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The role of the neoadjuvant approach in the treatment of primary operable HER2 positive breast cancer

https://doi.org/10.18027/2224-5057-2020-10-2-4

Abstract

Neoadjuvant systemic therapy is an essential component of the comprehensive treatment of primary operable HER2‑positive breast cancer. Therefore, it is extremely important to search for treatment efficacy predictors and optimal system for assessing tumor response to treatment. The study analyzed factors predicting pathological complete response (pCR) in patients with luminal and non‑luminal HER2‑positive tumor subtypes. The morphological assessment of the tumor response to treatment was carried out using the RCB system; additional characteristics of the residual tumor were studied as well. It was shown that a comprehensive assessment involving the use of the RCB system and determination of the Ki ‑ 67 level helps to divide patients into prognostic groups and individualize the adjuvant therapy plan.

About the Authors

M. A. Frolova
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Mona A. Frolova, MD, PhD, Leader Researcher at Department of Clinical Pharmacology and Chemotherapy

Moscow



Е. V. Glazkova
N. N. Blokhin National Medical Research Center of Oncology

Elena V. Glazkova, Postgraduate Student at Department of Clinical Pharmacology

Moscow



A. V. Petrovsky
N. N. Blokhin National Medical Research Center of Oncology

Alexandr V. Petrovsky, MD, PhD, Deputy Director for for Educational Activities

Moscow



О. V. Krokhina
N. N. Blokhin National Medical Research Center of Oncology

Olga V. Krokhina, MD, PhD, Breast Oncologist, Senior Researcher at Department of Reconstructive and Plastic Oncologic Surgery

Moscow



M. В. Stenina
N. N. Blokhin National Medical Research Center of Oncology

Marina B. Stenina, MD, PhD, DSc, Leading Researcher at Department of Clinical Pharmacology

Moscow



S. A. Tyulyandin
N. N. Blokhin National Medical Research Center of Oncology

Sergey A. Tyulyandin, MD, PhD, DSc, Prof, Deputy Director for Research, Head of Department of Clinical Pharmacology and Chemotherapy

Moscow



References

1. Rivenbark, A.G. Molecular and cellular heterogeneity in breast cancer: challenges for personalized medicine / A.G.Riverbank, S.M. O’Connor, W.B.Coleman //Am J Path. — 2013. — 183(4). — P. 1113 1124.

2. Cortazar, P. Pathological complete response and long term clinical benefit in breast cancer: the CTNeoBC pooled analysis / P. Cortazar, L. Zhang, M. Untch et al. // Lancet. — 2014. — Jul 12. — 384 (9938). — P. 164 72.

3. Baselga, J. Lapatinib with trastuzumab for HER2 positive early breast cancer (NeoALTTO): a randomised, open label, multicentre, phase 3 trial / J. Baselga, I. Bradbury, H. Eidtmann et al. // Lancet. — 2012. — 379. — P. 633 40.

4. Gianni, L. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, infl ammatory, or early HER2 positive breast cancer (NeoSphere): a randomised multicentre, open label, phase 2 trial / L. Gianni, T. Pienkowski, Y.H. Im et al. // Lancet Oncol. — 2012. — 13. — P. 25 32.

5. Schneeweiss, A. Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline containing and anthracycline free chemotherapy regimens in patients with HER2 positive early breast cancer: a randomized phase II cardiac safety study (TRYPHAENA) / A. Schneeweiss, S. Chia, T. Hickish et al. // Ann Oncol. — 2013. — 24. — P. 2278 2284.

6. Pegram, M.D. Rational combinations of trastuzumab with chemotherapeutic drugs used in the treatment of breast cancer / M.D. Pegram, G.E. Konecny, C. O’Callaghan et al. // J Natl Cancer Inst. — 2004. — 96. — P. 739 49.

7. von Minckwitz, G. Neoadjuvant carboplatin in patients with triple negative and HER2 positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial / G. von Minckwitz, A. Schneeweiss, S. Loibl et al. // Lancet Oncol. — 2014. — 15(7). — 747e56.

8. Symmans, W.F. Measurement of residual breast cancer burden to predict survival after neoadjuvant chemotherapy / W.F. Symmans, F. Peintinger, C. Hatzis et al. // J Clin Oncol. — 2007. — Oct 1. — 25(28). — P. 4414 22.

9. Untch, M. Neoadjuvant Treatment With Trastuzumab in HER2 Positive Breast Cancer: Results From the GeparQuattro Study / M. Untch, M. Rezai, S. Loibl et al. // JCO. — 2010. — Vol. 28, N 12. — April 20.

10. Denkert, C. Tumor Infiltrating Lymphocytes and Response to Neoadjuvant Chemotherapy With or Without Carboplatin in Human Epidermal Growth Factor Receptor 2 Positive and Triple Negative Primary Breast Cancers / C. Denkert, G. von Minckwitz, J.C. Brase et al. // J Clin Oncol. — 2015. — Mar 20. — 33(9). — P. 983 91.

11. Hamy, A.S. Stromal lymphocyte infiltration after neoadjuvant chemotherapy is associated with aggressive residual disease and lower disease free survival in HER2 positive breast cancer /A.S. Hamy, J.Y. Pierga, A. Sabaila // Ann Oncol. — 2017. — 28. — P. 2233 2240.

12. Sheri, A. Residual proliferative cancer burden to predict longterm outcome following neoadjuvant chemotherapy /A. Sheri, I.E. Smith, S.R. Johnston // Ann Oncol. — 2015. — 26. — P. 75 80.

13. von Minckwitz, G. Trastuzumab Emtansine for Residual Invasive HER2 Positive Breast Cancer / G. von Minckwitz, C.S. Huang, M.S. Mano et al. // N Engl J Med. — 2019. — Feb 14. — 380(7). — P. 617 628.


Review

For citations:


Frolova M.A., Glazkova Е.V., Petrovsky A.V., Krokhina О.V., Stenina M.В., Tyulyandin S.A. The role of the neoadjuvant approach in the treatment of primary operable HER2 positive breast cancer. Malignant tumours. 2020;10(2):45-52. (In Russ.) https://doi.org/10.18027/2224-5057-2020-10-2-4

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ISSN 2224-5057 (Print)
ISSN 2587-6813 (Online)