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(Neo)adjuvant therapy patterns and outcomes in patients with HR+/HER2+ early breast cancer: a real-world study using
Jiujun Zhu1, Dechuang Jiao1, Chengzheng Wang1
1Department of Breast Disease, Henan Breast Cancer Center, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China.
Background:
The introduction of pertuzumab in mainland China in 2019 has significantly altered the treatment practice for early breast cancer; however, comprehensive real-world data on hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-positive (HER2+) patients in this new era remain limited.
Objective:
To identify the clinicopathological characteristics, (neo)adjuvant treatment patterns, and clinical outcomes in treated patients with HR+/HER2+ early breast cancer in routine clinical practice in China.
Design:
A retrospective, observational study was conducted in patients with HR+/HER2+ early breast cancer who underwent surgery for breast cancer and had post-surgical pathologic reports available. De-identified patient data for this multicenter study were obtained from the National Cancer Information Database (NCID) in China.
Methods:
Patients were treated with neoadjuvant and adjuvant therapy with chemotherapy and/or HER2-targeted regimens in clinical practice. The main outcomes and measures were as follows: (neo)adjuvant treatment patterns, total pathologic complete responses (tpCR), breast pathologic complete responses (bpCR), disease-free survival (DFS), and event-free survival (EFS). Two-year DFS and EFS were evaluated using the Kaplan-Meier method. Multivariable logistic and Cox regression analyses were performed to identify associated factors of pCR and survival outcomes, respectively. The median duration of follow-up for the study was 13.9 months (range: 0.1-48.1).
Results:
A total of 13,323 patients with HR+/HER2+ early breast cancer were included in this analysis. Trastuzumab + pertuzumab (TP) was the most commonly used regimen in both neoadjuvant and adjuvant settings. Neoadjuvant therapy with dual HER2 blockade resulted in significantly higher tpCR rates (49.1% vs 29.9%) and bpCR rates (53.3% vs 34.4%) compared with trastuzumab alone (both p < 0.001), and numerically higher 2-year DFS rates (90.1% vs 87.1%; p = 0.273) and EFS rates (91.1% vs 89.4%; p = 0.297).
Conclusion:
The dual HER2 blockade regimens that were widely adopted in China for HR+/HER2+ early breast cancer have demonstrated effectiveness in improving pCR in routine clinical practice; a longer follow‑up is required to validate survival outcomes.
Trial Registration:
None.
