Pathologic complete response rates in triple-negative, HER2-positive, and hormone receptor-positive breast cancers after anthracycline-free neoadjuvant chemotherapy with carboplatin and paclitaxel with or without trastuzumab

Breast. 2015 Feb;24(1):18-23. doi: 10.1016/j.breast.2014.10.008. Epub 2014 Nov 20.

Abstract

Background: Pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) is considered a surrogate for improved survival. Platinum-containing NCT, particularly in patients with HER2+ and triple-negative breast cancers (TNBC) may increase pCR rates.

Methods: Tumor characteristics, pCR rates (no invasive disease in breast and lymph nodes), toxicities, and survival in patients who received carboplatin, a taxane, and trastuzumab (HER2+ disease) between April 2009 and December 2011, were reviewed.

Results: Thirty eight patients (39 tumors) completed a median of 4 cycles of NCT. Eighteen of 39 (46%) tumors were HER2+, 8/18 (44%) responded with pCR; 13/18 HER2+ tumors were HR+ (72%) and 4/13 (31%) had a pCR. Ten of 39 (26%) tumors were TNBC; 6/10 (60%) had a pCR. At a median of 25-months no recurrences were observed in patients with pCR.

Conclusions: Prospective studies of anthracycline-free platinum-containing NCT are warranted in LABC patients with HER2+ and TNBC.

Keywords: Carboplatin; Human epidermal growth factor receptor 2 (HER2); Inflammatory breast cancer; Locally advanced breast cancer (LABC); Pathologic complete response (pCR); Triple-negative breast cancer (TNBC).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Anthracyclines / administration & dosage
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology*
  • Carboplatin / administration & dosage
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / pathology*
  • Paclitaxel / administration & dosage
  • Receptor, ErbB-2
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Retrospective Studies
  • Trastuzumab
  • Triple Negative Breast Neoplasms / drug therapy
  • Triple Negative Breast Neoplasms / pathology

Substances

  • Anthracyclines
  • Antibodies, Monoclonal, Humanized
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Carboplatin
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab
  • Paclitaxel