Oncotarget

Research Papers:

Predictive factors of pathologic complete response in HER2-positive and axillary lymph node positive breast cancer after neoadjuvant paclitaxel, carboplatin plus with trastuzumab

Jinhua Ding, Yinlong Yang, Li Jiang, Weizhu Wu _ and Zhiming Shao

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Oncotarget. 2017; 8:56626-56634. https://doi.org/10.18632/oncotarget.17993

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Abstract

Jinhua Ding1,2,*, Yinlong Yang2,*, Li Jiang3, Weizhu Wu1 and Zhiming Shao2

1Department of Breast and Thyroid Surgery, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, China

2Department of Breast Surgery, Cancer Center and Cancer Institute, Shanghai Medical College, Fudan University, Shanghai, China

3Department of Emergency, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, China

*These authors contributed equally to this work

Correspondence to:

Weizhu Wu, email: [email protected]

Keywords: breast cancer, neoadjuvant chemotherapy, human epidermal growth factor receptor 2 (HER2), Ki67, pathological complete response (pCR)

Received: November 11, 2016     Accepted: April 17, 2017     Published: May 19, 2017

ABSTRACT

Objective: This study was performed to investigate the proportion as well as the predictive factors of pathologic complete response in HER2-positive and axillary lymph node positive breast cancer after neoadjuvant paclitaxel, carboplatin plus with trastuzumab (PCH).

Results: The pCR rate in the breast, axilla and both was 44.3% (39/88), 47.7% (42/88) and 34.1% (30/88), respectively. Patients with and without pCR were similar in term of age, BMI, menstrual status, family history, treatment cycles and tumor characteristics (laterality and size of tumor). Multivariate logistic regression demonstrated that pCR was significantly associated with HR negativity (HR = 5.587, 95% CI 2.25−3.889, p < 0.001), high Ki67 index (HR = 4.130, 95% CI 1.607−10.610, p = 0.003). Further investigation found that patients with HR-negative/high Ki67 index had higher pCR rate, compared to other patients (HR = 7.583, 95% CI 2.503−22.974, p < 0.001).

Materials and Methods: 88 consecutive Chinese HER2-positive/axillary lymph node-positive breast cancer patients with neodjuvant therapy regimen containing paclitaxel, carboplatin and trastuzumab were divided into two groups: pathological complete response (pCR) or non-pCR group. Clinico-pathological characteristics were compared and analyzed, and univariate and multivariate analyses were performed to detect the predictive factors of pCR.

Conclusions: Preoperative PCH regimen was an effective neoadjuvant therapy in HER2 positive and axillary lymph node positive patients, and patients coexisting with HR-negative and high Ki67 index may benefit more from this regimen.


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