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Ten-year survival of neoadjuvant dual HER2 blockade in patients with HER2-positive breast cancer

Authors
 Paolo Nuciforo  ;  John Townend  ;  Martine J Piccart  ;  Shona Fielding  ;  Panagiota Gkolfi  ;  Sarra El-Abed  ;  Evandro de Azambuja  ;  Gustavo Werutsky  ;  Judith Bliss  ;  Volker Moebus  ;  Marco Colleoni  ;  Alvaro Moreno Aspitia  ;  Henry Gomez  ;  Andrea Gombos  ;  Maria A Coccia-Portugal  ;  Ling-Ming Tseng  ;  Georg Kunz  ;  Guillermo Lerzo  ;  Joohyuk Sohn  ;  Vladimir Semiglazov  ;  Cristina Saura  ;  Judith Kroep  ;  Antonella Ferro  ;  David Cameron  ;  Richard Gelber  ;  Jens Huober  ;  Serena Di Cosimo 
Citation
 EUROPEAN JOURNAL OF CANCER, Vol.181 : 92-101, 2023-03 
Journal Title
EUROPEAN JOURNAL OF CANCER
ISSN
 0959-8049 
Issue Date
2023-03
MeSH
Antineoplastic Combined Chemotherapy Protocols / therapeutic use ; Breast Neoplasms* / pathology ; Female ; Humans ; Lapatinib / therapeutic use ; Male ; Neoadjuvant Therapy ; Receptor, ErbB-2 ; Trastuzumab / adverse effects ; Treatment Outcome
Keywords
Breast cancer ; Dual anti-HER2 blockade ; HER2-Positive ; Long-term survival ; Neoadjuvant ; Pathological complete response
Abstract
Background: Dual anti-HER2-targeted therapy in breast cancer (BC) significantly increased the rate of pathological complete response (pCR) compared to single blockade when added to chemotherapy. However, limited data exist on the long-term impact on survival of the additional increase in pCR. Methods: Neoadjuvant lapatinib and/or trastuzumab treatment optimisation (NCT00553358) is an international, randomised, open-label, phase III study investigating the addition of lapatinib to chemotherapy plus trastuzumab in HER2-positive early BC. Ten-year event-free survival (EFS), overall survival (OS) and safety were assessed on intention-to-treat population. The association between pCR and EFS or OS was investigated in landmark population. Results: A total of 455 patients were randomised to receive lapatinib (154), trastuzumab (149) or the combination (152). Ten-year EFS estimates were 63% (95% confidence interval [CI], 54%–71%) in the lapatinib group, 64% (95% CI, 55%–72%) in the trastuzumab group and 67% (95% CI, 58%–74%) in the combination group. Ten-year OS rates were 76% (95% CI, 67%–83%), 75% (95% CI, 66%–82%) and 80% (95% CI, 73%–86%) in the lapatinib, trastuzumab and combination groups, respectively. Women who achieved a pCR had improved EFS (hazard ratio 0.48, 95% CI, 0.31–0.73) and OS (hazard ratio 0.37, 95% CI, 0.20–0.63) compared with those who did not. The numerical difference in survival according to pCR status was greater in women treated with the combination and those with hormone-receptor-negative tumours. There were no new or long-term safety concerns. Conclusions: Patients with HER2-positive BC showed a durable survival benefit of neoadjuvant anti-HER2, irrespective of treatment arm. Patients who achieve pCR have significantly better outcomes than patients without pCR. © 2022 Elsevier Ltd
Full Text
https://www.sciencedirect.com/science/article/pii/S0959804922018317
DOI
10.1016/j.ejca.2022.12.020
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Joo Hyuk(손주혁) ORCID logo https://orcid.org/0000-0002-2303-2764
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198490
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