Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP
Abstract Grade 3/4 anaemia, which is mainly induced by carboplatin, frequently occurs in patients treated with neoadjuvant docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP). However, dose reduction of carboplatin may raise concerns about the oncological outcome. This study investigated the patholo...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5022 |
| _version_ | 1811176439238623232 |
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| author | Jung Hwan Ji Soong June Bae Seul‐Gi Kim Min Hwan Kim Gun‐Min Kim Joohyuk Sohn Joon Jeong Jee Hung Kim Sung Gwe Ahn |
| author_facet | Jung Hwan Ji Soong June Bae Seul‐Gi Kim Min Hwan Kim Gun‐Min Kim Joohyuk Sohn Joon Jeong Jee Hung Kim Sung Gwe Ahn |
| author_sort | Jung Hwan Ji |
| collection | DOAJ |
| description | Abstract Grade 3/4 anaemia, which is mainly induced by carboplatin, frequently occurs in patients treated with neoadjuvant docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP). However, dose reduction of carboplatin may raise concerns about the oncological outcome. This study investigated the pathologic complete response (pCR) rate, occurrence of grade 3/4 anaemia, and transfusion rate according to carboplatin dose in patients treated with neoadjuvant TCHP. We retrospectively analysed 294 patients treated with neoadjuvant TCHP between April 2015 and December 2020. Case matching was performed using propensity score matching. Among patients treated with neoadjuvant TCHP, carboplatin area under the plasma concentration–time curve 6 (AUC6) was used in 234 patients (79.6%) and upfront carboplatin AUC5 was used in 60 patients (20.4%). No significant difference in pCR rate was found between the two groups (AUC6: 70.9%, AUC5: 80.0%). In both oestrogen receptor‐positive (ER+) and ER‐ patients, no significant differences were observed between the AUC6 and AUC5 groups (ER+: 54.3% vs. 50.0%, ER‐: 81.7% vs. 86.0%). The case‐matched cohort showed consistent findings. The AUC5 group had lower frequencies of grade 3/4 anaemia (18.3% vs. 34.2%) and transfusion events (10.0% vs. 21.8%) than the AUC6 group. Compared with AUC5, carboplatin at AUC6 would associate with a 2.7‐fold increased risk of grade 3 or 4 chemotherapy‐induced anaemia. Carboplatin AUC5 has comparable cytotoxic effects to carboplatin AUC6 in patients with HER2+ breast cancer treated with six cycles of neoadjuvant TCHP, with fewer complications associated with clinically meaningful anaemia. AUC5 may be the optimal carboplatin dose to reduce TCHP‐induced anaemia in patients with HER2+ breast cancer treated with TCHP. |
| first_indexed | 2024-04-10T19:51:29Z |
| format | Article |
| id | doaj.art-36977867352a46bab6c51ccbc9befe28 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-10T19:51:29Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-36977867352a46bab6c51ccbc9befe282023-01-28T05:30:04ZengWileyCancer Medicine2045-76342023-01-011221409141710.1002/cam4.5022Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHPJung Hwan Ji0Soong June Bae1Seul‐Gi Kim2Min Hwan Kim3Gun‐Min Kim4Joohyuk Sohn5Joon Jeong6Jee Hung Kim7Sung Gwe Ahn8Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine Seoul Republic of KoreaDepartment of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine Seoul Republic of KoreaDivision of Medical Oncology, Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of KoreaDivision of Medical Oncology, Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of KoreaDivision of Medical Oncology, Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of KoreaDivision of Medical Oncology, Department of Internal Medicine Yonsei University College of Medicine Seoul Republic of KoreaDepartment of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine Seoul Republic of KoreaInstitute for Breast Cancer Precision Medicine Yonsei University College of Medicine Seoul Republic of KoreaDepartment of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine Seoul Republic of KoreaAbstract Grade 3/4 anaemia, which is mainly induced by carboplatin, frequently occurs in patients treated with neoadjuvant docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP). However, dose reduction of carboplatin may raise concerns about the oncological outcome. This study investigated the pathologic complete response (pCR) rate, occurrence of grade 3/4 anaemia, and transfusion rate according to carboplatin dose in patients treated with neoadjuvant TCHP. We retrospectively analysed 294 patients treated with neoadjuvant TCHP between April 2015 and December 2020. Case matching was performed using propensity score matching. Among patients treated with neoadjuvant TCHP, carboplatin area under the plasma concentration–time curve 6 (AUC6) was used in 234 patients (79.6%) and upfront carboplatin AUC5 was used in 60 patients (20.4%). No significant difference in pCR rate was found between the two groups (AUC6: 70.9%, AUC5: 80.0%). In both oestrogen receptor‐positive (ER+) and ER‐ patients, no significant differences were observed between the AUC6 and AUC5 groups (ER+: 54.3% vs. 50.0%, ER‐: 81.7% vs. 86.0%). The case‐matched cohort showed consistent findings. The AUC5 group had lower frequencies of grade 3/4 anaemia (18.3% vs. 34.2%) and transfusion events (10.0% vs. 21.8%) than the AUC6 group. Compared with AUC5, carboplatin at AUC6 would associate with a 2.7‐fold increased risk of grade 3 or 4 chemotherapy‐induced anaemia. Carboplatin AUC5 has comparable cytotoxic effects to carboplatin AUC6 in patients with HER2+ breast cancer treated with six cycles of neoadjuvant TCHP, with fewer complications associated with clinically meaningful anaemia. AUC5 may be the optimal carboplatin dose to reduce TCHP‐induced anaemia in patients with HER2+ breast cancer treated with TCHP.https://doi.org/10.1002/cam4.5022anaemiabreast cancercarboplatinneoadjuvant chemotherapypathologic complete response |
| spellingShingle | Jung Hwan Ji Soong June Bae Seul‐Gi Kim Min Hwan Kim Gun‐Min Kim Joohyuk Sohn Joon Jeong Jee Hung Kim Sung Gwe Ahn Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP Cancer Medicine anaemia breast cancer carboplatin neoadjuvant chemotherapy pathologic complete response |
| title | Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP |
| title_full | Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP |
| title_fullStr | Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP |
| title_full_unstemmed | Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP |
| title_short | Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP |
| title_sort | anaemia and pathologic complete response rate according to carboplatin dose in her2 breast cancer treated with neoadjuvant tchp |
| topic | anaemia breast cancer carboplatin neoadjuvant chemotherapy pathologic complete response |
| url | https://doi.org/10.1002/cam4.5022 |
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