Human Epidermal Receptor 2-positive Breast Research Articles

Efficacy and Safety of Neoadjuvant Pyrotinib for Human Epidermal Receptor 2-Positive Breast Cancer: A Meta-Analysis.

Efficacy and Safety of Neoadjuvant Pyrotinib for Human Epidermal Receptor 2-Positive Breast Cancer: A Meta-Analysis.

Neoadjuvant Pyrotinib plus Trastuzumab, Docetaxel, and Carboplatin in Early or Locally Advanced Human Epidermal Receptor 2-Positive Breast Cancer in China: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial

Introduction: This multicenter, randomized, double-blind, placebo-controlled phase 2 trial compared the efficacy, and safety of adding pyrotinib to trastuzumab, docetaxel, and carboplatin versus placebo, trastuzumab, docetaxel, and carboplatin in Chinese patients with human epidermal receptor 2 (HER2)-positive early or locally advanced breast cancer (<ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> identifier: NCT03756064). Methods: Sixty-nine women with HER2-positive early (T1-3, N0-1, M0) or locally advanced breast cancer (T2-3, N2 or N3, M0; T4, any N, M0) were recruited from October 1, 2019, to June 1, 2021. Before surgery, patients received 6 cycles of orally pyrotinib (400 mg once per day), trastuzumab (8-mg/kg loading dose and 6-mg/kg maintenance doses), docetaxel (75 mg/m²), and carboplatin (AUC = 6 mg/mL·min) or orally placebo, trastuzumab, and docetaxel, and carboplatin every 3 weeks. The primary end point was independent review committee-assessed total pathologic complete response rate. The 2-sided Cochran-Mantel-Haenszel test, stratified by age, hormone receptor status, tumor stage, nodal status, cTNM stage, and Ki-67 level was used to compare rates between treatment groups. Results: In total, 69 female patients were randomized (pyrotinib, 36; and placebo, 33; median age, 53 [31–69] years). In the intention-to-treat population, total pathologic complete response rates were 65.5% (19/29) in the pyrotinib group and 33.3% (10/30) in the placebo group (difference, 32.2%, p = 0.013). Diarrhea was been reported in 86.1% of patients (31/36) in the pyrotinib group as the most common adverse events (AEs) and 15.2% of patients (5/33) in the placebo group. But no grade 4 or 5 AEs were reported. Conclusion: Treatment with pyrotinib, trastuzumab, docetaxel, and carboplatin resulted in a statistically significant improvement in the total pathologic complete response rate versus placebo, trastuzumab, docetaxel, and carboplatin for the neoadjuvant treatment of HER2-positive early or locally advanced breast cancer in Chinese patients. Safety data were in line with the known pyrotinib safety profile and generally comparable between treatment groups.

Chemotherapy and Optimal Timing of Delivery for Women with Human Epidermal Receptor-2 Positive Breast Cancer [33B

INTRODUCTION: Data are limited regarding the optimal management of breast cancer in pregnancy, particularly for human epidermal receptor-2 (HER2+) tumors and the potential fetotoxicity of subtype-specific chemotherapy. We sought to compare strategies for the management of HER2+ tumors and to determine the optimal gestational age for induction in regards to chemotherapy status and maternal-fetal outcomes. METHODS: A decision-analytic model was designed for women with HER2+ breast cancer at 20 weeks electing to continue their pregnancies, comparing 32 different strategies for scheduled delivery between 24-39 weeks gestation, with chemotherapy induction either at 24 weeks or delayed until after delivery. Baseline estimates of stage-specific mortality and the impact of delayed cancer treatment on 5-year survival rates were obtained from the literature. Outcomes factored into the model included the risk of intrauterine fetal demise, spontaneous delivery, respiratory distress syndrome, cerebral palsy, and neonatal demise at each gestational age. Univariate and multivariate sensitivity analyses were performed to test the robustness of our model. RESULTS: For women assigned to antepartum chemotherapy, delivery at 39 weeks yielded the highest maternal and overall QALYs at all cancer stages. For women with HER2+ breast cancer deferring chemotherapy until after delivery, maternal quality-adjusted life years (QALYs) were maximized with induction at 37 weeks for stage I cancer, 32 weeks for stage II cancer, and 28 weeks for stage III cancer. Our model was heavily driven by the baseline probability of maternal death within 5 years, in addition to the expected progression of disease and decrease in survival rates with each week of non-treatment, and remained robust across reasonable ranges for all variables of interest. CONCLUSION: For women with HER2+ breast cancer diagnosed in early pregnancy, initiation of chemotherapy and delivery at term is recommended.

RegistHER: A prospective, longitudinal cohort study of women with HER2 positive metastatic breast cancer

670 Background: Human Epidermal Receptor 2 (HER2) is gene amplified in approx 25% of patients with breast cancer and is an unfavorable prognostic factor for survival. Both NCCN and ASCO recommend t...