Back to Search
Start Over
Axillary response according to neoadjuvant single or dual human epidermal growth factor receptor 2 (HER2) blockade in clinically node‐positive, HER2‐positive breast cancer
- Source :
- International Journal of Cancer
- Publication Year :
- 2021
- Publisher :
- John Wiley & Sons, Inc., 2021.
-
Abstract
- Incorporating dual human epidermal growth factor receptor 2 (HER2) blockade into neoadjuvant systemic therapy (NST) led to higher response in patients with HER2‐positive breast cancer. However, axillary response to treatment regimens, including single or dual HER2 blockade, in patients with clinically node‐positive breast cancer remains uncertain. Our study aimed to examine the pathologic axillary response according to the type of NST, that is, single or dual HER2 blockade. In our study, 546 patients with clinically node‐positive, HER2‐positive breast cancer who received NST followed by axillary surgery were retrospectively selected and divided into three groups: chemotherapy alone, chemotherapy + trastuzumab and chemotherapy + trastuzumab with pertuzumab. The primary outcome was the axillary pathologic complete response (pCR). Among 471 patients undergoing axillary lymph node dissection, the axillary pCR rates were 43.5%, 74.5% and 68.8% in patients who received chemotherapy alone, chemotherapy + trastuzumab and chemotherapy + trastuzumab with pertuzumab, respectively. There was no difference in axillary pCR rates between patients who received single or dual HER2 blockade (P = .379). Among patients receiving chemotherapy + trastuzumab, patients without breast pCR had the greatest risk for residual axillary metastases (relative risk, 9.8; 95% confidence interval, 3.2‐14.9; P<br />What's new? Dual blockade of the human epidermal growth factor receptor 2 (HER2) with trastuzumab and pertuzumab is the preferred option for neoadjuvant systemic therapy (NST) against node‐positive, HER2‐positive breast cancer. Whether this approach effectively improves pathologic complete response (pCR), however, remains unclear. Here, comparison of pCR for single or dual HER2 blockade shows that trastuzumab effectively increases axillary pCR rate in clinically node‐positive, HER2‐positive breast cancer. The addition of pertuzumab to trastuzumab did not further elevate pCR rate. The findings are relevant to decisions regarding axillary surgery in breast cancer patients with pCR after NST with HER2 targeted agents.
- Subjects :
- Oncology
Adult
Cancer Research
medicine.medical_specialty
Receptor, ErbB-2
medicine.medical_treatment
axillary response
Breast Neoplasms
Antibodies, Monoclonal, Humanized
Breast cancer
Trastuzumab
pertuzumab
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Biomarkers, Tumor
Humans
neoadjuvant therapy
skin and connective tissue diseases
Cancer Therapy and Prevention
neoplasms
Neoadjuvant therapy
Aged
Retrospective Studies
Aged, 80 and over
Chemotherapy
business.industry
Axillary Lymph Node Dissection
Middle Aged
medicine.disease
Prognosis
Blockade
HER2‐positive breast cancer
Gene Expression Regulation, Neoplastic
Survival Rate
Relative risk
Lymphatic Metastasis
Axilla
Female
Pertuzumab
Lymph Nodes
business
medicine.drug
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 10970215 and 00207136
- Volume :
- 149
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- International Journal of Cancer
- Accession number :
- edsair.doi.dedup.....57742b23220cdda0d3601616e5146508