Paclitaxel and Carboplatin as Neoadjuvant Chemotherapy in Patients With Locally Advanced Breast Cancer: A Phase II Trial of the Hellenic Cooperative Oncology Group

Gogas, Helen; Pectasides, Dimitrios; Kostopoulos, Ioannis; Lianos, Evangelos; Skarlos, Dimosthenis; Papaxoinis, George; Bobos, Mattheos; Kalofonos, Haralabos P.; Petraki, Kalliopi; Pavlakis, Kitty; Bafaloukos, Dimitrios; Fountzilas, George

doi:10.3816/cbc.2010.n.031

Cited by 16 publications

(12 citation statements)

References 38 publications

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“…Carboplatin and weekly paclitaxel also resulted in a high pCR rate (60%) in patients with TNBC. This supports previously reported findings [19-22], including the study by Chen et al [20], which, despite reporting an inferior pCR rate overall compared with our study (19.4% versus 36%) and others [19, 21, 22], did report that patients with TNBC and HER2+ disease had higher pCR rates than patients with other breast cancer subtypes (33.3%, TNBC; 40%, HER2+; P=0.017), albeit still lower than the pCR rates reported in our study. This may be explained by the inclusion of more patients with stage III disease in their study compared with ours (85% versus 51%) or the inclusion of more patients with HER2− tumors in their study compared with ours (78% versus 54%).…”

Section: Discussionsupporting

confidence: 93%

“…In the metastatic breast cancer setting, paclitaxel has demonstrated efficacy [12-14], and when combined with carboplatin and trastuzumab in patients with human epidermal growth factor receptor 2-positive (HER2+) tumors, this regimen has been shown to improve tumor response rates and prolong the time-to-progression compared with paclitaxel alone [15-18]. Treatment with neoadjuvant carboplatin and paclitaxel also leads to high pCR rates both in patients with HER2+ tumors - when given in combination with trastuzumab - and in patients with triple negative breast cancer (TNBC) (HER2-negative, HER2−; hormone receptor-negative, HR−) with relatively low toxicity [19-21]. The demonstrated correlation between pCR and superior oncologic outcomes supports the use of the neoadjuvant setting to test novel regimens, particularly in patients with HER2+ disease and TNBC.…”

Section: Introductionmentioning

confidence: 99%

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Pathologic complete response rates in triple-negative, HER2-positive, and hormone receptor-positive breast cancers after anthracycline-free neoadjuvant chemotherapy with carboplatin and paclitaxel with or without trastuzumab

Shinde

Zhai

et al. 2015

The Breast

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Background Pathologic complete response (pCR) to neoadjuvant chemotherapy (NCT) in the breast and lymph nodes in patients with locally advanced or inflammatory breast cancer (LABC) is associated with improved disease-free and overall survival. Increasingly, studies are testing the efficacy of platinum-containing NCT in LABC, particularly in patients with human epidermal growth factor receptor 2 (HER2)-positive (HER2+) and triple-negative breast cancers (TNBC). Methods In this retrospective study, we reviewed patients’ medical records and collected demographics, tumor HER2 and hormone receptor (HR) status, grade, and treatment-associated toxicities in patients with LABC previously treated with neoadjuvant carboplatin and trastuzumab (HER2+ disease) at City of Hope between April 2009 and December 2011. All patients provided written informed consent before study inclusion. The primary endpoint was pCR (no invasive disease in breast and lymph nodes); the secondary endpoint was pCR-breast (no invasive disease in breast only). Recurrence-free survival (RFS) was estimated using the Kaplan-Meier method. Results Thirty eight consecutive patients with 39 tumors (one patient with two primaries) were included in the study. Patients completed a median of four cycles of NCT. Eighteen of 39 (46%) tumors were HER2+; 8/18 (44%) had a pCR and 10/18 (56%) had a pCR-breast. Thirteen of 18 HER2+ tumors were HR+ (72%); 4/13 (31%) had a pCR and 5/13 (38%) had a pCR-breast. Ten of 39 (26%) tumors were TNBC; 6/10 (60%) had a pCR and 7/10 (70%) had a pCR-breast. Recurrence-free survival at 25-months median follow-up was 86% (95% CI 0.75-0.98); no recurrences were observed in patients with a pCR. Conclusions This regimen achieved a high rate of pCR in HER2+ and TNBC tumors. Further studies comparing platinum-containing and anthracycline-free regimens versus anthracycline-containing regimens in patients with locally advanced HER2+ breast cancer and TNBC are warranted.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Pathologic complete response rates in triple-negative, HER2-positive, and hormone receptor-positive breast cancers after anthracycline-free neoadjuvant chemotherapy with carboplatin and paclitaxel with or without trastuzumab

Shinde

Zhai

et al. 2015

The Breast

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“…The lower pCR rate in TN patients diagnosed with IBC likely reflects the aggressive nature of IBC and its resistance to therapy. This notion is supported by a study that included 40% IBC patients, in which the pCR rate was only 9.5% [36].…”

Section: Discussionsupporting

confidence: 61%

Triple-Negative Subtype Predicts Poor Overall Survival and High Locoregional Relapse in Inflammatory Breast Cancer

González-Angulo

Allen

et al. 2011

The Oncologist

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“…About 85% (63/74) of women with HER2 carcinoma also received trastuzumab at 4 mg/kg (initial dose) followed by 2 mg/kg weekly for 23 consecutive weeks plus 9 cycles at 6 mg/kg at intervals 3 weeks [33]. Approximately 1% (9/94) of women with TN carcinoma also received carboplatin AUC1.5 weekly associated to paclitaxel [34]. None of the women showed serious adverse effects that required discontinuation of NAC.…”

Section: Variables and Treatmentmentioning

confidence: 99%

Predictors of Pathological Complete Response in Women with Clinical Complete Response to Neoadjuvant Chemotherapy in Breast Carcinoma

et al. 2018

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Objective: There is insufficient information on predictors of pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast carcinoma that also presented clinical complete response (cCR) evaluated in breast, axilla and breast and axilla. Methods: This retrospective study included 310 women with breast carcinoma who received NAC from 1/1/13 to 12/31/15 with follow-up until 8/31/16. The factors analyzed to predict pCR and cCR were menopausal status, Ki67, estrogen receptor, histologic grade, molecular subtype, tumor size, axilla status, and stage. Results: The cCR/pCR rates were 53.2/16.5% (breast), 76.3/36.8% (axilla) and 50.6/13.9% (breast and axilla). Molecular subtype and HER2-positive were independent predictors to confirm pCR in women with cCR, mainly triple negative (TN) in breast (OR 22.81, 95% CI 7.13–72.96) and breast and axilla (OR 36.06, 95% CI 8.77–148.26), but not in axilla. Ki67 ≥50% expression was predictor of cCR in breast (OR 2.00, 95% CI 1.31–3.06) and breast and axilla (OR 1.67, 95% CI 1.10–1.45). Conclusion: TN subtype and HER2-positive were the main independent predictors of pCR in women who also had cCR to NAC in breast and breast and axilla, but none was predictor in axilla. The Ki67 ≥50% was the independent predictor of cCR in breast and breast and axilla.

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Paclitaxel and Carboplatin as Neoadjuvant Chemotherapy in Patients With Locally Advanced Breast Cancer: A Phase II Trial of the Hellenic Cooperative Oncology Group

Cited by 16 publications

References 38 publications

Pathologic complete response rates in triple-negative, HER2-positive, and hormone receptor-positive breast cancers after anthracycline-free neoadjuvant chemotherapy with carboplatin and paclitaxel with or without trastuzumab

Pathologic complete response rates in triple-negative, HER2-positive, and hormone receptor-positive breast cancers after anthracycline-free neoadjuvant chemotherapy with carboplatin and paclitaxel with or without trastuzumab

Triple-Negative Subtype Predicts Poor Overall Survival and High Locoregional Relapse in Inflammatory Breast Cancer

Predictors of Pathological Complete Response in Women with Clinical Complete Response to Neoadjuvant Chemotherapy in Breast Carcinoma

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