Retrospective Study to Determine Factors Influencing Outcome in Patients With Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Receiving Neoadjuvant Chemotherapy.

IF 3 Q2 ONCOLOGY

JCO Global Oncology Pub Date : 2025-04-01 Epub Date: 2025-04-23 DOI:10.1200/GO-24-00365

Minit Shah, Sushmita Rath, Seema Gulia, Prabhat Bhargava, Anbarasan Sekar, Swapnil Rane, Jyoti Bajpai, Tanuja Shet, Sangeeta Desai, Rajiv Sarin, Rima Pathak, Palak Popat, Pallavi Parab, Yogesh Kembhavi, Dinesh Jethwa, Snigdha Dutta, Asawari Patil, Nita Nair, Pallavi Rane, Ankush Shetake, Manali Kolkur, Shalaka Joshi, Rajendra A Badwe, Sudeep Gupta

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Abstract

Purpose: There are scant data on patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer treated with neoadjuvant therapy (NAT) in real-world settings with limited access to HER2-targeted therapy.

Methods: This was a retrospective analysis of patients with nonmetastatic, HER2-positive breast cancer treated with NAT between January 2014 and December 2018 to determine factors affecting pathologic complete response (pCR), event-free survival (EFS), and overall survival (OS).

Results: The cohort comprised 1,004 patients with a median age of 47 years, 533 (53.1%) with clinical T3/T4 tumors, 466 (46.4%) with clinical N2/3 status, and 527 (52.5%) with hormone receptor-positive disease. Trastuzumab was given to 528 (52.6%) patients in the neoadjuvant setting and 711 (70.8%) patients in neoadjuvant and/or postoperative settings. pCR was achieved in 226 (22.5%) patients; the 5-year EFS in the whole cohort, pCR group, and no-pCR group was 63.5% (95% CI, 60.36 to 66.63), 86.1% (95% CI, 81.59 to 90.60), and 57% ([95% CI, 53.47 to 60.52]; P < .001), respectively. In multivariable analysis in the full cohort, smaller tumor size (cT1/T2 v cT3/T4), higher grade (III v II), hormone receptor-negative status, and use of neoadjuvant HER2-targeted therapy were significantly associated with higher pCR, and smaller tumor size (cT1/T2 v cT3/T4), lower node involvement (cN0/N1 v cN2/N3), achievement of pCR, and receiving trastuzumab were significantly associated with higher EFS and OS.

Conclusion: In a setting with constrained access to HER2-targeted therapy, lower clinical tumor burden and receiving trastuzumab were significantly associated with increased pCR and survival in patients with HER2-positive breast cancer treated with NAT. Efforts should be made to enhance early diagnosis and access to HER2-targeted therapy worldwide.

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人表皮生长因子受体2阳性乳腺癌患者接受新辅助化疗影响预后因素的回顾性研究

目的：在现实环境中，由于HER2靶向治疗的可及性有限，人类表皮生长因子受体2 （HER2）阳性乳腺癌患者接受新辅助治疗（NAT）的数据很少。方法：回顾性分析2014年1月至2018年12月期间接受NAT治疗的非转移性her2阳性乳腺癌患者，以确定影响病理完全缓解（pCR）、无事件生存期（EFS）和总生存期（OS）的因素。结果：该队列包括1004例患者，中位年龄为47岁，533例（53.1%）为临床T3/T4肿瘤，466例（46.4%）为临床N2/3状态，527例（52.5%）为激素受体阳性疾病。528例（52.6%）新辅助组患者接受曲妥珠单抗治疗，711例（70.8%）新辅助组和/或术后组患者接受曲妥珠单抗治疗。226例（22.5%）患者获得pCR；全队列、pCR组和无pCR组的5年EFS分别为63.5% （95% CI, 60.36 ~ 66.63）、86.1% （95% CI, 81.59 ~ 90.60）和57% ([95% CI, 53.47 ~ 60.52]；P < 0.001)。在全队列的多变量分析中，较小的肿瘤大小（cT1/T2 v cT3/T4）、较高的分级（III v II）、激素受体阴性状态和使用新辅助her2靶向治疗与较高的pCR显著相关，较小的肿瘤大小（cT1/T2 v cT3/T4）、较低的淋巴结累及（cN0/N1 v cN2/N3）、实现pCR和接受曲妥珠单抗与较高的EFS和OS显著相关。结论：在her2靶向治疗可及性受限的情况下，接受NAT治疗的her2阳性乳腺癌患者，较低的临床肿瘤负担和接受曲妥珠单抗与pCR增加和生存率显著相关。应努力在全球范围内加强早期诊断和her2靶向治疗的可及性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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