Evaluation of clinical and pathological responses of HER-2 positive locally advanced breast cancer patients after neoadjuvant therapy and surgery

Year 2023, Volume: 48 Issue: 3, 1062 - 1071, 30.09.2023

Ertuğrul Bayram , Burak Mete , Pakize İrem Kahramanoğlu , Ebru Melekoğlu , Mehmet Turker , İ. Oğuz Kara

https://doi.org/10.17826/cumj.1343734

Abstract

Purpose: This study aimed to compare the effectiveness and toxicity of neoadjuvant dual Human epidermal growth factor receptor-2 (HER-2) blockade combined with chemotherapy in advanced breast cancer.
Materials and Methods: Patients with HER2-positive breast cancer who received trastuzumab (T)+ pertuzumab (P) with weekly neoadjuvant paclitaxel or docetaxel were included in the study. Patients’ age, clinical stage, histological reports, ki-67 index, toxicity profiles, and the state of the pathological and radiological response following neoadjuvant therapy were evaluated.
Results: All 40 patients were women (mean age 50.9) and the overall rate of pathological complete responses was 62.5% (25/40). The rates of non-responsive patients and grade 2 neuropathy were statistically significantly higher in the group receiving P+T+Weekly Paclitaxel. When SUV values were analyzed based on hormone positivity, it was found that they decreased dramatically in both groups and were statistically significant. The logistic regression analysis developed to predict the precise response status to therapy was found to be significant.
Conclusion: When comparing the agents used in dual HER-2 targeted therapies, patient response rates and toxicity profiles may differ. Ductal carcinoma in situ (DCIS) and molecular subtype were found to be significant variables in the developed logistic regression model.

Keywords

breast cancer, dual blockage, HER-2, response rate

HER-2 pozitif lokal ileri meme kanseri hastalarının neoadjuvan tedavi ve cerrahi sonrası klinik ve patolojik yanıtlarının değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, ilerlemiş meme kanserinde neoadjuvan dual insan epidermal büyüme faktörü reseptörü 2 (HER2) blokajında kullanılan kemoterapotiklerin etkinliğini ve toksisitesini karşılaştırmaktı.
Gereç ve Yöntem: Haftalık neoadjuvan paklitaksel veya dosetaksel ile trastuzumab (T)+ pertuzumab (P) alan HER2 pozitif meme kanserli hastalar çalışmaya dahil edildi. Hastaların yaşı, klinik evresi, histolojik raporları, ki-67 indeksi, toksisite profilleri ve neoadjuvan tedavi sonrası patolojik ve radyolojik yanıt durumu değerlendirildi.
Bulgular: Çalışmaya dahil edilen 40 hastanın tümü kadındı (ortalama yaş 50.9) ve genel patolojik tam yanıt oranı %62.5 idi (25/40). Haftalık P+T+Paklitaksel alan grupta tedaviye yanıtsız hasta ve grade 2 nöropati oranları istatistiksel olarak anlamlı derecede yüksekti. SUV değerleri hormon pozitifliğine göre analiz edildiğinde, her iki grupta da önemli ölçüde azaldığı ve istatistiksel olarak anlamlı olduğu bulundu. Tedaviye kesin yanıt durumunu tahmin etmek için geliştirilen lojistik regresyon analizi anlamlı bulunmuştur.
Sonuç: Dual HER-2 hedefli tedavilerde kullanılan ajanlar karşılaştırıldığında hasta yanıt oranları ve toksisite profilleri farklı olabilmektedir. Geliştirilen lojistik regresyon modelinde duktal karsinom in situ (DCIS) ve moleküler alt tipin anlamlı değişkenler olduğu bulunmuştur.

Keywords

: Meme kanseri, dual blokaj, HER2, yanıt oranı

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