From the Guidelines
The pathologic complete response rate of Taxane, Carboplatin, and Trastuzumab neoadjuvant chemotherapy is approximately 57.3% to 66.2%, with the highest rate seen in patients who received pertuzumab, trastuzumab, docetaxel, and carboplatin chemotherapy. This regimen consists of docetaxel, carboplatin, and trastuzumab given every three weeks for six cycles before surgery. The pathologic complete response rate can vary based on hormone receptor status, with higher rates observed in hormone receptor-negative/HER2-positive tumors compared to hormone receptor-positive/HER2-positive tumors 1. Patient factors such as age, tumor size, and lymph node involvement can also influence response rates.
Key Points
- The addition of pertuzumab to the TCH regimen can further increase pathologic complete response rates to approximately 45-60% 1.
- Achievement of pathologic complete response with neoadjuvant therapy is associated with improved long-term outcomes, including disease-free and overall survival, making it an important prognostic indicator in breast cancer treatment.
- The reported pathologic complete response rates in the studies ranged from 57.3% to 66.2%, with the highest seen in patients who received pertuzumab, trastuzumab, docetaxel, and carboplatin chemotherapy 1.
Treatment Considerations
- The regimen of docetaxel, carboplatin, and trastuzumab, with or without pertuzumab, is a viable option for neoadjuvant therapy in patients with HER2-positive breast cancer.
- The choice of regimen should be individualized based on patient factors, such as hormone receptor status, age, tumor size, and lymph node involvement.
- The potential benefits and risks of each regimen, including the addition of pertuzumab, should be carefully considered in the context of each patient's unique situation 1.
From the Research
Pathologic Complete Response Rate
The pathologic complete response (pCR) rate of Taxane (Taxane), Carboplatin (Carboplatin), and Trastuzumab (Trastuzumab) neoadjuvant chemotherapy is as follows:
- A study published in 2016 2 reported a pCR rate of 43.6% in patients with HER2-positive breast cancer treated with docetaxel, carboplatin, and trastuzumab.
- A retrospective analysis published in 2021 3 found a pCR rate of 27.4% in patients with early-stage HER2-positive breast cancer treated with docetaxel, carboplatin, and trastuzumab.
- A study published in 2010 4 reported a pCR rate of 24.1% in patients with HER2-positive tumors treated with docetaxel and carboplatin, which improved to 40% when trastuzumab was added.
- A retrospective analysis published in 2022 5 did not provide a specific pCR rate, but discussed the importance of achieving pCR in patients with HER2-positive breast cancer.
- A study published in 2020 6 reported a pCR rate of 63.7% in patients with HER2-positive breast cancer treated with docetaxel, carboplatin, trastuzumab, and pertuzumab, but found that carboplatin dose capping affected pCR rates.
Factors Affecting pCR Rate
Several factors can affect the pCR rate, including:
- Tumor type: Patients with triple-negative breast cancer (TNBC) had the best response to neoadjuvant treatment, followed by patients with HER2-positive tumors 4.
- Addition of trastuzumab: The addition of trastuzumab to docetaxel and carboplatin improved the pCR rate in patients with HER2-positive tumors 4.
- Carboplatin dose capping: Carboplatin dose capping resulted in inferior pCR rates, particularly in the ER+ subgroup 6.
- Patient age and weight: Patients with lower delivered area under the curve (dAUC) were more frequently younger and overweight/obese 6.