A Multicenter Study on Efficacy of Dual-target Neoadjuvant Therapy for HER2-positive Breast Cancer and a Consistent Analysis of Efficacy Evaluation of Neoadjuvant Therapy by Miller-Payne and RCB Pathological Evaluation Systems (CSBrS-026)

Overview

Journal Chin J Cancer Res

Specialty Oncology

Date 2024 Jan 11

PMID 38204446

Authors

Hongyu Xiang

Ling Xin

Jingming Ye

Ling Xu

Hong Zhang

Shuang Zhang

Yinhua Liu

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to investigate the factors influencing pathological complete response (pCR) rate in early breast cancer patients receiving neoadjuvant dual-target [trastuzumab (H) + pertuzumab (P)] therapy combined with chemotherapy. Additionally, the consistency of the Miller-Payne and residual cancer burden (RCB) systems in evaluating the efficacy of neoadjuvant therapy for early human epidermal growth factor receptor-2 (HER2)+ breast cancer was analyzed.

Methods: The clinicopathological data of female patients with early-stage HER2+ breast cancer who received dual-target neoadjuvant therapy at 26 hospitals of the Chinese Society of Breast Surgery (CSBrS) from March 2019 to December 2021 were collected. Patients were allocated to four groups: the HER2 immunohistochemistry (IHC) 3+/hormone receptor (HR)-, IHC3+/HR+, IHC2+ hybridization (ISH)+/HR- and IHC2+ ISH+/HR+ groups. The overall pCR rate for patients, the pCR rate in each group and the factors affecting the pCR rate were analyzed. The consistency between the Miller-Payne and RCB systems in assessing the efficacy of neoadjuvant therapy was analyzed.

Results: From March 1, 2019, to December 31, 2021, 77,376 female patients with early-stage breast cancer were treated at 26 hospitals; 18,853 (24.4%) of these patients were HER2+. After exclusion of unqualified patients, 2,395 patients who received neoadjuvant dual-target (H+P) therapy combined with chemotherapy were included in this study. The overall pCR rate was 53.0%, and the patients' HR statuses and different HER2+ statuses were significantly correlated with the pCR rate (P0.05). The consistency of the pathological efficacy assessed by the Miller-Payne and RCB systems was 88.0% (=0.717, P0.001).

Conclusions: Different HER2 expression statuses and HR expression statuses are correlated with the pCR rate after dual-target neoadjuvant therapy in HER2+ breast cancer patients. There is a relatively good consistency between Miller-Payne and RCB systems in evaluating the pathologic efficacy of neoadjuvant therapy for HER2+ breast cancer.

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References

Ogston K, Miller I, Payne S, Hutcheon A, Sarkar T, Smith I . A new histological grading system to assess response of breast cancers to primary chemotherapy: prognostic significance and survival. Breast. 2003; 12(5):320-7. DOI: 10.1016/s0960-9776(03)00106-1. View

Escriva-de-Romani S, Arumi M, Bellet M, Saura C . HER2-positive breast cancer: Current and new therapeutic strategies. Breast. 2018; 39:80-88. DOI: 10.1016/j.breast.2018.03.006. View

Hammond M, Hayes D, Dowsett M, Allred D, Hagerty K, Badve S . American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. Arch Pathol Lab Med. 2010; 134(6):907-22. PMC: 3073033. DOI: 10.5858/134.6.907. View

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Wolff A, Hammond M, Allison K, Harvey B, Mangu P, Bartlett J . Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update. J Clin Oncol. 2018; 36(20):2105-2122. DOI: 10.1200/JCO.2018.77.8738. View

Wang W, Liu Y, Zhang H, Zhang S, Duan X, Ye J . Prognostic value of residual cancer burden and Miller-Payne system after neoadjuvant chemotherapy for breast cancer. Gland Surg. 2022; 10(12):3211-3221. PMC: 8749085. DOI: 10.21037/gs-21-608. View

Gianni L, Pienkowski T, Im Y, Tseng L, Liu M, Lluch A . 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol. 2016; 17(6):791-800. DOI: 10.1016/S1470-2045(16)00163-7. View

Health Commission Of The Peoples Republic Of China N . National guidelines for diagnosis and treatment of breast cancer 2022 in China (English version). Chin J Cancer Res. 2022; 34(3):151-175. PMC: 9273574. DOI: 10.21147/j.issn.1000-9604.2022.03.02. View

Cortazar P, Zhang L, Untch M, Mehta K, Costantino J, Wolmark N . Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet. 2014; 384(9938):164-72. DOI: 10.1016/S0140-6736(13)62422-8. View

10.

Whitehead I, Irwin G, Bannon F, Coles C, Copson E, Cutress R . The NeST (Neoadjuvant systemic therapy in breast cancer) study: National Practice Questionnaire of United Kingdom multi-disciplinary decision making. BMC Cancer. 2021; 21(1):90. PMC: 7825231. DOI: 10.1186/s12885-020-07757-6. View

11.

Fraser Symmans W, Peintinger F, Hatzis C, Rajan R, Kuerer H, Valero V . Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy. J Clin Oncol. 2007; 25(28):4414-22. DOI: 10.1200/JCO.2007.10.6823. View

12.

Shao Z, Pang D, Yang H, Li W, Wang S, Cui S . Efficacy, Safety, and Tolerability of Pertuzumab, Trastuzumab, and Docetaxel for Patients With Early or Locally Advanced ERBB2-Positive Breast Cancer in Asia: The PEONY Phase 3 Randomized Clinical Trial. JAMA Oncol. 2019; 6(3):e193692. PMC: 6813591. DOI: 10.1001/jamaoncol.2019.3692. View