Effect analysis of pertuzumab,trastuzumab,and anthracycline-based chemotherapy for the neoadjuvant treatment of patients with HER-2-positive breast cancer

CHEN Mie; LI Yongfei; LU Cheng

doi:10.3969/j.issn.1009-0460.2023.12.015

Abstract：Objective To explore the efficacy and safety of pertuzumab,trastuzumab,and anthracycline-based chemotherapy for the neoadjuvant treatment of patients with epidermal growth factor receptor 2(HER-2)-positive breast cancer.Methods From June 2018 to December 2022,81 HER-2-positive breast cancer patients who received dual-target neoadjuvant therapy containing trastuzumab and pertuzumab and underwent surgery were enrolled.Patients were assigned into two groups,where the anthracycline group received a treatment regimen of EC(epirubicin,cyclophosphamide)regimen for 4 cycles followed by THP(docetaxel,trastuzumab,pertuzumab)regimen for 4 cycles,and the anthracycline removal group received a treatment regimen of TCbHP(paclitaxel,carboplatin,trastuzumab,pertuzumab)for 6 cycles.The pathological complete remission(pCR)and adverse reactions between both groups were compared.Results Among 81 eligible patients,there were 22 cases in the anthracycline group and 59 cases in the anthracycline removal group.No statistically significant difference was observed in terms of age,clinical T stage,clinical N stage,ER expression,PR expression,Ki-67 level,body mass index(BMI)and vascular cancer thrombus between both groups(P>0.05).Among the 81 patients,a total of 44(54.3%)achieved pCR after surgery,including 13 in the anthracycline group and 31 in the anthracycline removal group.There was no statistically significant difference in the pCR rate between both groups(59.1%vs.52.5%,P=0.599).According to the adverse reaction grading 5.0 version,all 81 patients did not experience intolerable adverse reactions(mainly grades 1-2)after treatment,and all showed relief after symptomatic treatment.The incidence of neutropenia in the anthracycline group was lower than that in the anthracycline removal(61.02%vs.86.36%,P = 0.034).Conclusion HER-2-positive breast cancer patients can benefit from the treatment plan of exempting anthracycline drugs,and the incidence of neutropenia is reduced,which is worth further study.