title: Docetaxel, cyclophosphamide, and trastuzumab as neoadjuvant chemotherapy for HER2-positive primary breast cancer.
abstract: BACKGROUND
  The standard primary systemic therapy for human epidermal growth factor receptor 2-positive (HER2+) breast cancer is anthracyclines and/or taxanes combined with trastuzumab, which demonstrates a high pathological complete response (pCR). A pCR is a predictive marker of prognosis. However, results slightly differ, depending on the hormone receptor status. The efficacy and tolerability of docetaxel, cyclophosphamide, and trastuzumab (HER-TC) as neoadjuvant chemotherapy (NAC) remain unclear. We performed a prospective multicenter study of HER-TC NAC for HER2+ primary breast cancer.
  
  
  METHODS
  Eligible patients had a clinical diagnosis of HER2+ invasive breast cancer greater than 1 cm but less than 7 cm and a tumor stage of N0 or N1. T hey were diagnosed between July 2011 and February 2014. For NAC, four cycles of HER-TC (6 mg/kg loading dose, 8 mg/kg, 75, and 600 mg/m2) were administered intravenously every 3 weeks. We investigated the pCR of the primary breast tumors. A pCR was defined as no histological evidence of invasive carcinoma or the appearance of only ductal carcinoma in situ.
  
  
  RESULTS
  We enrolled 42 patients. The completion rate for four cycles of HER-TC was 97.6 % (41/42 patients). The overall pCR rate was 43.9 % (18/41 patients). The pCR rate for patients with the luminal HER2 subtype [estrogen receptor (ER)-positive+, HER2+] and the HER2-enriched subtype (ER-, HER2+) was 40.0 % (8/20 patients) and 47.6 % (10/21 patients), respectively. A pCR was achieved with nearly the same probability for each subtype.
  
  
  CONCLUSIONS
  Four cycles of HER-TC may be a NAC option for HER2-positive breast cancer.
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. kacchan@koto.kpu-m.ac.jp.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Nakatsukasa
authors.affiliation: Nara City Hospital, Nara, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koyama
authors.affiliation: Nara City Hospital, Nara, Japan.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Oouchi
authors.affiliation: Nara City Hospital, Nara, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Imanishi
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Mizuta
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Sakaguchi
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Imai
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Okamoto
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Asako
authors.initials: A
authors.lastname: Hamaoka
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Soushi
authors.affiliation: Ayabe City Hospital, Ayabe, Japan.
authors.forename: Ikuya
authors.initials: I
authors.lastname: Fujiwara
authors.affiliation: Saiseikai Kyoto Hospital, Kyoto, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kotani
authors.affiliation: Saiseikai Kyoto Hospital, Kyoto, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsuda
authors.affiliation: Saiseikai Shiga Hospital, Ritto, Shiga, Japan.
authors.forename: Kenichirou
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Saiseikai Shiga Hospital, Ritto, Shiga, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Morita
authors.affiliation: Fukuchiyama City Hospital, Kyoto, Japan.
authors.forename: Sadao
authors.initials: S
authors.lastname: Kawakami
authors.affiliation: Aiseikai Yamashina Hospital, Kyoto, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Kadotani
authors.affiliation: Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Konishi
authors.affiliation: Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Goto
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Taguchi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D000068878:Trastuzumab / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D003520:Cyclophosphamide; D000077143:Docetaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D043823:Taxoids; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Breast cancer; Human epidermal growth factor receptor 2-positive; Neoadjuvant chemotherapy