Abstract
(1) Background: Neoadjuvant therapy is widely used to treat locally advanced breast cancer. It has been recently shown that it can also improve the prognosis of patients during the early stages of breast cancer. In the past, advanced breast cancer with positive Human Epidermal growth factor Receptor 2 (HER2+) resulted in poor prognoses; however, outcomes have since changed after the introduction of HER2-targeting therapy. Achieving pathological Complete Response (pCR) is the most important aim, as it is a predictor of long-term outcomes in high-risk breast cancer subtypes. (2) Methods: We performed a retrospective review of all breast cancer patients who were treated with neoadjuvant therapy at Taichung Veterans General Hospital (VGHTC) between 2010 and 2018. A total of 147 HER2+ breast cancer patients who underwent neoadjuvant chemotherapy involving anthracycline and taxane-based regimens were enrolled. Within that population, 95 and 52 cases received single-blockade (Trastuzumab) and dual-blockade (Trastuzumab and Pertuzumab) neoadjuvant anti-HER2 therapy, respectively. (3) Results: The dual-blockade therapy group displayed a significantly higher pCR rate after surgery as compared to the single-blockade group (63.5% vs. 43.2%, p = 0.019). Advanced stage, larger tumor size, lymph node involvement and HER2 expression status were associated with the pCR rate. The 4-year OS was 85.2% and 100% in the single-blockage and dual-blockade therapy groups, respectively (p = 0.041). (4) Conclusion: Anthracycline, followed by taxane-based neoadjuvant chemotherapy combined with the dual HER2-blockade, had a higher pCR rate and better outcome when compared with the single HER2-blockade strategy in locally advanced HER2 breast cancer.
Highlights
We have previously shown that when compared to Epirubicin-based neoadjuvant chemotherapy, Pegylated-liposomal Doxorubicin (PLD)-based neoadjuvant chemotherapy offers similar treatment outcomes in addition to a reduced toxicity profile within the study’s follow-up duration [14]
We found that a higher clinical stage, large tumor size, lymph node involvement and HER2 expression status with
HER2+ breast cancer in Taiwanese women, focusing especially on the efficacy of neoadjuvant chemotherapy combined with dual-targeting therapy
Summary
Breast cancer is one of the leading causes of death among females throughout the world, with a 5-year survival rate of merely 28% upon metastasis. Despite differences in genetic constitutions and lifestyles, Asian women and white women display similar breast cancer statistics [1]. The proportion of histology of breast cancer is similar, with the rate of acquiring cancer consistently rising until the age of 80 amongst women in both demographics. It is noteworthy that breast cancer is the most common cancer among women in Taiwan [2], with its mortality rate increasing proportionally with age. In the past, advanced breast cancer with positive Human Epidermal growth factor
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