title: Association between HER2 status and response to neoadjuvant anthracycline followed by paclitaxel plus carboplatin chemotherapy without trastuzumab in breast cancer.
abstract: BACKGROUND
  We recently showed HER2-positive breast cancers are less likely to respond to neoadjuvant anthracycline chemotherapy. Here, we investigated whether HER2-positive breast cancers responded to sequential neoadjuvant anthracycline followed by paclitaxel plus carboplatin regimen in the absence of trastuzumab.
  
  
  METHODS
  Women (n=372) with operable primary breast cancer initially received two cycles of neoadjuvant anthracyclines, the clinical tumor response was assessed, then patients were received four cycles of paclitaxel plus carboplatin regimen. All the patients did not received trastuzumab treatment in the neoadjuvant setting. HER2 status was determined by immunohistochemistry and/or by fluorescence in situ hybridization in core-biopsy breast cancer tissue obtained before the neoadjuvant chemotherapy.
  
  
  RESULTS
  Eighteen percent (67/372) of patients achieved a pathologic complete response (pCR) in their breast. HER2-positive tumors had a significant higher pCR rate than HER2-negative tumors (33.0% versus 13.5%, P<0.001) in this cohort of 372 patients, and positive HER2 status remained an independent favorable predictor of pCR in a multivariate analysis [odds ratio (OR), 2.26; 95% confidence interval (CI), 1.18 to 4.36, P=0.015]. Furthermore, patients who responded to initial anthracycline regimens were more likely to respond to paclitaxel plus carboplatin than patients who did not (pCR, 27.2% versus 14.6%, P=0.005). Patients with HER2-positive tumors exhibited a significant higher pCR rate than did patients with HER2-negative tumors in both anthracycline response group (40.5% versus 20.0%, P=0.025) and anthracycline non-response group (28.3% versus 11.3%, P=0.002).
  
  
  CONCLUSIONS
  Under the circumstance of no trastuzumab treatment, women with HER2-positive cancers derive a large benefit from paclitaxel-carboplatin-based neoadjuvant chemotherapy.
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Yao
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Yiqiang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Ouyang
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Jinfeng
authors.initials: J
authors.lastname: Li
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Tianfeng
authors.initials: T
authors.lastname: Wang
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Zhaoqing
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Tie
authors.initials: T
authors.lastname: Fan
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Benyao
authors.initials: B
authors.lastname: Lin
authors.affiliation: Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Breast Center, 2 Department of Pathology, Beijing Cancer Hospital & Institute, Peking University Cancer Hospital, Beijing 100142, China.
authors.forename: Yuntao
authors.initials: Y
authors.lastname: Xie
keywords: HER2; breast cancer; carboplatin; neoadjuvant chemotherapy; paclitaxel