Trastuzumab or lapatinib with standard chemotherapy for HER2-positive breast cancer

The addition of trastuzumab (T) and lapatinib (L) to neoadjuvant chemotherapy increases the pathological complete response (pCR) rate in patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. We investigated the efficacy of T or L with neoadjuvant chemotherapy an...

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Detalles Bibliográficos
Autores: Alba, Emilio|||0000-0002-3364-2603, Albanell Mestres, Joan|||0000-0003-1239-4580, de la Haba Rodríguez, Juan Rafael|||0000-0001-5111-1702, Barnadas i Molins, Agustí|||0000-0002-0429-1349, Calvo Martínez, Lourdes, Sanchez Rovira, Pedro|||0000-0003-2658-1467, Ramos Vázquez, Manuel, Rojo, Federico|||0000-0001-9989-0290, Burgués, Octavio|||0000-0002-2471-5516, Carrasco, Eva|||0000-0002-2771-7197, Caballero, Rosalía, Porras, Ignacio, Tibau Martorell, Ariadna|||0000-0003-0229-6987, Cámara, Maria Carmen, Lluch, Ana|||0000-0003-2766-407X
Tipo de recurso: artículo
Fecha de publicación:2014
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:184992
Acceso en línea:https://ddd.uab.cat/record/184992
https://dx.doi.org/urn:doi:10.1038/bjc.2013.831
Access Level:acceso abierto
Palabra clave:HER2-positive breast cancer
Lapatinib
Neoadjuvant
Trastuzumab
Biomarkers
Descripción
Sumario:The addition of trastuzumab (T) and lapatinib (L) to neoadjuvant chemotherapy increases the pathological complete response (pCR) rate in patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. We investigated the efficacy of T or L with neoadjuvant chemotherapy and specific efficacy biomarkers. Patients with stages I-III (including inflammatory) HER2-positive breast cancer were randomised to receive epirubicin (E) plus cyclophosphamide (C) × 4 cycles followed by docetaxel (D) plus either T (EC-DT) or L (EC-DL). End points included pCR (primary), clinical response, toxicity, and pCR-predictive biomarkers. We randomised 102 patients to EC-DT (50) and EC-DL (52). Median age was 48, 56% were premenopausal and 58% had oestrogen receptor (ER)-positive tumours. Pathological complete response in breast was 52.1% (95% CI:38.0-66.2%) for EC-DT and 25.5% (95% CI:13.5-37.5%) for EC-DL (P =0.0065). Pathological complete response in breast and axilla was 47.9% for EC-DT and 23.5% for EC-DL (P =0.011). Grade 3-4 toxicity did not differ across treatments, except for diarrhoea (2% in EC-DT vs 13.5% in EC-DL, P =0.030). Multivariate analyses showed that treatment (P =0.036) and ER (P =0.014) were the only predictors of pCR in both groups. EC-DT exhibited higher efficacy and lower toxicity than EC-DL. Of the different biomarkers studied, only the absence of ER expression was associated with increased pCR.

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