Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab

Abstract To compare outcomes in patients with human epidermal growth factor receptor-2 (HER2)-positive breast cancer who received either dose-dense neoadjuvant chemotherapy (NAC) with trastuzumab or standard-interval chemotherapy with trastuzumab. Patients with HER2-positive breast cancer who receiv...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Lize Wang, Yang Zhang, Yingjian He, Jinfeng Li, Tianfeng Wang, Yuntao Xie, Zhaoqing Fan, Tao Ouyang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/ecd2633c9afa4d6586badc99a62e6da3
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:ecd2633c9afa4d6586badc99a62e6da3
record_format	dspace
spelling	oai:doaj.org-article:ecd2633c9afa4d6586badc99a62e6da32021-12-02T17:52:18ZImpact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab10.1038/s41523-021-00284-y2374-4677https://doaj.org/article/ecd2633c9afa4d6586badc99a62e6da32021-06-01T00:00:00Zhttps://doi.org/10.1038/s41523-021-00284-yhttps://doaj.org/toc/2374-4677Abstract To compare outcomes in patients with human epidermal growth factor receptor-2 (HER2)-positive breast cancer who received either dose-dense neoadjuvant chemotherapy (NAC) with trastuzumab or standard-interval chemotherapy with trastuzumab. Patients with HER2-positive breast cancer who received NAC, including epirubicin and cyclophosphamide followed by paclitaxel with trastuzumab were included. Patients were divided into either the dose-dense or standard-interval group. We compared pathologic complete remission (pCR), distant disease-free survival (DDFS), event-free survival (EFS), and breast cancer-specific survival (BCSS) between the two groups. Two hundred (49.6%) patients received dose-dense NAC, and 203 (50.4%) received standard-interval NAC. The pCR rate was 38.4% in the dose-dense group and 29.2% in the standard-interval group (P = 0.052). In patients with lymph node (LN) metastases, the LN pCR rate was 70.9% in the dose-dense group and 56.5% in the standard-interval group (P = 0.037). After a median follow-up of 54.6 months, dose-dense chemotherapy presented an improvement on DDFS (hazard ratio [HR] = 0.49, 95% confidence interval [CI]: 0.19–1.28, EFS (HR = 0.54, 95% CI: 0.24–1.21), and BCSS (HR = 0.41, 95% CI: 0.11–1.51), but the difference was not significant. Compared with standard-interval chemotherapy, dose-dense chemotherapy resulted in a superior 5-year DDFS (100% vs. 75.3%, P = 0.017) and 5-year EFS (96.9% vs. 78.3%, P = 0.022) in patients younger than 40 years. HER2-positive patients can achieve a higher LN pCR rate with dose-dense NAC than with standard-interval NAC with trastuzumab. Better survival may also be achieved with dose-dense chemotherapy with trastuzumab than with standard-interval chemotherapy with trastuzumab among young patients (age ≤ 40 years).Lize WangYang ZhangYingjian HeJinfeng LiTianfeng WangYuntao XieZhaoqing FanTao OuyangNature PortfolioarticleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENnpj Breast Cancer, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Lize Wang Yang Zhang Yingjian He Jinfeng Li Tianfeng Wang Yuntao Xie Zhaoqing Fan Tao Ouyang Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab
description	Abstract To compare outcomes in patients with human epidermal growth factor receptor-2 (HER2)-positive breast cancer who received either dose-dense neoadjuvant chemotherapy (NAC) with trastuzumab or standard-interval chemotherapy with trastuzumab. Patients with HER2-positive breast cancer who received NAC, including epirubicin and cyclophosphamide followed by paclitaxel with trastuzumab were included. Patients were divided into either the dose-dense or standard-interval group. We compared pathologic complete remission (pCR), distant disease-free survival (DDFS), event-free survival (EFS), and breast cancer-specific survival (BCSS) between the two groups. Two hundred (49.6%) patients received dose-dense NAC, and 203 (50.4%) received standard-interval NAC. The pCR rate was 38.4% in the dose-dense group and 29.2% in the standard-interval group (P = 0.052). In patients with lymph node (LN) metastases, the LN pCR rate was 70.9% in the dose-dense group and 56.5% in the standard-interval group (P = 0.037). After a median follow-up of 54.6 months, dose-dense chemotherapy presented an improvement on DDFS (hazard ratio [HR] = 0.49, 95% confidence interval [CI]: 0.19–1.28, EFS (HR = 0.54, 95% CI: 0.24–1.21), and BCSS (HR = 0.41, 95% CI: 0.11–1.51), but the difference was not significant. Compared with standard-interval chemotherapy, dose-dense chemotherapy resulted in a superior 5-year DDFS (100% vs. 75.3%, P = 0.017) and 5-year EFS (96.9% vs. 78.3%, P = 0.022) in patients younger than 40 years. HER2-positive patients can achieve a higher LN pCR rate with dose-dense NAC than with standard-interval NAC with trastuzumab. Better survival may also be achieved with dose-dense chemotherapy with trastuzumab than with standard-interval chemotherapy with trastuzumab among young patients (age ≤ 40 years).
format	article
author	Lize Wang Yang Zhang Yingjian He Jinfeng Li Tianfeng Wang Yuntao Xie Zhaoqing Fan Tao Ouyang
author_facet	Lize Wang Yang Zhang Yingjian He Jinfeng Li Tianfeng Wang Yuntao Xie Zhaoqing Fan Tao Ouyang
author_sort	Lize Wang
title	Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab
title_short	Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab
title_full	Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab
title_fullStr	Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab
title_full_unstemmed	Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab
title_sort	impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for her2-positive breast cancer patients who receive trastuzumab
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ecd2633c9afa4d6586badc99a62e6da3
work_keys_str_mv	AT lizewang impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab AT yangzhang impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab AT yingjianhe impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab AT jinfengli impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab AT tianfengwang impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab AT yuntaoxie impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab AT zhaoqingfan impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab AT taoouyang impactofdosedenseneoadjuvantchemotherapyonpathologicresponseandsurvivalforher2positivebreastcancerpatientswhoreceivetrastuzumab
_version_	1718379260982329344

Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab

Ejemplares similares