Weekly paclitaxel plus carboplatin with or without trastuzumab as neoadjuvant chemotherapy for HER2-positive breast cancer: loss of HER2 amplification and its impact on response and prognosis
Purpose Neoadjuvant chemotherapy (NCT) plus anti-HER2 agents are the standard of care for locally advanced HER2-positive breast cancer. The aim of this study was to evaluate the prevalence and prognostic impact of HER2 loss in patients with HER2-positive disease treated with neoadjuvant therapy with...
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| Veröffentlicht in: | Breast cancer research and treatment 2017, Vol.161 (2), p.259-267 |
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| creator | Wang, Ruo-Xi Chen, Sheng Jin, Xi Chen, Can-Ming Shao, Zhi-Ming |
| description | Purpose
Neoadjuvant chemotherapy (NCT) plus anti-HER2 agents are the standard of care for locally advanced HER2-positive breast cancer. The aim of this study was to evaluate the prevalence and prognostic impact of HER2 loss in patients with HER2-positive disease treated with neoadjuvant therapy with or without trastuzumab.
Methods
549 consecutive HER2-positive patients were included in this study. 379 patients were treated with paclitaxel, carboplatin, and trastuzumab (PCH cohort) and 170 were treated with paclitaxel and carboplatin only (PC cohort). Conversion of biomarkers before and after NCT was evaluated via immunohistochemistry (IHC) test. Cox regression model was used to investigate prognostic markers to relapse-free survival (RFS).
Results
50.9% patients were considered as pCR responder in PCH cohort, whereas only 25.9% of patients experienced pCR in PC cohort (
P
|
| doi_str_mv | 10.1007/s10549-016-4064-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868344363</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A477133963</galeid><sourcerecordid>A477133963</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-1829964487e651f501b90402b6bead4a219b3af6af048260a87465822f8a4ad23</originalsourceid><addsrcrecordid>eNqNktGK1DAUhoso7jr6AN5IQBBvuiZpmqTeLcvqCguCKF6W087pTMY0qUm6Or6cr2ZmZtVdUZBeBHK-_z85PX9RPGb0hFGqXkRGa9GUlMlSUCnK5k5xzGpVlYozdbc4zgVVSk3lUfEgxg2ltFG0uV8ccaV1LarmuPj-EfGT3ZIJemsSfEVLJjtH0kPo_GQhGUe-mLQmPuxPPyeSAsQ0f5tH6AhE4tDDcjNfgUukX-Po0xoDTFsyZM3F-TteTj6aZK6QdAGzNJu7HsNLYn2MxA97iMA4WTOYPrf0joBbEpMiMWN-WSL5JmCcvIu4L03Br1x2jQ-LewPYiI-uz0Xx4dX5-7OL8vLt6zdnp5dlX9MqlUzzppFCaIWyZkNNWddQQXknO4SlAM6aroJBwkCF5pKCVkLWmvNBg4AlrxbF84Nv7vx5xpja0cQerYU8_hxbpqWuhKhk9R-oyJ2lyotaFE__QDd-Di4Pkqla8VoLWv2mVmCxNW7weQP9zrQ9FUqxqmr2bU_-QuVviaPpvcPB5Ptbgmc3BGsEm9bR23n3_-NtkB3APuSFBRzaKZgRwrZltN0FsT0Esc15a3dBbJuseXI92dyNuPyl-Jm8DPADEHPJrTDcGP2frj8Av_3onA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1857258403</pqid></control><display><type>article</type><title>Weekly paclitaxel plus carboplatin with or without trastuzumab as neoadjuvant chemotherapy for HER2-positive breast cancer: loss of HER2 amplification and its impact on response and prognosis</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Wang, Ruo-Xi ; Chen, Sheng ; Jin, Xi ; Chen, Can-Ming ; Shao, Zhi-Ming</creator><creatorcontrib>Wang, Ruo-Xi ; Chen, Sheng ; Jin, Xi ; Chen, Can-Ming ; Shao, Zhi-Ming</creatorcontrib><description>Purpose
Neoadjuvant chemotherapy (NCT) plus anti-HER2 agents are the standard of care for locally advanced HER2-positive breast cancer. The aim of this study was to evaluate the prevalence and prognostic impact of HER2 loss in patients with HER2-positive disease treated with neoadjuvant therapy with or without trastuzumab.
Methods
549 consecutive HER2-positive patients were included in this study. 379 patients were treated with paclitaxel, carboplatin, and trastuzumab (PCH cohort) and 170 were treated with paclitaxel and carboplatin only (PC cohort). Conversion of biomarkers before and after NCT was evaluated via immunohistochemistry (IHC) test. Cox regression model was used to investigate prognostic markers to relapse-free survival (RFS).
Results
50.9% patients were considered as pCR responder in PCH cohort, whereas only 25.9% of patients experienced pCR in PC cohort (
P
< 0.001). HER2 loss were more frequently shown in PCH cohort with a proportion of 19.8%, compared to 9.4% in PC cohort (
P
= 0.009). In PCH cohort, patients with a loss of HER2 expression tended to have a higher risk of relapse compared to patients with maintained HER2 expression (HR = 2.639, 95% CI 1.103–6.311,
P
= 0.029). However, it did not correlate to patient outcome in the PC cohort (
P
= 0.296). Loss of HER2 was also correlated to ER conversion in PCH cohort.
Conclusion
Our study has provided new evidence that anti-HER2 treatment has a significant impact on HER2 loss. Far more importantly, the loss of HER2 amplification could identify non-pCR patients with high risk of disease relapse, which might help in tailoring following systemic treatment.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-016-4064-9</identifier><identifier>PMID: 27885439</identifier><identifier>CODEN: BCTRD6</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adjuvant chemotherapy ; Adult ; Aged ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biomarkers, Tumor ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - metabolism ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Cancer research ; Cancer therapies ; Carboplatin - administration & dosage ; Chemotherapy ; Drug therapy ; Female ; Gene Amplification ; Humans ; Immunohistochemistry ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Neoplasm Staging ; Oncology ; Paclitaxel - administration & dosage ; Pathology ; Preclinical Study ; Prognosis ; Receptor, ErbB-2 - genetics ; Receptor, ErbB-2 - metabolism ; Risk Factors ; Trastuzumab - administration & dosage ; Treatment Outcome</subject><ispartof>Breast cancer research and treatment, 2017, Vol.161 (2), p.259-267</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>COPYRIGHT 2017 Springer</rights><rights>Breast Cancer Research and Treatment is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-1829964487e651f501b90402b6bead4a219b3af6af048260a87465822f8a4ad23</citedby><cites>FETCH-LOGICAL-c503t-1829964487e651f501b90402b6bead4a219b3af6af048260a87465822f8a4ad23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-016-4064-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-016-4064-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27885439$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Ruo-Xi</creatorcontrib><creatorcontrib>Chen, Sheng</creatorcontrib><creatorcontrib>Jin, Xi</creatorcontrib><creatorcontrib>Chen, Can-Ming</creatorcontrib><creatorcontrib>Shao, Zhi-Ming</creatorcontrib><title>Weekly paclitaxel plus carboplatin with or without trastuzumab as neoadjuvant chemotherapy for HER2-positive breast cancer: loss of HER2 amplification and its impact on response and prognosis</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
Neoadjuvant chemotherapy (NCT) plus anti-HER2 agents are the standard of care for locally advanced HER2-positive breast cancer. The aim of this study was to evaluate the prevalence and prognostic impact of HER2 loss in patients with HER2-positive disease treated with neoadjuvant therapy with or without trastuzumab.
Methods
549 consecutive HER2-positive patients were included in this study. 379 patients were treated with paclitaxel, carboplatin, and trastuzumab (PCH cohort) and 170 were treated with paclitaxel and carboplatin only (PC cohort). Conversion of biomarkers before and after NCT was evaluated via immunohistochemistry (IHC) test. Cox regression model was used to investigate prognostic markers to relapse-free survival (RFS).
Results
50.9% patients were considered as pCR responder in PCH cohort, whereas only 25.9% of patients experienced pCR in PC cohort (
P
< 0.001). HER2 loss were more frequently shown in PCH cohort with a proportion of 19.8%, compared to 9.4% in PC cohort (
P
= 0.009). In PCH cohort, patients with a loss of HER2 expression tended to have a higher risk of relapse compared to patients with maintained HER2 expression (HR = 2.639, 95% CI 1.103–6.311,
P
= 0.029). However, it did not correlate to patient outcome in the PC cohort (
P
= 0.296). Loss of HER2 was also correlated to ER conversion in PCH cohort.
Conclusion
Our study has provided new evidence that anti-HER2 treatment has a significant impact on HER2 loss. Far more importantly, the loss of HER2 amplification could identify non-pCR patients with high risk of disease relapse, which might help in tailoring following systemic treatment.</description><subject>Adjuvant chemotherapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biomarkers, Tumor</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - metabolism</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Carboplatin - administration & dosage</subject><subject>Chemotherapy</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Gene Amplification</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm Metastasis</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Paclitaxel - administration & dosage</subject><subject>Pathology</subject><subject>Preclinical Study</subject><subject>Prognosis</subject><subject>Receptor, ErbB-2 - genetics</subject><subject>Receptor, ErbB-2 - metabolism</subject><subject>Risk Factors</subject><subject>Trastuzumab - administration & dosage</subject><subject>Treatment Outcome</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNktGK1DAUhoso7jr6AN5IQBBvuiZpmqTeLcvqCguCKF6W087pTMY0qUm6Or6cr2ZmZtVdUZBeBHK-_z85PX9RPGb0hFGqXkRGa9GUlMlSUCnK5k5xzGpVlYozdbc4zgVVSk3lUfEgxg2ltFG0uV8ccaV1LarmuPj-EfGT3ZIJemsSfEVLJjtH0kPo_GQhGUe-mLQmPuxPPyeSAsQ0f5tH6AhE4tDDcjNfgUukX-Po0xoDTFsyZM3F-TteTj6aZK6QdAGzNJu7HsNLYn2MxA97iMA4WTOYPrf0joBbEpMiMWN-WSL5JmCcvIu4L03Br1x2jQ-LewPYiI-uz0Xx4dX5-7OL8vLt6zdnp5dlX9MqlUzzppFCaIWyZkNNWddQQXknO4SlAM6aroJBwkCF5pKCVkLWmvNBg4AlrxbF84Nv7vx5xpja0cQerYU8_hxbpqWuhKhk9R-oyJ2lyotaFE__QDd-Di4Pkqla8VoLWv2mVmCxNW7weQP9zrQ9FUqxqmr2bU_-QuVviaPpvcPB5Ptbgmc3BGsEm9bR23n3_-NtkB3APuSFBRzaKZgRwrZltN0FsT0Esc15a3dBbJuseXI92dyNuPyl-Jm8DPADEHPJrTDcGP2frj8Av_3onA</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Wang, Ruo-Xi</creator><creator>Chen, Sheng</creator><creator>Jin, Xi</creator><creator>Chen, Can-Ming</creator><creator>Shao, Zhi-Ming</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>2017</creationdate><title>Weekly paclitaxel plus carboplatin with or without trastuzumab as neoadjuvant chemotherapy for HER2-positive breast cancer: loss of HER2 amplification and its impact on response and prognosis</title><author>Wang, Ruo-Xi ; Chen, Sheng ; Jin, Xi ; Chen, Can-Ming ; Shao, Zhi-Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-1829964487e651f501b90402b6bead4a219b3af6af048260a87465822f8a4ad23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adjuvant chemotherapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biomarkers, Tumor</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - metabolism</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Carboplatin - administration & dosage</topic><topic>Chemotherapy</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Gene Amplification</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm Metastasis</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Paclitaxel - administration & dosage</topic><topic>Pathology</topic><topic>Preclinical Study</topic><topic>Prognosis</topic><topic>Receptor, ErbB-2 - genetics</topic><topic>Receptor, ErbB-2 - metabolism</topic><topic>Risk Factors</topic><topic>Trastuzumab - administration & dosage</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Ruo-Xi</creatorcontrib><creatorcontrib>Chen, Sheng</creatorcontrib><creatorcontrib>Jin, Xi</creatorcontrib><creatorcontrib>Chen, Can-Ming</creatorcontrib><creatorcontrib>Shao, Zhi-Ming</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Ruo-Xi</au><au>Chen, Sheng</au><au>Jin, Xi</au><au>Chen, Can-Ming</au><au>Shao, Zhi-Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Weekly paclitaxel plus carboplatin with or without trastuzumab as neoadjuvant chemotherapy for HER2-positive breast cancer: loss of HER2 amplification and its impact on response and prognosis</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2017</date><risdate>2017</risdate><volume>161</volume><issue>2</issue><spage>259</spage><epage>267</epage><pages>259-267</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><coden>BCTRD6</coden><abstract>Purpose
Neoadjuvant chemotherapy (NCT) plus anti-HER2 agents are the standard of care for locally advanced HER2-positive breast cancer. The aim of this study was to evaluate the prevalence and prognostic impact of HER2 loss in patients with HER2-positive disease treated with neoadjuvant therapy with or without trastuzumab.
Methods
549 consecutive HER2-positive patients were included in this study. 379 patients were treated with paclitaxel, carboplatin, and trastuzumab (PCH cohort) and 170 were treated with paclitaxel and carboplatin only (PC cohort). Conversion of biomarkers before and after NCT was evaluated via immunohistochemistry (IHC) test. Cox regression model was used to investigate prognostic markers to relapse-free survival (RFS).
Results
50.9% patients were considered as pCR responder in PCH cohort, whereas only 25.9% of patients experienced pCR in PC cohort (
P
< 0.001). HER2 loss were more frequently shown in PCH cohort with a proportion of 19.8%, compared to 9.4% in PC cohort (
P
= 0.009). In PCH cohort, patients with a loss of HER2 expression tended to have a higher risk of relapse compared to patients with maintained HER2 expression (HR = 2.639, 95% CI 1.103–6.311,
P
= 0.029). However, it did not correlate to patient outcome in the PC cohort (
P
= 0.296). Loss of HER2 was also correlated to ER conversion in PCH cohort.
Conclusion
Our study has provided new evidence that anti-HER2 treatment has a significant impact on HER2 loss. Far more importantly, the loss of HER2 amplification could identify non-pCR patients with high risk of disease relapse, which might help in tailoring following systemic treatment.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>27885439</pmid><doi>10.1007/s10549-016-4064-9</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2017, Vol.161 (2), p.259-267 |
| issn | 0167-6806 1573-7217 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adjuvant chemotherapy Adult Aged Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biomarkers, Tumor Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - metabolism Breast Neoplasms - mortality Breast Neoplasms - pathology Cancer research Cancer therapies Carboplatin - administration & dosage Chemotherapy Drug therapy Female Gene Amplification Humans Immunohistochemistry Medicine Medicine & Public Health Middle Aged Neoadjuvant Therapy Neoplasm Metastasis Neoplasm Staging Oncology Paclitaxel - administration & dosage Pathology Preclinical Study Prognosis Receptor, ErbB-2 - genetics Receptor, ErbB-2 - metabolism Risk Factors Trastuzumab - administration & dosage Treatment Outcome |
| title | Weekly paclitaxel plus carboplatin with or without trastuzumab as neoadjuvant chemotherapy for HER2-positive breast cancer: loss of HER2 amplification and its impact on response and prognosis |
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