Targeted anti-HER2 therapy is a keystone in radical breast cancer therapy. In Poland preoperative use of trastuzumab was not reimbursed until 2016 and pertuzumab is still not covered. Moreover, adjuvant use of trastuzumab was not covered for patients with stage IIIB-C breast cancer. The aim of the study was to analyse of the subset of patients with HER2-positive breast cancer who were treated preoperatively in s center in Poland without use of anti-HER2 medications to analyse their prognosis compared to other breast cancer subtypes.
We reviewed the records of patients enrolled to the prospective study of prediction of chemotherapy response (MILESTONE-BreastPred). All patients were enrolled between 2011—2015, with intent of preoperative breast cancer chemotherapy, mainly by AC-P or TAC regimens. In the whole group PET/CT was used as an method of staging.
197PSubtype HER2-positive TNBC LUM B HER2-negative P numer of patients 119 87 160 median age 47 42.7 46.6 n.s. % G3 66.4 86.1 47.4 0.001 % N + 74.8 60.9 67.5 n.s. % CSIII 56.2 42.9 38.8 0.048 % de novo CSIV 11.9 3.5 8.1 n.s. % inoperable after chemotherapy [%] 17.7 10.3 10 n.s. % pCR 32.65 39.74 20.14 0.005 % 5-year PFS 47.2 70.6 68.3 0.001 median PFS [mo] 56.7 NR 92.9 0.001
HER2-positive breast cancer in Polish population is at presentation more advanced than other subtypes, and despite relatively high pCR rate, has poor prognosis, when treated without sufficient anti-HER2 therapy. Prognosis in HER2-positive breast cancer in the analysed subgroup of Polish patients was poorer than in TNBC. The results underline the importance of treatment according to international guidelines and speak in favour of including anti-HER2 therapy preoperatively. The study was supported by the Polish National Center of Research and Development MILESTONE project – Molecular diagnostics and imaging in individualized therapy for breast, thyroid and prostate cancer, grant no. STRATEGMED 2/267398/4/NCBR/2015.
The authors.
the Polish National Center of Research and Development MILESTONE project – Molecular diagnostics and imaging in individualized therapy for breast, thyroid and prostate cancer, grant no. STRATEGMED 2/267398/4/NCBR/2015.
All authors have declared no conflicts of interest.