Real‑world experience with pertuzumab and trastuzumab combined with chemotherapy in neoadjuvant treatment for patients with early‑stage HER2‑positive breast cancer: the NEOPERSUR study

• Alejandro Falcón González ^[1] ; Javier Salvador Boffil ^[1] ; Manuel Ruiz Borrego ^[1] ; Josefina Cruz Jurado ^[2] ; Rocío Álvarez Ambite ^[2] ; Elisenda Llabrés Valenti ^[11] ; Rocío Urbano Cubero ^[3] ; Pedro Sánchez Rovira ^[3] ; Maria Carmen Álamo de la Gala ^[4] ; Fernando Henao Carrasco ^[4] ; María Antonia Martínez Guisado ^[12] ; Carlos José Rodríguez González ^[5] ; Marta Amérigo Góngora ^[6] ; Juan Bayo Calero ^[6] ; Lourdes Rodríguez Pérez ^[7] ; Pilar López Álvarez ^[8] ; Encarnación González Flores ^[9] ; María Valero Arbizu ^[13] ; Alicia Quílez Cutillas ^[10] ; Eloísa Rubio Pérez ^[1]
  1. [1] Hospital Universitario Virgen del Rocío

     Hospital Universitario Virgen del Rocío

     Sevilla, España

     
  2. [2] Hospital Universitario de Canarias

     Hospital Universitario de Canarias

     San Cristóbal de La Laguna, España

     
  3. [3] Hospital Universitario de Jaén

     Hospital Universitario de Jaén

     Jaén, España

     
  4. [4] Hospital Universitario Virgen Macarena

     Hospital Universitario Virgen Macarena

     Sevilla, España

     
  5. [5] Hospital Universitario San Cecilio

     Hospital Universitario San Cecilio

     Granada, España

     
  6. [6] Hospital Juan Ramón Jiménez

     Hospital Juan Ramón Jiménez

     Huelva, España

     
  7. [7] Hospital Universitario Puerta del Mar

     Hospital Universitario Puerta del Mar

     Cádiz, España

     
  8. [8] Hospital Universitario de Valme

     Hospital Universitario de Valme

     Sevilla, España

     
  9. [9] Hospital Universitario Virgen de las Nieves

     Hospital Universitario Virgen de las Nieves

     Granada, España

     
  10. [10] Hospital Universitario de Puerto Real

      Hospital Universitario de Puerto Real

      Puerto Real, España

      
  11. [11] Oncology Service, Complejo Hospitalario Universitario Insular Materno-Infantil, 35016 Las Palmas, Gran Canaria, Spain
  12. [12] Oncology Department, Complejo Hospitalario Torrecárdenas de Almería, 04009 Almería, Spain
  13. [13] Medical Oncology Unit, Oncoavanze-Hospitales Quirónsalud, 41013 Seville, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 9, 2024, págs. 2217-2226
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose HER2-targeted therapies have dramatically improved outcomes of patients with HER2-positive breast cancer (BC), as demonstrated in neoadjuvant trials. This study aims to provide real-world evidence on the use and effectiveness of combined pertuzumab, trastuzumab and chemotherapy (CT) in early-stage HER2-positive BC.

    Methods A retrospective, multicentre study was conducted on patients diagnosed with HER2-positive early BC treated with neoadjuvant pertuzumab and trastuzumab plus CT at 13 Spanish sites. The primary endpoint was pathological complete response (pCR).

    Results A total of 310 patients were included. Pertuzumab and trastuzumab were combined with anthracyclines and taxanes, carboplatin and docetaxel, and taxane-based CT in 77.1%, 16.5%, and 6.5% of patients, respectively. Overall, the pCR rate was 62.2%. The pCR was higher amongst patients with hormone receptor-negative tumours and with tumours expressing higher levels of Ki-67 (> 20%). After postoperative adjuvant treatment, 13.9% of patients relapsed. Those patients who did not achieve pCR, with tumours at advanced stages (III), and with node-positive disease were more likely to experience distant relapse. Median overall survival (OS) and distant disease-free survival (D-DFS) were not reached at the study end. The estimated mean OS and D-DFS times were 7.5 (95% CI 7.3–7.7) and 7.3 (95% CI 7.1–7.5) years, respectively (both were significantly longer amongst patients who achieved pCR). Grade 3–4 anti-HER2 related toxicities were reported in six (1.9%) patients.

    Conclusion Neoadjuvant pertuzumab and trastuzumab plus CT achieve high pCR rates in real-life patients with HER2- positive early BC, showing an acceptable safety profile. Innovative adjuvant strategies are essential in patients at high risk of distant disease recurrence.