(Neo)adjuvant therapy patterns and outcomes in patients with HR+/HER2+ early breast cancer: a real-world study using the national cancer information database in China.

内容摘要

The introduction of pertuzumab in mainland China in 2019 has significantly altered the treatment practice for early breast cancer; however, comprehensive real-world data on hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-positive (HER2+) patients in this new era remain limited. To identify the clinicopathological characteristics, (neo)adjuvant treatment patterns, and clinical outcomes in treated patients with HR+/HER2+ early breast cancer in routine clinical practice in China. A retrospective, observational study was conducted in patients with HR+/HER2+ early breast cancer who underwent surgery for breast cancer and had post-surgical pathologic reports available. De-identified patient data for this multicenter study were obtained from the National Cancer Information Database (NCID) in China. Patients were treated with neoadjuvant and adjuvant therapy with chemotherapy and/or HER2-targeted regimens in clinical practice. The main outcomes and measures were as follows: (neo)adjuvant treatment patterns, total pathologic complete responses (tpCR), breast pathologic complete responses (bpCR), disease-free survival (DFS), and event-free survival (EFS). Two-year DFS and EFS were evaluated using the Kaplan-Meier method. Multivariable logistic and Cox regression analyses were performed to identify associated factors of pCR and survival outcomes, respectively. The median duration of follow-up for the study was 13.9&#x2009;months (range: 0.1-48.1). A total of 13,323 patients with HR+/HER2+ early breast cancer were included in this analysis. Trastuzumab&#x2009;+&#x2009;pertuzumab (TP) was the most commonly used regimen in both neoadjuvant and adjuvant settings. Neoadjuvant therapy with dual HER2 blockade resulted in significantly higher tpCR rates (49.1% vs 29.9%) and bpCR rates (53.3% vs 34.4%) compared with trastuzumab alone (both p&#x2009;<&#x2009;0.001), and numerically higher 2-year DFS rates (90.1% vs 87.1%; p&#x2009;=&#x2009;0.273) and EFS rates (91.1% vs 89.4%; p&#x2009;=&#x2009;0.297). The dual HER2 blockade regimens that were widely adopted in China for HR+/HER2+ early breast cancer have demonstrated effectiveness in improving pCR in routine clinical practice; a longer follow&#x2011;up is required to validate survival outcomes. None. Treatment patterns and survival for HR+/HER2+ early breast cancer in China: a real-world study of patients receiving (neo)adjuvant therapy Although the introduction of pertuzumab in mainland China in 2019 has significantly altered the treatment of early breast cancer, comprehensive real-world data on hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-positive (HER2+) patients remain limited. Between 2019 and 2022, we conducted a retrospective, observational study of 13,323 patients diagnosed with HR+/HER2+ early breast cancer from the National Cancer Information Database (NCID) in China. We found that trastuzumab&#x2004;+&#x2004;pertuzumab (TP) was the most commonly used regimen in both neoadjuvant and adjuvant settings. Compared with trastuzumab alone, dual HER2 blockade (TP or trastuzumab&#x2004;+&#x2004;tyrosine kinase inhibitors) yielded significantly improved total pathological and breast pathological complete responses, as well as numerically higher 2-year disease-free survival and event-free survival rates. Overall, dual HER2 blockade is observed to have treatment effectiveness in routine clinical practice.