RT Journal Article
T1 Different Pathological Complete Response Rates According to PAM50 Subtype in HER2+ Breast Cancer Patients Treated With Neoadjuvant Pertuzumab/Trastuzumab vs. Trastuzumab Plus Standard Chemotherapy: An Analysis of Real-World Data.
A1 Díaz-Redondo, Tamara
A1 Lavado-Valenzuela, Rocio
A1 Jimenez, Begoña
A1 Pascual, Tomas
A1 Gálvez, Fernando
A1 Falcón, Alejandro
A1 Alamo, Maria Del Carmen
A1 Morales, Cristina
A1 Amerigo, Marta
A1 Pascual, Javier
A1 Sanchez-Muñoz, Alfonso
A1 González-Guerrero, Macarena
A1 Vicioso, Luis
A1 Laborda, Aurora
A1 Ortega, Maria Victoria
A1 Perez, Lidia
A1 Fernandez-Martinez, Aranzazu
A1 Chic, Nuria
A1 Jerez, Jose Manuel
A1 Alvarez, Martina
A1 Prat, Aleix
A1 Ribelles, Nuria
A1 Alba, Emilio
K1 breast cancer
K1 neoadjuvant
K1 pertuzumab
K1 real-world data
K1 trastuzumab
AB Background: Double blockade with pertuzumab and trastuzumab combined with chemotherapy is the standard neoadjuvant treatment for HER2-positive early breast cancer. Data derived from clinical trials indicates that the response rates differ among intrinsic subtypes of breast cancer. The aim of this study is to determine if these results are valid in real-world patients. Methods: A total of 259 patients treated in eight Spanish hospitals were included and divided into two cohorts: Cohort A (132 patients) received trastuzumab plus standard neoadjuvant chemotherapy (NAC), and Cohort B received pertuzumab and trastuzumab plus NAC (122 patients). Pathological complete response (pCR) was defined as the complete disappearance of invasive tumor cells. Assignment of the intrinsic subtype was realized using the research-based PAM50 signature. Results: There were more HER2-enriched tumors in Cohort A (70 vs. 56%) and more basal-like tumors in Cohort B (12 vs. 2%), with similar luminal cases in both cohorts (luminal A 12 vs. 14%; luminal B 14 vs. 18%). The overall pCR rate was 39% in Cohort A and 61% in Cohort B. Better pCR rates with pertuzumab plus trastuzumab than with trastuzumab alone were also observed in all intrinsic subtypes (luminal PAM50 41 vs. 11.4% and HER2-enriched subtype 73.5 vs. 50%) but not in basal-like tumors (53.3 vs. 50%). In multivariate analysis the only significant variables related to pCR in both luminal PAM50 and HER2-enriched subtypes were treatment with pertuzumab plus trastuzumab (Cohort B) and histological grade 3. Conclusions: With data obtained from patients treated in clinical practice, it has been possible to verify that the addition of pertuzumab to trastuzumab and neoadjuvant chemotherapy substantially increases the rate of pCR, especially in the HER2-enriched subtype but also in luminal subtypes, with no apparent benefit in basal-like tumors.
SN 2234-943X
YR 2019
FD 2019-11-05
LK https://hdl.handle.net/10668/27602
UL https://hdl.handle.net/10668/27602
LA en
DS RISalud
RD Feb 23, 2025