TY - JOUR
T1 - Trastuzumab in combination with weekly paclitaxel and carboplatin as neo-adjuvant treatment for HER2-positive breast cancer
T2 - The TRAIN-study
AU - van Ramshorst, Mette S.
AU - van Werkhoven, Erik
AU - Mandjes, Ingrid A.M.
AU - Schot, Margaret
AU - Wesseling, Jelle
AU - Vrancken Peeters, Marie Jeanne T.F.D.
AU - Meerum Terwogt, Jetske M.
AU - Bos, Monique M E M
AU - Oosterkamp, Hendrika M
AU - Rodenhuis, Sjoerd
AU - Linn, Sabine C.
AU - Sonke, Gabe S
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Aim To determine the efficacy and safety of an anthracycline-free neo-adjuvant regimen consisting of weekly paclitaxel, carboplatin and trastuzumab in HER2-positive breast cancer. Patients and methods Patients with stage II or III HER2-positive breast cancer received weekly paclitaxel ([P], 70 mg/m2), trastuzumab ([T], 2 mg/kg, loading dose 4 mg/kg) and carboplatin ([C], AUC = 3 mg ml−1 min) for 24 weeks. In weeks 7, 8, 15, 16, 23 and 24, trastuzumab was administered without chemotherapy. The primary end-point was pathologic complete response in the surgical resection specimen, defined as the absence of invasive tumour cells in breast and axilla. Results One hundred and eleven patients were included in the study, and 108 were evaluable for the primary end-point. The pathologic complete response rate was 43% (95% confidence interval [CI]: 33–52). Median follow-up was 52 months, and the 3-year event-free survival was 88% (95% CI: 82–94), and the 3-year overall survival was 92% (95% CI: 88–98). The most common grade 3–4 adverse events were neutropenia (67%) and thrombocytopenia (43%). Less than five percent of patients experienced febrile neutropenia. No symptomatic left ventricular systolic dysfunction was observed during neo-adjuvant treatment. Conclusion An anthracycline-free neo-adjuvant regimen of weekly paclitaxel, trastuzumab and carboplatin is highly effective in HER2-positive breast cancer with manageable toxicity.
AB - Aim To determine the efficacy and safety of an anthracycline-free neo-adjuvant regimen consisting of weekly paclitaxel, carboplatin and trastuzumab in HER2-positive breast cancer. Patients and methods Patients with stage II or III HER2-positive breast cancer received weekly paclitaxel ([P], 70 mg/m2), trastuzumab ([T], 2 mg/kg, loading dose 4 mg/kg) and carboplatin ([C], AUC = 3 mg ml−1 min) for 24 weeks. In weeks 7, 8, 15, 16, 23 and 24, trastuzumab was administered without chemotherapy. The primary end-point was pathologic complete response in the surgical resection specimen, defined as the absence of invasive tumour cells in breast and axilla. Results One hundred and eleven patients were included in the study, and 108 were evaluable for the primary end-point. The pathologic complete response rate was 43% (95% confidence interval [CI]: 33–52). Median follow-up was 52 months, and the 3-year event-free survival was 88% (95% CI: 82–94), and the 3-year overall survival was 92% (95% CI: 88–98). The most common grade 3–4 adverse events were neutropenia (67%) and thrombocytopenia (43%). Less than five percent of patients experienced febrile neutropenia. No symptomatic left ventricular systolic dysfunction was observed during neo-adjuvant treatment. Conclusion An anthracycline-free neo-adjuvant regimen of weekly paclitaxel, trastuzumab and carboplatin is highly effective in HER2-positive breast cancer with manageable toxicity.
KW - Breast cancer
KW - Human epidermal growth factor receptor 2
KW - Neo-adjuvant treatment
KW - Trastuzumab
UR - http://www.scopus.com/inward/record.url?scp=85012222931&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2016.12.023
DO - 10.1016/j.ejca.2016.12.023
M3 - Article
C2 - 28335887
AN - SCOPUS:85012222931
SN - 0959-8049
VL - 74
SP - 47
EP - 54
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -