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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Simple Summary

The current standard of care for patients with HER2-positive early breast cancer who have a pathological complete response after neoadjuvant HER2-targeted therapy plus chemotherapy is continuation of HER2-targeted therapy in the adjuvant setting. However, it is not clear how long-term outcomes differ by the HER2-targeted regimen received in each setting. To investigate this question, we pooled patient-level data (n = 1763) from neoadjuvant studies of trastuzumab and pertuzumab to evaluate outcomes with respect to single versus dual HER2 targeting in the neoadjuvant and adjuvant settings. Patients treated with dual HER2-targeted therapy in both the neoadjuvant and adjuvant settings had the highest 4-year event-free survival rates, suggesting that this treatment approach may provide the most benefit for patients with HER2-positive early breast cancer.

Abstract

The standard-of-care for patients with pathological complete response (pCR) after neoadjuvant human epidermal growth factor receptor 2 (HER2)-targeted therapy plus chemotherapy is continuation of HER2-targeted therapy in the adjuvant setting. Our objective was to evaluate risk of recurrence or death in these patients and determine if outcomes differed by the HER2-targeted regimen received in each setting. We analyzed patient-level data from five randomized trials evaluating trastuzumab, pertuzumab, or both as part of systemic neoadjuvant and adjuvant therapy for HER2-positive early breast cancer, and assessed event-free survival (EFS) in 1763 patients. Patients with pCR had decreased risk of an EFS event versus those with residual disease (unadjusted hazard ratio [HR] = 0.35; 95% confidence interval [CI]: 0.27–0.46). Regardless of pCR status, after adjusting for baseline factors, reduction in EFS event risk was greater in patients administered pertuzumab/trastuzumab in both settings versus those administered only trastuzumab in both settings (HR = 0.36; 95% CI: 0.26–0.49), or pertuzumab/trastuzumab in the neoadjuvant setting and only trastuzumab in the adjuvant setting (HR = 0.67; 95% CI: 0.47–0.96). Patients with pCR had longer EFS than those with residual disease. Patients treated with pertuzumab/trastuzumab in both the neoadjuvant and adjuvant settings had the lowest risk of breast cancer recurrence.

Details

Title
Event-Free Survival in Patients with Early HER2-Positive Breast Cancer with a Pathological Complete Response after HER2-Targeted Therapy: A Pooled Analysis
Author
Swain, Sandra M 1   VIAFID ORCID Logo  ; Harrison Macharia 2 ; Cortes, Javier 3   VIAFID ORCID Logo  ; Dang, Chau 4   VIAFID ORCID Logo  ; Gianni, Luca 5 ; Hurvitz, Sara A 6 ; Jackisch, Christian 7 ; Schneeweiss, Andreas 8 ; Slamon, Dennis 6 ; Valagussa, Pinuccia 5   VIAFID ORCID Logo  ; Yolande du Toit 9   VIAFID ORCID Logo  ; Heinzmann, Dominik 2 ; Knott, Adam 2 ; Song, Chunyan 9 ; Cortazar, Patricia 9 

 Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, MedStar Health, Washington, DC 20057, USA 
 F. Hoffmann-La Roche Ltd., 4070 Basel, Switzerland 
 Quirónsalud Group, IOB Institute of Oncology, Madrid and Barcelona, 08023 Barcelona, Spain; Vall d’Hebron Institute of Oncology (VHIO), 08023 Barcelona, Spain 
 Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY 10013, USA 
 Fondazione Michelangelo, 20121 Milano, Italy 
 David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 94720, USA 
 Sana Klinikum Offenbach, 63069 Offenbach, Germany 
 National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany 
 Genentech, Inc., South San Francisco, CA 94080, USA 
First page
5051
Publication year
2022
Publication date
2022
Publisher
MDPI AG
e-ISSN
20726694
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2728448407
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.