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ePoster Display

155P - The addition of pyrotinib in early or locally advanced HER2-positive breast cancer patients with no response to two cycles of neoadjuvant therapy: A prospective, multicenter study

Date

16 Sep 2021

Session

ePoster Display

Presenters

zhi gang YU

Citation

Annals of Oncology (2021) 32 (suppl_5): S407-S446. 10.1016/annonc/annonc687

Authors

Z.G. YU1, B. Xiong2, Z. Yang3, L. Kong4, F. Wang5, Y. Wang5

Author affiliations

  • 1 Breast Cancer Center, The Second Hospital of Shandong University, 250033 - Jinan/CN
  • 2 Breast Cancer Center, Affiliated Hospital of Jining Medical University, 272000 - Jining/CN
  • 3 Thyroid And Breast Surgery, Affiliated Hospital of Binzhou Medical University, 256600 - Binzhou/CN
  • 4 Breast Cancer Center, Linyi Cancer Hospital, 276000 - Linyi/CN
  • 5 Breast Cancer Center, The Second Hospital of Shandong University, 280000 - JINAN/CN
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Abstract 155P

Background

Early assessment of clinical response to treatment would facilitate individualized therapy, with ineffective therapy changed. Pyrotinib is a new oral, irreversible pan-ErbB receptor tyrosine kinase inhibitor that targets human epidermal growth factor receptor (HER) 1, HER2, and HER4. Whether the addition of pyrotinib to TCH (trastuzumab, docetaxel, carboplatin) regimen can bring benefit to non-responder after 2 neoadjuvant cycles of TCH is unclear. This prospective, open-label, multicenter study (NCT03847818) explored the efficacy and safety of neoadjuvant pyrotinib + TCH in patients with early or locally advanced HER2-positive breast cancer who did not respond after 2 neoadjuvant cycles of TCH.

Methods

Eligible patients were aged 18–70 years, with stage II-III HER2-positive invasive breast cancer. Patients received 2 cycles of TCH (docetaxel: 75 mg/m2 every 3 weeks; carboplatin: area under the curve 5; and trastuzumab: 8 mg/kg loading dose, followed by 6 mg/kg every 3 weeks) first, and those with complete/partial response continued 4 cycles of TCH (cohort A). Non-responder after 2 cycles of TCH received 4 cycles of TCH (cohort B) or pyrotinib (400 mg orally once per day) + TCH (cohort C). The primary endpoint was the proportion of patients who achieved total pathological complete response (tpCR, ypT0/is, ypN0).

Results

From December 2018 to December 2020, a total of 66 patients were enrolled and completed the neoadjuvant therapy and surgery, including 30 patients in cohort A, 10 in cohort B, and 26 in cohort C. The tpCR rate was the highest in cohort C (34.6%), followed by 30.0% in cohort A and 10.0% in cohort B. The most common grade 3-4 adverse events were diarrhea (40.3%), vomiting (25.2%), and neutropenia (7.5%) in cohort C. No treatment-related death was observed.

Conclusions

This exploratory analysis demonstrated the efficacy and tolerable toxicity of pyrotinib + TCH in patients with early or locally advanced HER2-positive breast cancer who did not respond after 2 cycles of TCH in the neoadjuvant setting, and also confirmed the importance of early efficacy assessment during neoadjuvant therapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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