Cancer Res Treat.  2022 Oct;54(4):1091-1098. 10.4143/crt.2021.901.

Real World Evidence of Neoadjuvant Docetaxel/Carboplatin/Trastuzumab/Pertuzumab (TCHP) in Patients with HER2-Positive Early or Locally Advanced Breast Cancer: A Single-Institutional Clinical Experience

• Kim JY
• Nam SJ
• Lee JE
• Yu J
• Chae BJ
• Lee SK
• Ryu JM
• Ahn JS
• Im YH
• Kim SW
• Park YH

• KMID: 2534188
• DOI: http://doi.org/10.4143/crt.2021.901

Abstract

Purpose
Docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP) regimen is frequently used to treat early and locally advanced human epidermal growth factor receptor 2 (HER2)–positive breast cancer (BC) in neoadjuvant setting. However, large-scaled real-world evidence did not exist.
Materials and Methods
We retrospectively reviewed medical records of patients with early or locally advanced HER2-positive BC who underwent neoadjuvant TCHP followed by curative surgery at Samsung Medical Center between January 2016 and August 2020.
Results
Of 447 patients, 316 (70.7%) received breast-conserving surgery and 131 (29.3%) received total mastectomy. In terms of neoadjuvant chemotherapy response, pathologic complete response (pCR) and residual cancer burden (RCB) score were analyzed. The rate of pCR was 64% a class of RCB 0 was observed in 65% of cases, RCB class I in 12%, RCB class II in 14%, and RCB class III in 2%. The 3-year event-free survival rate was 90.6%, BC with pCR occurred in 92.8%, and BC with non-pCR in 86.3% (p=0.016). In terms of distant metastasis, the 3-year distant recurrence-free survival rate was 93.5%; BC with pCR occurred in 95.9% and BC with non-pCR in 89.2% (p=0.013). Mucositis (85.2%), pain (83.2%), and diarrhea (70.5%) were the most common non-hematologic adverse events. In terms of hematologic adverse events, anemia (89.9%) was the most commonly observed adverse events followed by thrombocytopenia (29.8%).
Conclusion
Neoadjuvant TCHP therapy had a pCR rate of 64% and a 3-year event-free survival of 90% in real world experience. In terms of toxicity profile, anemia was frequently observed and adequate management including occasional transfusion was required.

Keyword

Neoadjuvant TCHP regimen; HER2-positive breast cancer; Real world evidence

Figure

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  Fig. 1 Pathologic complete response (pCR) according to hormone receptor (HR) status (A), clinical stage (B), and histologic grade (C).

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  Fig. 2 Multivariate analysis of factors affecting to pathologic complete response (pCR) (A) and event-free survival (EFS) (B). CI, confidence interval; HG, histologic grade; NG, nuclear grade.

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  Fig. 3 Event-free survival (A), distant recurrence-free survival (B), and overall survival (C) according to pathologic complete response (pCR) or non-pCR.

Reference

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