104P - Pathologic tumor response & long term outcome with neoadjuvant trastuzumab in Her-2 positive breast cancer

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer agents
Breast Cancer, Locally Advanced
Presenter Sana Zeeshan
Citation Annals of Oncology (2016) 27 (suppl_9): ix30-ix34. 10.1093/annonc/mdw576
Authors S.M. Khan, S. Zeeshan, N. Khan
  • Surgery, The Aga Khan University Hospital, 74800 - Karachi/PK

Abstract

Background

HER2 receptor regulates cell growth, survival & differentiation. It is over expressed in 20% to 30% of all breast cancers & is associated with poor prognosis with a shorter time to relapse & lower overall survival rate. Trastuzumab is a HER2-directed humanized monoclonal antibody which is given in combination with chemotherapy to patients who have HER2-positive breast cancer. It significantly improves response rates, time to progression & overall survival in HER2-positive breast cancer compared with chemotherapy alone. Its use in the neoadjuvant setting significantly increases pathologic complete response (pCR) rates to as high as 65% which correlates with better survival

Methods

Breast cancer database was retrospectively reviewed to determine the pathologic response to neoadjuvant trastuzumab in HER2-positive breast cancer & correlate long-term outcomes and to compare the incidence of pCR in HER2-positive & HER2-negative patients receiving neoadjuvant chemotherapy only with their outcomes

Results

Out of 3766 patients, 448 fulfilled the selection criteria. 13.8% of HER2-positive patients received Neoadjuvant chemotherapy (NAC) along with neoadjuvant trastuzumab, 14% of HER2-positives received NAC without trastuzumab. A parallel group of HER2-negative patients who received NAC was also included. Incidence of pCR was highest in patients who received targeted therapy (54.8%) & showed favorable disease free survival. Absence of targeted therapy in patients who were HER2-positive yielded lower incidence of pCR (23.9%) similar to HER2-negatives receiving NAC only. In the long-term outcome, tumors with pCR showed better DFS (94.9%) with lower recurrence (5.1%) as compared to tumors with no pCR. Recurrence was found to be highest in HER2-positives who did not receive trastuzumab at all (20% vs 4.7% in neoadjuvant trastuzumab group)

Conclusions

In HER 2-positive breast cancer, neoadjuvant Trastuzumab significantly increases pCR rate with a better long-term outcome Absence of targeted therapy in HER2-positive tumors yields lower incidence of pCR In the long-term outcome, HER2-positive patients who do not receive trastuzumab show a higher incidence of recurrence

Clinical trial indentification

Legal entity responsible for the study

The Aga Khan University

Funding

The Aga Khan University

Disclosure

All authors have declared no conflicts of interest.