Journal of Clinical & Experimental Pharmacology

Abstract

Combination of Nab-Paclitaxel with Trastuzumab as Neoadjuvant Chemotherapy for HER2-positive Breast Cancer Patients: Experience from a Single Center

Li T, Yang M, Ren C, Lao H and Zeng Y

Background: Several phase II and pilot studies showed that neoadjuvant nab-paclitaxel-based chemotherapy and trastuzumab treatment was effective and safe. However, combination of nab-paclitaxel alone with trastuzumab has not been investigated. Methods: This is a retrospective analysis. From July 2009 to June 2014, Patients with histologically confirmed, nonmetastatic HER2-positive breast cancer who received a 3-week regimen of nab-paclitaxel with trastuzumab in Guangdong General Hospital were screened. Baseline and pathological data and blood test results were collected from the electronic patient medical records. Survival data, severe adverse events and cardiac events were collected by telephone follow-up. The primary endpoint was pCR. The secondary endpoints included pCR in breast, DFS during follow-up period, breast conserving rates, tolerance, adverse events and symptomatic cardiac events. Results: 23 patients who met the eligibility criteria were indentified. 21 (91.3%) patients completed NC courses and received surgery. The breast conserving rates were 19.0%. 10 (47.6%) patients achieved a pCR and 13 (61.9%) achieved a pCR in breast. 7 (53.8%) of the 13 patients with clinical stage IIB-IIIC before surgery achieved a pCR. The pCR rates among hormone-receptor-negative and hormone-receptor-positive patients were 58.3% (7/12) and 33.3% (3/9) respectively. During a median follow-up of 31.3 months, no death was indentified and the 3-year estimated DFS was 81.2%. Two patients reported cardiac events during and after adjuvant chemotherapy. No severe adverse events that required hospitalization were identified during NC period. Grade 3 events were rare. Conclusion: The combination of nab-paclitaxel and trastuzumab as NC lead to related high pCR rates and was well tolerated. No cardiac events or severe adverse events were indentified during NC period. The studied regimen may be a potential NC therapy for HER2-positive patients. Further study is recommended in the future.