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 Anti-Cancer Agents & Biologic Therapy
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



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


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


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)


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


The Aga Khan University


All authors have declared no conflicts of interest.