Docetaxel, cisplatin, and trastuzumab as primary systemic therapy for human epidermal growth factor receptor 2-positive locally advanced breast cancer
Abstract
PURPOSE: To evaluate the efficacy and safety of docetaxel, cisplatin, and trastuzumab as primary systemic therapy for human epidermal growth factor receptor 2 (HER2) -positive, locally advanced breast cancer (LABC). PATIENTS AND METHODS: Forty-eight patients with immunohistochemistry-confirmed HER2-positive LABC or inflammatory breast cancer received 12 weeks of docetaxel, cisplatin, and trastuzumab with filgrastim, followed by surgery, adjuvant doxorubicin and cyclophosphamide, and locoregional radiotherapy with or without tamoxifen. The primary end point was pathologic complete response (pCR) in breast. RESULTS: Baseline mean tumor size was 9.2 cm (range, 4 to 32 cm). pCR occurred in breast in 11 patients (23%; 95% CI, 12% to 37%) and breast and axilla in eight patients (17%; 95% CI, 8% to 30%). pCR rates in breast (HER2 positive, seven of 30 patients, 23% v HER2 negative, four of 18 patients, 22%; P > .05) and breast and axilla (four of 30 patients, 13% v four of 18 patients, 22%, respectively; P > .05) were similar regardless of HER2 status by fluorescence in situ hybridization (FISH). At a median follow-up time of 43 months, 4-year progression-free survival (PFS) rate was 81% (95% CI, 64% to 90%); overall survival (OS) rate was 86% (95% CI, 71% to 94%). In patients with pCR in breast and axilla, PFS and OS rates were 100% (95% CI, inestimable). In patients without pCR, PFS rate was 76% (95% CI, 57% to 88%; P = .15, log-rank test), and OS rate was 83% (95% CI, 66% to 92%; P = .21). Survival rates were similar regardless of FISH status. There were only two grade 4 adverse events. CONCLUSION: Twelve weeks of docetaxel, cisplatin, and trastuzumab is clinically active and leads to excellent survival in patients with large, HER2-positive tumors.
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Some patients with HER2+ tumors convert to HER2-negative following neoadjuvant trastuzumab and chemotherapy.
“some patients with HER2+ tumors convert to HER2-negative following neoadjuvant trastuzumab and chemotherapy”
From ERBB Receptors: From Oncogene Discovery to Basic Science to Mechanism-Based Cancer Therapeutics (2014) · cites this paper as Hurley et al., 2006
Patients with HER2+ tumors that convert to HER2-negative following neoadjuvant trastuzumab and chemotherapy exhibit a shorter relapse-free survival compared to those with residual tumors that remain HER2 amplified.
“these patients exhibit a shorter relapse-free survival compared to those with residual tumors that remain HER2 amplified (Hurley et al., 2006; Mittendorf et al., 2009).”
From ERBB Receptors: From Oncogene Discovery to Basic Science to Mechanism-Based Cancer Therapeutics (2014) · cites this paper as Hurley et al., 2006
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- Authors
- Hurley, J., Doliny, P., Reis, I., Silva, O., Gomez-Fernandez, C., Velez, P., Pauletti, G., Powell, J. E., Pegram, M. D., & Slamon, D. J.
- Affiliations
- University of Miami (US)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2006-04-20
- Volume
- 24
- Issue
- 12
- Pages
- 1831-1838
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2161791469
- Cited by
- 245
- References
- 38
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2022: 8 · 2021: 15 · 2020: 4 · 2019: 10 · 2018: 5 · 2017: 5 · 2016: 12 · 2015: 10 · 2014: 13 · 2013: 17 · 2012: 18
- FWCI
- 11.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gastric Cancer Management and Outcomes
- Keywords
- docetaxel, cisplatin, trastuzumab, HER2-positive breast cancer, locally advanced breast cancer, inflammatory breast cancer, neoadjuvant chemotherapy, pathological complete response, progression-free survival, overall survival, treatment toxicity, locoregional radiotherapy
- MeSH terms
- Trastuzumab, Docetaxel, Adult, Aged, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Cisplatin, Female, Humans, Infusions, Intravenous, Middle Aged, Survival Analysis, Treatment Outcome, Disease Progression, Receptor, ErbB-2, Erb-b2 Receptor Tyrosine Kinases, Taxoids, Antibodies, Monoclonal, Humanized
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