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Posted by on Aug 8, 2021 in Breast cancer | 0 comments

In a nutshell

This study examined the use of paclitaxel (Taxol) and carboplatin (Paraplatin) as weekly chemotherapy (CT) with trastuzumab (Herceptin) and pertuzumab (Perjeta) in HER2+ breast cancer (BC) in order to reduce toxicity rates. The authors found that the weekly regimen of chemotherapy can be considered an alternative to standard chemotherapy regimens for HER2+ BC. 

Some background

BC is one of the most common forms of cancer experienced by women worldwide. HER2 is a protein found on some BC cells that helps tumors grow and spread. HER2+ receptors have been shown to be an effective target for certain anti-cancer drugs such as trastuzumab and pertuzumab.

Standard chemotherapy for BC includes drugs such as paclitaxel and carboplatin. They can be given in combination with trastuzumab and pertuzumab targeted therapies. However,  these chemotherapy drugs can have significant side effects that decrease the quality of life of patients. It is not known if chemotherapy drugs can be given weekly with targeted therapy in order to reduce toxicity in patients with HER2+ BC. 

Methods & findings

There were 30 patients with HER2+ BC evaluated in this study. Patients received weekly paclitaxel and carboplatin with trastuzumab and pertuzumab (wPCbTP). After 12-weeks if patients did not respond they were switched to an alternative chemotherapy regimen. This treatment was followed by surgery to remove the tumor. After surgery, almost all patients ()28 out of 30) received radiation therapy to the lymph nodes. Patients were followed up 3 months after surgery.

The complete response rate (no cancer cells left after surgery) was 77%. 3 patients did not respond to the initial chemotherapy and were switched to an alternate option. 2 out of these patients achieved a complete response after surgery. 

The most common side effects after chemotherapy were low white and red blood cell counts and diarrhea. A split dose of pertuzumab was associated with lower rates of diarrhea. 

The bottom line

The authors concluded that weekly chemotherapy with targeted therapy is a good treatment option for patients with HER2+ BC before surgery.

The fine print

The study size was very small and patients were followed up for a short time. Larger studies are needed.  

Published By :

Breast Cancer Research and Treatment

Date :

Jun 04, 2021

Original Title :

Neoadjuvant weekly paclitaxel and carboplatin with trastuzumab and pertuzumab in HER2-positive breast cancer: a Brown University Oncology Research Group (BrUOG) study.

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