Efficacy and Safety of Dual Anti-HER2 Blockade and Docetaxel With or Without Carboplatin as Neoadjuvant Regimen for Treatment of HER2-Positive Breast Cancer

• Published in: Technology in cancer research & treatment 2023-01, Vol.22, p.15330338231218152-15330338231218152
• Main Authors: Lin, Binwei, Fan, Jinjia, Liu, Fang, Wen, Yixue, Li, Jie, Gao, Feng, Zhang, Yu, Feng, Gang, Du, Xiaobo, Chen, Wenzhi
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - adverse effects; Asthenia; Breast cancer; Breast Neoplasms - pathology; Cancer therapies; Carboplatin; Colony-stimulating factor; Docetaxel; ErbB-2 protein; Female; Granulocyte-macrophage colony-stimulating factor; Humans; Navigating Breast Health: From Screening to Survivorship; Neoadjuvant Therapy - adverse effects; Neutropenia; Prospective Studies; Receptor, ErbB-2; Remission; Remission (Medicine); Retrospective Studies; Toxicity; Trastuzumab; Trastuzumab - therapeutic use; Treatment Outcome
• ISSN: 1533-0346; 1533-0338
• DOI: 10.1177/15330338231218152

Introduction: This study aimed to compare the efficacy and safety of docetaxel + trastuzumab + pertuzumab and docetaxel + carboplatin + trastuzumab + pertuzumab for treating HER2-positive breast cancer. Method: HER2-positive breast cancer from patients diagnosed between January 2020 and September 2022 were included in this retrospective study. Docetaxel + trastuzumab + pertuzumab or docetaxel + carboplatin + trastuzumab + pertuzumab was selected as the neoadjuvant regimen. The primary endpoint was a complete pathological remission rate. Secondary endpoints were toxicity during neoadjuvant treatment, adjustment of the neoadjuvant therapy scheme, and adjuvant medication. Result: A total of 81 patients were included in this study (38 in the docetaxel + carboplatin + trastuzumab + pertuzumab treatment group and 43 in the docetaxel + trastuzumab + pertuzumab group). The complete pathological remission rates in the docetaxel + carboplatin + trastuzumab + pertuzumab and docetaxel + trastuzumab + pertuzumab groups were 44.7% (95% confidence interval: 30.2%-60.3%) and 51.2% (95% confidence interval: 36.8%-65.4%), respectively. The incidence of grade 3 or higher toxicity in the docetaxel + carboplatin + trastuzumab + pertuzumab group was significantly higher than that in the docetaxel + trastuzumab + pertuzumab group (68.4% vs 39.5%, P = .009). Neutropenia and asthenia were the most common grade 3 or higher toxicities. The incidence of neoadjuvant scheme adjustment was significantly higher in the docetaxel + carboplatin + trastuzumab + pertuzumab group than in the docetaxel + trastuzumab + pertuzumab group (26.3% vs 7.0%, P = .039). The proportion of patients who received