[Dose-dense paclitaxel plus carboplatin in combination with trastuzumab neoadjuvant versus standard adjuvant therapy in human epidermal growth factor receptor-2 positive and hormone receptor negative breast cancer: a prospective cohort study].
Zhonghua Zhong Liu Za Zhi
; 45(8): 709-716, 2023 Aug 23.
Article
en Zh
| MEDLINE
| ID: mdl-37580278
ABSTRACT
Objective:
To provide survival evidence of anthracycline-free neoadjuvant chemotherapy for patients with stages â ¡-â ¢ human epidermal growth factor receptor-2 (HER-2) positive and hormone receptor (HR) negative breast cancer.Methods:
The prospective cohort study was conducted at the Department of Medical Oncology of Cancer Hospital, Chinese Academy of Medical Sciences. Patients with HER-2 positive and HR negative breast cancer in stages â ¡-â ¢ were enrolled to receive neoadjuvant therapy (NAT) of dose-dense paclitaxel (175 mg/m(2)) plus carboplatin (AUC=4.0) biweekly for 6 cycles in combination with trastuzumab (PCbH), and matched patients who received standard adjuvant therapy of physicians' choice were recruited for survival and safety comparison.Results:
From July 2013 to November 2019, 166 patients were included (neoadjuvant 51, adjuvant 115). Compared with those who received adjuvant therapy, patients receiving NAT were younger (<35 years 19.6% vs 5.2%, P=0.014), had larger tumors (T3 62.7% vs 7.8%, P<0.001) and more advanced diseases (stage â ¡A 2.0% vs 41.7%, P<0.001). Patients in the neoadjuvant group all received surgery, and 96 (83.5%) in the adjuvant group received anthracycline-and-taxane-containing regimens. A total of 98 patients (49 pairs) were matched, and the covariates between the two groups were acceptably balanced. Within a median follow-up of 46.5 (range, 14-87) months, the 4-year recurrence-free survival (RFS) rate among patients who received NAT was 73.3% (95% CI 59.0%-87.6%), versus 80.6% (95% CI 67.9%-93.3%) among those in the adjuvant group without statistical difference (P=0.418). A similar result was observed for the 4-year overall survival (OS) [neoadjuvant versus adjuvant 91.5% (95% CI 81.7%-100.0%) vs 97.8% (95% CI 93.5%-100.0%), P=0.314]. Compared with standard adjuvant therapy, PCbH was related to less neutropenia and better cardiac safety.Conclusions:
These results support the consideration of anthracycline-free neoadjuvant chemotherapy combined with anti-HER-2 therapy for patients with stages â ¡-â ¢ HER-2-positive and HR-negative breast cancer. Optimized regimens with both efficacy and safety are needed and to be further investigated.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Carboplatino
/
Paclitaxel
/
Neoplasias de la Mama Triple Negativas
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
Idioma:
Zh
Revista:
Zhonghua Zhong Liu Za Zhi
Año:
2023
Tipo del documento:
Article
País de afiliación:
China