR rate, has poor prognosis, when treated without sufficient anti-HER2 therapy. Prognosis in HER2-positive breast cancer in the analysed subgroup of Polish patients was poorer than in TNBC. The results underline the importance of treatment according to international guidelines and speak in favour of including anti-HER2 therapy preoperatively. The study was supported by the Polish National Center of Research and Development MILESTONE project – Molecular diagnostics and imaging in individualized therapy for breast, thyroid and prostate cancer, grant no. STRATEGMED 2/267398/4/NCBR/2015. Legal entity responsible for the studyThe authors. Fundingthe Polish National Center of Research and Development MILESTONE project – Molecular diagnostics and imaging in individualized therapy for breast, thyroid and prostate cancer, grant no. STRATEGMED 2/267398/4/NCBR/2015. DisclosureAll authors have declared no conflicts of interest.