Abstract
ObjectiveThis study was performed to investigate the proportion as well as the predictive factors of pathologic complete response in HER2-positive and axillary lymph node positive breast cancer after neoadjuvant paclitaxel, carboplatin plus with trastuzumab (PCH).ResultsThe pCR rate in the breast, axilla and both was 44.3% (39/88), 47.7% (42/88) and 34.1% (30/88), respectively. Patients with and without pCR were similar in term of age, BMI, menstrual status, family history, treatment cycles and tumor characteristics (laterality and size of tumor). Multivariate logistic regression demonstrated that pCR was significantly associated with HR negativity (HR = 5.587, 95% CI 2.25−3.889, p < 0.001), high Ki67 index (HR = 4.130, 95% CI 1.607−10.610, p = 0.003). Further investigation found that patients with HR-negative/high Ki67 index had higher pCR rate, compared to other patients (HR = 7.583, 95% CI 2.503−22.974, p < 0.001).Materials and Methods88 consecutive Chinese HER2-positive/axillary lymph node-positive breast cancer patients with neodjuvant therapy regimen containing paclitaxel, carboplatin and trastuzumab were divided into two groups: pathological complete response (pCR) or non-pCR group. Clinico-pathological characteristics were compared and analyzed, and univariate and multivariate analyses were performed to detect the predictive factors of pCR.ConclusionsPreoperative PCH regimen was an effective neoadjuvant therapy in HER2 positive and axillary lymph node positive patients, and patients coexisting with HR-negative and high Ki67 index may benefit more from this regimen.
Highlights
Amplification of human epidermal growth factor receptor 2 (HER2) is identified in approximately 20–25% of human breast cancers [1, 2]
Preoperative PCH regimen was an effective neoadjuvant therapy in HER2 positive and axillary lymph node positive patients, and patients coexisting with hazard ratio (HR)-negative and high Ki67 index may benefit more from this regimen
In our study, data of patients with HER2-positive and lymph node positive disease, who were treated with carboplatin, paclitaxel concurrently with trastuzumab was retrospectively analyzed, in order to identify effective predictive markers for pathological complete response (pCR) that could be used in the future for treatment decision making
Summary
Amplification of HER2 is identified in approximately 20–25% of human breast cancers [1, 2]. Compared to lymph node negative breast cancer, tumor with HER2 positive and lymph nodewww.impactjournals.com/oncotarget positive was a subtype of biological and anatomic more aggressive disease. The effectiveness of this regimen used for this type of disease was not established, and the predictive factors of pCR have not been clarified yet. In our study, data of patients with HER2-positive and lymph node positive disease, who were treated with carboplatin, paclitaxel concurrently with trastuzumab was retrospectively analyzed, in order to identify effective predictive markers for pCR that could be used in the future for treatment decision making
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