Meeting
2018 ASCO Annual Meeting
Different pCR rates according PAM50 defined subtypes in HER2 positive early breast cancer treated with neoadjuvant pertuzumab and trastuzumab.
Authors
Tamara Diaz-Redondo
Unidad de Gestión Clínica Intercentros de Oncología, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Malaga, Spain
Tamara Diaz-Redondo , Rocío Lavado-Valenzuela , Begona Jimenez Rodriguez , Tomás Pascual , Fernando Galvez Montosa , Alejandro Falcon , Maria Carmen Álamo de la Gala , Cristina Morales-Estevez , Marta Amerigo Góngora , Javier Pascual , Nuria Ribelles , Macarena González Guerrero , Aurora Laborda Illanez , Luis Vicioso , Aranzazu Fernández , Nuria Chic , Jose Manuel Jerez , Martina Álvarez , Aleix Prat , Emilio Alba
Organizations
Unidad de Gestión Clínica Intercentros de Oncología, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Malaga, Spain, IBIMA, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Laboratorio de Biología Molecular del Cáncer (CIMES), Universidad de Málaga, Malaga, Spain, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumours Lab (IDIBAPS), Barcelona, Spain, Hospital Ciudad de Jaén, Jaen, Spain, Medical Oncology Department. Hospital Universitario Virgen del Rocío, Seville, Spain, Hospital Universitario Virgen Macarena, Sevilla, Spain, Oncology Department, Maimonides Institute of Biomedical Research (IMIBIC), Reina Sofía Hospital, University of Córdoba, Córdoba, Spain, Hospital Juan Ramón Jiménez, Huelva, Spain, Huelva, Spain, Hospital Costa del Sol, Marbella, Spain, IBIMA, Unidad de Gestión Clínica Intercentros de Oncología, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Malaga, Spain, Hospital universitario Puerta del Mar, Cádiz, Spain, Cadiz, Spain, Laboratorio de Biología Molecular del Cáncer, Centro de Investigaciones Médico-Sanitarias (CIMES), Universidad de Málaga, Málaga, Spain, Malaga, Spain, IBIMA-Hospital Regional Universitario y Virgen de la Victoria, Malaga, Spain, Universidad de Malaga, Department of Languages and Computer Science, Malaga, Spain, IBIMA, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Laboratorio de Biología Molecular del Cáncer (CIMES), Universidad de Málaga, Málaga, Spain, Department of Medical Oncology, Hospital Clinic, Barcelona, Spain, IBIMA, Unidad de Gestión Clínica Intercentros de Oncología, Hospitales Universitarios Regional y Virgen de la Victoria de Málaga, Laboratorio de Biología Molecular del Cáncer (CIMES), Universidad de Málaga, Malaga, Spain
Research Funding
Other
Background: We aim to compare the benefit of adding pertuzumab (P) to the standard neoadjuvant treatment with trastuzumab (T) in patients (pt) with early immunohistochemically (IHC) defined HER2+ breast cancer (BC) in the different intrinsic molecular subtypes defined by PAM50 gene expression analysis. Methods: 219 pt. with IHC HER2+ BC, stage I-IIIC, diagnosed in 8 Spanish hospitals were consecutively treated with neoadjuvant chemotherapy (NAC) + antitargeted HER2 therapy. Cohort A (n128) received NAC+T and Cohort B (n91) received NAC+T+P. Patients were classified into intrinsic molecular subtypes based on the PAM50 signature. Rate of pathologic complete response in breast and axilla (pCR) in the different subtypes was compared by ChiSquared test. A multivariate logistic regression model was used to analyze the potential effects of the covariates over the pCR rates. Results: Characteristics of the patients and intrinsic molecular subtypes are shown in Table 1. The overall pCR rate was significantly higher in cohort B vs A (66%vs39%, p = 0,0002). The pCR rate in the HER2E was 50% for T and 77% for T+P (p = 0,002) and 11% for T and 54% for T+P (p = 0.0007) in Luminals. In the multivariate analysis, the improvement pCR rates was highly associated with cohort (p = 0.00015, OR:3.22) and was not related to clinicopathologic covariates (p > 0.05). These results were confirmed for the HER2E subtype (p = 0.00168, OR:3.11) and more strongly for Luminals (p = 0.0045, OR:23.35). Conclusions: The highest pCR was reached by the PAM50 HER2E patients treated with T+P. In Luminal subtype the improvement of pCR is strongly associated with the used of pertuzumab and this association is independent of clinical covariates.
| T+NCT (n128) | T+P+NCT (n91) | |
|---|---|---|
| Median age (range) | 52 (29-83) | 51 (30-77) |
| n (%) | n (%) | |
| Ki67 | ||
| < 14% | 11 (9) | 4 (4) |
| 15-50% | 58 (45) | 61(67) |
| > 50% | 24(19) | 22 (24) |
| Unk | 35(27) | 4 (4) |
| HR | ||
| + | 89 (70) | 56 (62) |
| - | 39 (30) | 35 (38) |
| PAM50 Sub | ||
| HER2E | 88 (69) | 53 (58) |
| Lum B | 19 (15) | 15 (17) |
| Lum A | 16 (12) | 13 (14) |
| Basal like | 2 (2) | 10 (11) |
| Normal like | 3 (2) | 0 |
| T | ||
| T1 | 23 (18) | 12 (13) |
| T2 | 75 (59) | 50 (55) |
| T3 | 12 (9) | 19 (21) |
| T4 | 10 (8) | 10 (11) |
| Tx | 8 (6) | |
| Node | ||
| - | 54 (42) | 31 (34) |
| + | 74 (58) | 60 (66) |
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Abstract Details
Session Type
Publication Only
Session Title
Publication Only: Breast Cancer - Local/Regional/Adjuvant
Track
Breast Cancer
Sub Track
Neoadjuvant Therapy
Citation
J Clin Oncol 36, 2018 (suppl; abstr e12634)
DOI
10.1200/JCO.2018.36.15_suppl.e12634
Abstract #
e12634
Abstract Disclosures
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