Trastuzumab or lapatinib with standard chemotherapy for HER2-positive breast cancer : results from the GEICAM/2006-14 trial
Alba, Emilio (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
Albanell Mestres, Joan (Parc de Salut MAR de Barcelona)
de la Haba Rodríguez, Juan Rafael (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Barnadas i Molins, Agustí (Institut d'Investigació Biomèdica Sant Pau)
Calvo, L.. (Complejo Hospitalario Universitario de A Coruña)
Sánchez-Rovira, P. (Complejo Hospitalario de Jaén)
Ramos, M. (Centro Oncológico de Galicia)
Rojo, F. (Hospital Universitario Fundación Jiménez Díaz)
Burgués, Octavio (Hospital Clínic Universitari (València))
Carrasco, E. (Grupo GEICAM de Investigación en Cáncer de Mama)
Caballero, Rosalía (Grupo GEICAM de Investigación en Cáncer de Mama)
Porras, I (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Tibau Martorell, Ariadna (Institut d'Investigació Biomèdica Sant Pau)
Cámara, M. C. (Grupo GEICAM de Investigación en Cáncer de Mama)
Lluch, Ana (Hospital Clínic Universitari (València))
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2014
Abstract:	The addition of trastuzumab (T) and lapatinib (L) to neoadjuvant chemotherapy increases the pathological complete response (pCR) rate in patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. We investigated the efficacy of T or L with neoadjuvant chemotherapy and specific efficacy biomarkers. Patients with stages I-III (including inflammatory) HER2-positive breast cancer were randomised to receive epirubicin (E) plus cyclophosphamide (C) × 4 cycles followed by docetaxel (D) plus either T (EC-DT) or L (EC-DL). End points included pCR (primary), clinical response, toxicity, and pCR-predictive biomarkers. We randomised 102 patients to EC-DT (50) and EC-DL (52). Median age was 48, 56% were premenopausal and 58% had oestrogen receptor (ER)-positive tumours. Pathological complete response in breast was 52. 1% (95% CI:38. 0-66. 2%) for EC-DT and 25. 5% (95% CI:13. 5-37. 5%) for EC-DL (P =0. 0065). Pathological complete response in breast and axilla was 47. 9% for EC-DT and 23. 5% for EC-DL (P =0. 011). Grade 3-4 toxicity did not differ across treatments, except for diarrhoea (2% in EC-DT vs 13. 5% in EC-DL, P =0. 030). Multivariate analyses showed that treatment (P =0. 036) and ER (P =0. 014) were the only predictors of pCR in both groups. EC-DT exhibited higher efficacy and lower toxicity than EC-DL. Of the different biomarkers studied, only the absence of ER expression was associated with increased pCR.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra, i la creació d'obres derivades, sempre que no sigui amb finalitats comercials i que es distribueixin sota la mateixa llicència que regula l'obra original. Cal que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	HER2-positive breast cancer ; Lapatinib ; Neoadjuvant ; Trastuzumab ; Biomarkers
Published in:	British journal of cancer, Vol. 110 (01 2014) , p. 1139-1147, ISSN 1532-1827

DOI: 10.1038/bjc.2013.831
PMID: 24457911

9 p, 234.9 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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