دورية أكاديمية

Safety and efficacy analysis of neoadjuvant pertuzumab, trastuzumab and standard chemotherapy for HER2-positive early breast cancer: real-world data from NeoPowER study.

التفاصيل البيبلوغرافية
العنوان: Safety and efficacy analysis of neoadjuvant pertuzumab, trastuzumab and standard chemotherapy for HER2-positive early breast cancer: real-world data from NeoPowER study.
المؤلفون: Canino F; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy. fabio.canino@unimore.it., Barbolini M; Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy., De Giorgi U; Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Fontana T; Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Gaspari V; Department of Medical Oncology, Infermi Hospital, AUSL della Romagna, Rimini, Italy., Gianni C; Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Gianni L; Department of Medical Oncology, Infermi Hospital, AUSL della Romagna, Rimini, Italy., Maestri A; Department of Medical Oncology, AUSL di Bologna, Bologna, Italy., Minichillo S; Department of Medical Oncology, AUSL di Bologna, Bologna, Italy., Moscetti L; Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy., Mura A; Department of Medical Oncology, AUSL di Bologna, Bologna, Italy., Nicoletti SVL; Department of Medical Oncology, Infermi Hospital, AUSL della Romagna, Rimini, Italy., Omarini C; Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy., Pagani R; Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Sarti S; Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Toss A; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy.; Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy., Zamagni C; Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Cuoghi Costantini R; Unit of Clinical Statistics, University Hospital of Modena, Modena, Italy., Caggia F; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy., Antonelli G; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy., Baglio F; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy., Belluzzi L; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy., Martinelli G; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy., Natalizio S; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy., Ponzoni O; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy., Dominici M; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy.; Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy., Piacentini F; Division of Medical Oncology, Department of Medical and Surgical Sciences for Children and Adults, University Hospital of Modena, Largo del Pozzo 71, Modena, 41124, Italy.; Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy.
المصدر: BMC cancer [BMC Cancer] 2024 Jun 15; Vol. 24 (1), pp. 735. Date of Electronic Publication: 2024 Jun 15.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Breast Neoplasms*/drug therapy , Breast Neoplasms*/pathology , Breast Neoplasms*/metabolism , Trastuzumab*/administration & dosage , Trastuzumab*/adverse effects , Trastuzumab*/therapeutic use , Neoadjuvant Therapy*/methods , Antineoplastic Combined Chemotherapy Protocols*/therapeutic use , Antineoplastic Combined Chemotherapy Protocols*/adverse effects , Antibodies, Monoclonal, Humanized*/adverse effects , Antibodies, Monoclonal, Humanized*/administration & dosage , Antibodies, Monoclonal, Humanized*/therapeutic use , Receptor, ErbB-2*/metabolism, Humans ; Female ; Middle Aged ; Retrospective Studies ; Adult ; Aged ; Treatment Outcome ; Neoplasm Staging
مستخلص: Background: The addition of pertuzumab (P) to trastuzumab (H) and standard chemotherapy (CT) as neoadjuvant treatment (NaT) for patients with HER2 + breast cancer (BC), has shown to increase the pathological complete response (pCR) rate, without main safety concerns. The aim of NeoPowER trial is to evaluate safety and efficacy of P + H + CT in a real-world population.
Methods: We retrospectively reviewed the medical records of stage II-III, HER2 + BC patients treated with NaT: who received P + H + CT (neopower group) in 5 Emilia Romagna institutions were compared with an historical group who received H + CT (control group). The primary endpoint was the safety, secondary endpoints were pCR rate, DRFS and OS and their correlation to NaT and other potential variables.
Results: 260 patients were included, 48% received P + H + CT, of whom 44% was given anthraciclynes as part of CT, compared to 83% in the control group. The toxicity profile was similar, excluding diarrhea more frequent in the neopower group (20% vs. 9%). Three patients experienced significant reductions in left ventricular ejection fraction (LVEF), all receiving anthracyclines. The pCR rate was 46% (P + H + CT) and 40% (H + CT) (p = 0.39). The addition of P had statistically correlation with pCR only in the patients receiving anthra-free regimens (OR = 3.05,p = 0.047). Preoperative use of anthracyclines (OR = 1.81,p = 0.03) and duration of NaT (OR = 1.18,p = 0.02) were statistically related to pCR. 12/21 distant-relapse events and 14/17 deaths occurred in the control group. Patients who achieve pCR had a significant increase in DRFS (HR = 0.23,p = 0.009).
Conclusions: Adding neoadjuvant P to H and CT is safe. With the exception of diarrhea, rate of adverse events of grade > 2 did not differ between the two groups. P did not increase the cardiotoxicity when added to H + CT, nevertheless in our population all cardiac events occurred in patients who received anthracycline-containing regimens. Not statistically significant, higher pCR rate is achievable in patients receiving neoadjuvant P + H + CT. The study did not show a statistically significant correlation between the addition of P and long-term outcomes.
(© 2024. The Author(s).)
References: Pathol Oncol Res. 2021 May 04;27:1609785. (PMID: 34257621)
Breast. 2020 Dec;54:242-247. (PMID: 33186804)
Medicine (Baltimore). 2022 Oct 7;101(40):e30892. (PMID: 36221359)
Eur J Cancer. 2023 Sep;190:112885. (PMID: 37142539)
Lancet. 2010 Jan 30;375(9712):377-84. (PMID: 20113825)
Lancet. 2014 Jul 12;384(9938):164-72. (PMID: 24529560)
J Clin Oncol. 2023 Jun 1;41(16):2988-2997. (PMID: 36977286)
Breast Cancer Res Treat. 2019 Jan;173(2):319-328. (PMID: 30324275)
JAMA Oncol. 2021 Jul 01;7(7):978-984. (PMID: 34014249)
Ann Oncol. 2013 Sep;24(9):2278-84. (PMID: 23704196)
Eur J Cancer. 2018 Jan;89:27-35. (PMID: 29223479)
Breast. 2022 Oct;65:110-115. (PMID: 35921798)
Breast Cancer Res Treat. 2020 Nov;184(2):469-479. (PMID: 32876911)
Lancet Oncol. 2016 Jun;17(6):791-800. (PMID: 27179402)
Breast Cancer Res Treat. 2018 Dec;172(3):733-740. (PMID: 30220055)
Lancet Oncol. 2012 Jan;13(1):25-32. (PMID: 22153890)
J Oncol Pharm Pract. 2020 Apr;26(3):572-579. (PMID: 31256745)
N Engl J Med. 2019 Feb 14;380(7):617-628. (PMID: 30516102)
JAMA Oncol. 2021 Nov 01;7(11):1654-1663. (PMID: 34529000)
Lancet Oncol. 2018 Dec;19(12):1630-1640. (PMID: 30413379)
Cancers (Basel). 2022 Jun 18;14(12):. (PMID: 35740668)
Clin Drug Investig. 2023 Sep;43(9):691-698. (PMID: 37479867)
Am J Cancer Res. 2020 Apr 01;10(4):1045-1067. (PMID: 32368385)
Front Oncol. 2023 Jun 27;13:1177681. (PMID: 37441419)
Ann Oncol. 2018 Mar 1;29(3):646-653. (PMID: 29253081)
فهرسة مساهمة: Keywords: Early breast cancer; HER2 dual blockade; HER2+; Neoadjuvant treatment; Pertuzumab; Real world data
المشرفين على المادة: K16AIQ8CTM (pertuzumab)
P188ANX8CK (Trastuzumab)
0 (Antibodies, Monoclonal, Humanized)
EC 2.7.10.1 (Receptor, ErbB-2)
EC 2.7.10.1 (ERBB2 protein, human)
تواريخ الأحداث: Date Created: 20240615 Date Completed: 20240615 Latest Revision: 20240618
رمز التحديث: 20240618
مُعرف محوري في PubMed: PMC11179289
DOI: 10.1186/s12885-024-12506-0
PMID: 38879498
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2407
DOI:10.1186/s12885-024-12506-0