Comparative study between TCH (Paclitaxel, Carboplatin and Herceptin) and TH (Paclitaxel and Herceptin) as neoadjuvant treatment for HER-2 positive breast cancer patients

Abstract

Author(s): Asmaa Elkady, Mohamed Sheta, Hwaida M Mokhtar

Background: Breast cancer is considered the most commonly diagnosed cancer worldwide. Neoadjuvant chemotherapy has been shown optimal response for breast cancer with clinical significance. In addition, HER-2 overexpression or gene amplification is detected in about 20%–25% of breast cancer patients, and which shows more aggressive disease status and poor response to chemotherapy. The efficacy of trastuzumab in combination with paclitaxel and carboplatin has been revealed in many studies however, it showed frequently associated adverse event. Consequently, this study aimed at comparing the efficacy of trastuzumab in combination with paclitaxel and carboplatin with trastuzumab-paclitaxel without carboplatin.

Methodology: Our study has included 62 patients with pathologically proven breast cancer with Human Epidermal Growth Factor Receptor 2 positive , who were presented to Clinical Oncology Department Tanta University Hospital, from May 2019 to May 2021. Mammography, CT scan, ER, and PR were investigated among the studied patients.

Results: comparison between trastuzumab in combination with paclitaxel and carboplatin with trastuzumab-paclitaxel without carboplatin therapy in patients with HER-2 receptor positive revealed 64.52% pathological complete response in patients on paclitaxel-carboplatin-trastuzumab therapy in comparison to 54.84% in trastuzumab-paclitaxel without carboplatin group. Furthermore, anemia, neutropenia and asthenia were significantly higher in paclitaxel-carboplatin-trastuzumab group in comparison with trastuzumab-paclitaxel without carboplatin group (all p-value<0.05). Moreover, cardiac insufficiencies were insignificantly different between both groups.

Conclusion: paclitaxel-carboplatin-trastuzumab showed higher p(CR) than TH in patients with HER-2 receptor positive breast cancer patients but insignificant p value (p>0.05). Toxicity (anemia, neutropenia and asthenia )were significantly was higher in TCH group (p<0.05). Mortality rate was insignificantly different between TCH group and TH group (p>0.05).

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