Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing Country

Background: Data regarding pathologic response of Trastuzumab based chemotherapy in locally advanced HER2 positive breast cancer in neoadjuvant setting is scarce. Methods: A retrospective analysis was conducted from January 2014 to January 2019 at a tertiary cancer care centre in North India and 81...

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Main Authors: Dinesh Chandra Doval, Sneha Bothra, Pankaj Goyal, Chaturbhuj Agrawal, Parveen Jain, Rupal Tripathi, Anurag Sharma, Sunil Pasricha, Kumardeep Dutta Choudhary
Format: Article
Language:English
Published: West Asia Organization for Cancer Prevention 2021-11-01
Series:Asian Pacific Journal of Cancer Care
Subjects:
Online Access:http://www.waocp.com/journal/index.php/apjcc/article/view/730
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author Dinesh Chandra Doval
Sneha Bothra
Pankaj Goyal
Chaturbhuj Agrawal
Parveen Jain
Rupal Tripathi
Anurag Sharma
Sunil Pasricha
Kumardeep Dutta Choudhary
author_facet Dinesh Chandra Doval
Sneha Bothra
Pankaj Goyal
Chaturbhuj Agrawal
Parveen Jain
Rupal Tripathi
Anurag Sharma
Sunil Pasricha
Kumardeep Dutta Choudhary
author_sort Dinesh Chandra Doval
collection DOAJ
description Background: Data regarding pathologic response of Trastuzumab based chemotherapy in locally advanced HER2 positive breast cancer in neoadjuvant setting is scarce. Methods: A retrospective analysis was conducted from January 2014 to January 2019 at a tertiary cancer care centre in North India and 81 breast cancer patients who underwent neoadjuvant chemotherapy were included. The clinical and pathologic characteristics, response, toxicity and survival data was collected, collated and analyzed. Results: The most commonly observed tumor characteristics at baseline were clinical stage T4 (72.8%), nodal stage N2 (40.7%), invasive ductal carcinoma on histology (98.8%), grade 3 (66.7%) and hormone receptor negativity (54.3%). In terms of post treatment characteristics, a higher incidence of partial response (55.6%), post treatment tumor stage ypT0 (45.7%), nodal status ypN0 (54.3%), absence of extracapsular invasion (77.8%) and absence of pathologic complete response (pCR, 63%) were observed. pCR was attained in 30 patients and was most commonly associated with clinical tumor stage T4 (26/30), nodal stage N2-N3 (19/30), grade 3 (21/30) and hormone receptor negativity (20/30). Altogether, 19.75% had grade 3/4 adverse events. At 6 years, 86% v/s 61% patients were disease free (p=0.037) and 93% v/s 79% patients (p=0.181) were alive in the pCR and no pCR groups, respectively. Conclusion: Even in locally advanced breast cancer (LABC), Trastuzumab had good response in terms of pCR and survival outcomes. Thus, one can be encouraged to use this single HER2 blockade if dual blockade is not feasible in HER2 positive LABC in the neoadjuvant setting.
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spelling doaj.art-ca073e01f158489290114d1862e42d0f2024-01-27T05:14:00ZengWest Asia Organization for Cancer PreventionAsian Pacific Journal of Cancer Care2588-36822021-11-016444945610.31557/apjcc.2021.6.4.449-456730Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing CountryDinesh Chandra Doval0Sneha Bothra1Pankaj Goyal2Chaturbhuj Agrawal3Parveen Jain4Rupal Tripathi5Anurag Sharma6Sunil Pasricha7Kumardeep Dutta Choudhary8Department of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Research, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Research, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Pathology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, IndiaDepartment of Medical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India.Background: Data regarding pathologic response of Trastuzumab based chemotherapy in locally advanced HER2 positive breast cancer in neoadjuvant setting is scarce. Methods: A retrospective analysis was conducted from January 2014 to January 2019 at a tertiary cancer care centre in North India and 81 breast cancer patients who underwent neoadjuvant chemotherapy were included. The clinical and pathologic characteristics, response, toxicity and survival data was collected, collated and analyzed. Results: The most commonly observed tumor characteristics at baseline were clinical stage T4 (72.8%), nodal stage N2 (40.7%), invasive ductal carcinoma on histology (98.8%), grade 3 (66.7%) and hormone receptor negativity (54.3%). In terms of post treatment characteristics, a higher incidence of partial response (55.6%), post treatment tumor stage ypT0 (45.7%), nodal status ypN0 (54.3%), absence of extracapsular invasion (77.8%) and absence of pathologic complete response (pCR, 63%) were observed. pCR was attained in 30 patients and was most commonly associated with clinical tumor stage T4 (26/30), nodal stage N2-N3 (19/30), grade 3 (21/30) and hormone receptor negativity (20/30). Altogether, 19.75% had grade 3/4 adverse events. At 6 years, 86% v/s 61% patients were disease free (p=0.037) and 93% v/s 79% patients (p=0.181) were alive in the pCR and no pCR groups, respectively. Conclusion: Even in locally advanced breast cancer (LABC), Trastuzumab had good response in terms of pCR and survival outcomes. Thus, one can be encouraged to use this single HER2 blockade if dual blockade is not feasible in HER2 positive LABC in the neoadjuvant setting.http://www.waocp.com/journal/index.php/apjcc/article/view/730trastuzumab; locally advanced breast cancer
spellingShingle Dinesh Chandra Doval
Sneha Bothra
Pankaj Goyal
Chaturbhuj Agrawal
Parveen Jain
Rupal Tripathi
Anurag Sharma
Sunil Pasricha
Kumardeep Dutta Choudhary
Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing Country
Asian Pacific Journal of Cancer Care
trastuzumab; locally advanced breast cancer
title Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing Country
title_full Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing Country
title_fullStr Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing Country
title_full_unstemmed Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing Country
title_short Real World Data of Response of Trastuzumab Based Chemotherapy in Locally Advanced HER2 Positive Breast Cancer from a Developing Country
title_sort real world data of response of trastuzumab based chemotherapy in locally advanced her2 positive breast cancer from a developing country
topic trastuzumab; locally advanced breast cancer
url http://www.waocp.com/journal/index.php/apjcc/article/view/730
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