Real-world effectiveness of dual HER2 blockade with pertuzumab and trastuzumab for neoadjuvant treatment of HER2-positive early breast cancer (The NEOPETRA Study)

González-Santiago, Santiago; Saura, Cristina; Ciruelos, Eva; Alonsó, José Luis; Morena, Pilar de la; Eslava, Marta Santisteban; Sancho, María I. Gallegos; Luna, Alicia de; Dalmau, E.; Servitja, Sònia; Ruíz-Borrego, Manuel; Chacón, José Ignacio

doi:10.1007/s10549-020-05866-1

Cited by 23 publications

(17 citation statements)

References 33 publications

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“…Several clinical trials have evaluated the efficacy and safety of the TCbH-P regimen as a perioperative treatment [ 5 , 8 , 11 ]. In most publications, the percentage of pCR was 55–66% [ 8 , 9 , 27 ], whereas in our study we identified pCR in only 52.9% of women. We believe this is due to the high proportion of HER2-positive luminal cancer patients, with pCR found in only 33.3% (vs. 66.7% in ER-negative, HER2-positive patients), and the significantly lower chance of pCR observed in our patients aged 60 years and older, compared with younger patients (11.1% vs. 89.9%).…”

Section: Discussioncontrasting

confidence: 82%

“…The most common adverse events found in our study were anaemia, weakness, neuropathy, and neutropenia. Diarrhoea was observed in our patients less frequently (26%) than in other studies, whereas most publications report the occurrence of diarrhoea in 40–56% of patients started on the treatment [ 8 , 9 , 27 , 32 , 33 ]. It should be noted, then, that we observed diarrhoea significantly more often in patients aged 60 years and older (71%) than in younger patients.…”

Section: Discussioncontrasting

confidence: 80%

“…Anthracyclines may be used sequentially, followed by taxanes in combination with anti-HER2 drugs, or an anthracycline-free regimen containing taxanes and carboplatin with targeted therapy is recommended [ 1 , 2 , 3 ]. The results of previous studies confirm the similar efficacy of both treatment modalities, with a lower risk of cardiotoxicity in the case of anthracycline-free regimens [ 8 , 9 , 10 , 11 ].…”

Section: Introductionsupporting

confidence: 77%

“…Improved long-term outcomes were also achieved when neoadjuvant treatment with anti-HER2 therapy was included in the standard of care [ 4 , 5 , 6 , 7 , 8 , 9 ]. The use of neoadjuvant therapy can facilitate surgical treatment, increase the number of patients eligible for breast-conserving therapy (BCT), determine the degree of sensitivity to the therapy used, and identify patients who do not achieve pCR and thus should be treated more intensively after surgery [ 1 , 2 , 3 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Neoadjuvant Pertuzumab Plus Trastuzumab in Combination with Docetaxel and Carboplatin in Patients with HER2-Positive Breast Cancer: Real-World Data from the National Institute of Oncology in Poland

Jagiełło-Gruszfeld

Rosińska

Meluch

et al. 2022

Cancers

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Neoadjuvant systemic therapy has now become the standard in early breast cancer management. Chemotherapy in combination with trastuzumab +/− pertuzumab targeted therapy can improve the rates of pathologic complete response (pCR) in patients with HER2-positive breast cancer. Achieving a pCR is considered a good prognostic factor, in particular, in patients with more aggressive breast cancer subtypes such as TNBC or HER2-positive cancers. Furthermore, most studies demonstrate that chemotherapy in combination with trastuzumab and pertuzumab is well tolerated. The retrospective analysis presented here concentrates on neoadjuvant therapy with the TCbH-P regimen, with a particular emphasis on patients over 60 years of age. We analysed the factors affecting the achievement of pCR and present the adverse effects of the applied therapies, opening discussion about optimizing the therapy of older patients with HER-2 positive breast cancer.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 80%

Section: Introductionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Neoadjuvant Pertuzumab Plus Trastuzumab in Combination with Docetaxel and Carboplatin in Patients with HER2-Positive Breast Cancer: Real-World Data from the National Institute of Oncology in Poland

Jagiełło-Gruszfeld

Rosińska

Meluch

et al. 2022

Cancers

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“…Using these to predict the pCR for HER2+ breast cancer patients might not be suitable. There were lots of studies that aimed to evaluate the predictive values of some clinical and pathological factors, such as hormone receptor (23,24), trastuzumab use (24). The nomograms based on these factors were proposed (25,26).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Genetic Predictive Models for the Prediction of Pathological Complete Response to Optimize the Effectiveness for Trastuzumab Based Chemotherapy

Chen

Zheng

et al. 2021

Front. Oncol.

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BackgroundTrastuzumab shows excellent benefits for HER2+ breast cancer patients, although 20% treated remain unresponsive. We conducted a retrospective cohort study to optimize neoadjuvant chemotherapy and trastuzumab treatment in HER2+ breast cancer patients.MethodsSix hundred patients were analyzed to identify clinical characteristics of those not achieving a pathological complete response (pCR) to develop a clinical predictive model. Available RNA sequence data was also reviewed to develop a genetic model for pCR.ResultsThe pCR rate was 39.8% and pCR was associated with superior disease free survival and overall survival. ER negativity and PR negativity, higher HER2 IHC scores, higher Ki-67, and trastuzumab use were associated with improved pCR. Weekly paclitaxel and carboplatin had the highest pCR rate (46.70%) and the anthracycline+taxanes regimen had the lowest rate (11.11%). Four published GEO datasets were analyzed and a 10-gene model and immune signature for pCR were developed. Non-pCR patients were ER+PR+ and had a lower immune signature and gene model score. Hormone receptor status and immune signatures were independent predictive factors of pCR.ConclusionHormone receptor status and a 10-gene model could predict pCR independently and may be applied for patient selection and drug effectiveness optimization.

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Pathological and clinical outcomes following neoadjuvant dual HER2 therapy for early‐stage breast cancer: An Australian institutional real‐world experience

Narayanan,

Ngui,

Kinchington

et al. 2024

Cancer Medicine

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AimThere has been significant progress made in developing novel targeted therapies in the neoadjuvant setting for non‐metastatic HER2‐positive breast cancer, which may be used in combination with conventional chemotherapy to optimise pathological responses at surgery. However, these therapies, particularly the chemotherapeutic components, may portend significant and long‐lasting toxicity. Hence, de‐escalation of treatment intensity has been an area of interest and was evaluated in the phase II NeoSphere study. Herein, we report the real‐world pathological and survival outcomes from neoadjuvant taxane and dual HER2 blockade recorded at our centre.MethodsThis was a retrospective cohort study of patients receiving neoadjuvant pertuzumab, trastuzumab and taxane chemotherapy for non‐metastatic HER2‐positive breast cancer at a single centre in Sydney, Australia. We collected data pertaining to baseline demographic characteristics, pathological response rates, post‐surgical prescribing patterns and also undertook survival analyses for invasive disease‐free survival (iDFS) as well as exploratory analyses for correlations between pre‐specified clinicopathologic factors and pathological response at surgery.ResultsOur population was largely similar at baseline to the NeoSphere study. 71 patients were included in the final analysis. 61% achieved a pathological complete response (pCR). Three patients received conventional chemotherapy in the adjuvant setting. 92% of included patients were alive and disease‐free at 3 years of follow‐up. Only 3 events of recurrence or death were recorded at a median follow‐up of 32 months. No significant difference in iDFS was noted between patients achieving pCR and those with residual disease at surgery.ConclusionThis study demonstrates that de‐escalated adjuvant treatment for HER2‐positive early breast cancer achieved favourable pathological and long‐term outcomes comparable to large trials, some utilising more intensive chemotherapeutic components.

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Real-world effectiveness of dual HER2 blockade with pertuzumab and trastuzumab for neoadjuvant treatment of HER2-positive early breast cancer (The NEOPETRA Study)

Cited by 23 publications

References 33 publications

Neoadjuvant Pertuzumab Plus Trastuzumab in Combination with Docetaxel and Carboplatin in Patients with HER2-Positive Breast Cancer: Real-World Data from the National Institute of Oncology in Poland

Neoadjuvant Pertuzumab Plus Trastuzumab in Combination with Docetaxel and Carboplatin in Patients with HER2-Positive Breast Cancer: Real-World Data from the National Institute of Oncology in Poland

Clinical and Genetic Predictive Models for the Prediction of Pathological Complete Response to Optimize the Effectiveness for Trastuzumab Based Chemotherapy

Pathological and clinical outcomes following neoadjuvant dual HER2 therapy for early‐stage breast cancer: An Australian institutional real‐world experience

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