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Real-world effectiveness of dual HER2 blockade with pertuzumab and trastuzumab for neoadjuvant treatment of HER2-positive early breast cancer (The NEOPETRA Study)

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dc.contributor.authorGonzález-Santiago, Santiago
dc.contributor.authorSaura, Cristina
dc.contributor.authorEva Ciruelos,
dc.contributor.authorAlonso Romero, José Luis
dc.contributor.authorMorena, Pilar de la
dc.contributor.authorSantisteban Eslava, Marta
dc.contributor.authorGallegos Sancho, María Isabel
dc.contributor.authorLuna, Alicia de
dc.contributor.authorDalmau, Elsa
dc.contributor.authorServitja, Sonia
dc.contributor.authorRuiz Borrego, Manuel
dc.contributor.authorChacón, José Ignacio
dc.contributor.departmentMedicina
dc.date.accessioned2024-11-07T09:02:08Z
dc.date.available2024-11-07T09:02:08Z
dc.date.issued2020-09-02
dc.description© Springer Science+Business Media, LLC, part of Springer Nature 2020. This document is the Published version of a Published Work that appeared in final form in Breast Cancer Research and Treatment. To access the final edited and published work see https://doi.org/10.1007/s10549-020-05866-1
dc.description.abstractPurpose: Neoadjuvant clinical trials with dual HER2 blockade with pertuzumab and trastuzumab plus chemotherapy demonstrated high rates of pathological complete response (pCR) in HER2-positive early breast cancer (BC). We investigated whether the benefit on pCR seen in clinical trials is confirmed in a real-world setting. Methods: Multicenter, retrospective study in patients with HER2-positive early BC receiving neoadjuvant treatment with pertuzumab and trastuzumab in routine clinical practice (n = 243). The primary endpoint was total pCR (tpCR) (ypT0/is ypN0). Results: A total of 243 evaluable patients were included. Pertuzumab and trastuzumab were combined with anthracyclines and taxanes in 74.1% of patients, with single-agent taxane in 11.1% of patients and with platinum-based chemotherapy (CT) in 14.4% of patients. The tpCR rate was 66.4%:71% with anthracyclines and taxanes, 59.3% with single-agent taxane, and 48.6% with platinum-based combinations. The tpCR rate was higher among patients with hormone receptor (HR)-negative tumors (80.9%) vs HR-positive tumors (55.4%) (p < 0.001). A pCR in the breast (ypT0/is) was achieved in 67.6% of patients. Of 143 patients who showed radiological complete response (rCR) (62%), 112 (78.3%) patients also achieved tpCR. Assessment of rCR by magnetic resonance imaging (MRI) showed the highest negative predictive value (NPV) for predicting tpCR (83.5%). Breast-conserving surgery was performed in 58.7% of patients. Grade 3 and grade 4 toxicities were reported in 33 (18.2%) and 12 (6.6%) patients, respectively. No toxicity leading to death was reported. Conclusions: This real-world analysis shows that neoadjuvant pertuzumab, trastuzumab, and chemotherapy achieve comparable or even higher rates of tpCR than those seen in clinical trials. The pCR benefit is higher in HR-negative tumors. The assessment of rCR by MRI showed the highest ability for predicting pCR. In addition, this neoadjuvant strategy confers an acceptable safety profile.es
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dc.identifier.citationBreast Cancer Research and Treatment (2020) 184:469–479
dc.identifier.doihttps://doi.org/10.1007/s10549-020-05866-1
dc.identifier.issnPrint: 0167-6806
dc.identifier.issnElectronic: 1573-7217
dc.identifier.urihttp://hdl.handle.net/10201/146065
dc.languageenges
dc.publisherSpringer
dc.relationThe study was sponsored by Roche Farma S.A.es
dc.relation.publisherversionhttps://link.springer.com/article/10.1007/s10549-020-05866-1
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectBreast canceres
dc.subjectEarly stagees
dc.subjectEpidermal growth factor receptor (HER2)es
dc.subjectPathological complete response (pCR)es
dc.subjectPertuzumabes
dc.subjectTrastuzumabes
dc.titleReal-world effectiveness of dual HER2 blockade with pertuzumab and trastuzumab for neoadjuvant treatment of HER2-positive early breast cancer (The NEOPETRA Study)es
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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