The efficacy and safety of hypofractionated radiotherapy with concurrent anti‐HER‐2 therapy following breast‐conserving therapy for breast cancer

Abstract

The purpose of this study was to report rates and severities of radiation‐related toxicities and analyze disease‐control outcomes in patients who have received hypofractionated whole breast radiation (HF) with concurrent trastuzumab with or without pertuzumab. We conducted a retrospective cohort study including women with stage I‐III HER2‐positive breast cancer who received HF at the University of Pennsylvania between 1/2005 and 5/2018 with concurrent trastuzumab with or without pertuzumab. Fractionation was 266 cGy daily to a total dose of 4256 cGy with or without a sequential tumor bed boost. Eighty patients were included in the cohort with a median follow‐up time of 21.44 months. There was one grade 3 acute toxicity (fatigue) and no grade 3 late toxicities. 91% and 25% of patients experienced grade 1‐2 acute and late skin reactions, respectively. An excellent‐good cosmetic outcome was reported by 74% and 95% of patients and physicians, respectively. No patients experienced tumor recurrences, and the only death was due to a secondary cause. These results suggest that hypofractionated whole breast radiation administered concurrently with anti‐HER‐2 therapies is efficacious and has acceptable toxicity in early‐stage breast cancer patients treated with lumpectomy. Continued follow‐up is warranted to evaluate long‐term outcomes.

Stereotactic Radiation and Dual Human Epidermal Growth Factor Receptor 2 Blockade with Trastuzumab and Pertuzumab in the Treatment of Breast Cancer Brain Metastases: A Single Institution Series

“…Dreyfuss et al reported radiation-related toxicities in 80 patients receiving hypofractionated whole breast radiation with concurrent PT. There was one grade 3 acute toxicity (fatigue) and no grade 3 late toxicities [ 17 ]. More recently, in a large retrospective cohort of 55 patients, the combination of locoregional breast RT with PT resulted as well tolerated.…”

“…Even if there are some data on the association of RT and PT in other settings such as palliative bone treatment and postoperative BC treatment [ 17 , 18 , 19 ] with a favourable tolerance profile, no literature data is available on the association between PT and brain fSRT.…”

Effect of postmastectomy radiotherapy on pT1-2N1 breast cancer patients with different molecular subtypes: A real-world study based on the inverse probability of treatment weighting method

“…[27] Indeed, antiHER2 therapy can be administered under RT and has been shown to be safe, although special attention should be given with regard to cardiotoxicity. [28–30]…”

“…[27] Indeed, antiHER2 therapy can be administered under RT and has been shown to be safe, although special attention should be given with regard to cardiotoxicity. [28][29][30] Previous studies have shown that high-risk tumors have the greatest benefit from RT. Although there is heterogeneity in TNBC, most of the TNBC have a high risk of recurrence.…”