Breast Cancer Research and Treatment

, Volume 132, Issue 2, pp 589–600

Phase II trial of preoperative paclitaxel, gemcitabine, and trastuzumab combination therapy in HER2 positive stage II/III breast cancer: The Korean Cancer Study Group BR 07-01

  • Seock-Ah Im
  • Keun Seok Lee
  • Jungsil Ro
  • Eun Sook Lee
  • Youngmee Kwon
  • Jin-Hee Ahn
  • Jin Seok Ahn
  • Jee Hyun Kim
  • Han Sung Kang
  • Kyung Hwan Shin
  • Dong-Young Noh
  • In-Ae Park
  • Sung-Bae Kim
  • Young Hyuck Im
  • Sung Whan Ha
Clinical trial

DOI: 10.1007/s10549-011-1852-0

Cite this article as:
Im, SA., Lee, K.S., Ro, J. et al. Breast Cancer Res Treat (2012) 132: 589. doi:10.1007/s10549-011-1852-0

Abstract

An addition of trastuzumab preoperatively to chemotherapy for human epidermal growth factor receptor 2 (HER2) positive breast cancer improved relapse-free survival (RFS). This study was designed to evaluate the efficacy and safety of preoperative paclitaxel, gemcitabine, and trastuzumab (PGH) combination for HER2-positive breast caner. Pathologically, proven node positive stage II/III breast cancer patients with adequate organ function and no history of anti-cancer therapy were eligible. Patients received weekly trastuzumab with paclitaxel 80 mg/m2 and gemcitabine 1,200 mg/m2 on days 1 and 8, every 3 weeks for 6 cycles. Postoperatively, patients completed trastuzumab for 1 year and hormone therapy for 5 years if indicated. All patients received postoperative radiation therapy. Of 53 enrolled patients with a median tumor of 5.3 (range, 2.0 to >12) cm; 43.4%, T3/T4; 75.4%, N2/N3; and 45.3%, positive hormone receptors. The pathologic complete response (pCR) rate was 58.5% in both tumor and lymph nodes. Grade 3/4 adverse events were neutropenia (32%), febrile neutropenia (0.6%), and transient elevation of AST/ALT (1.6%) during a total of 318 cycles. All patients maintained normal cardiac function. With a median follow-up of 40 months, 3-year RFS rate was 84% with 91.7% distant metastasis-free survival rates. Remarkable pCR rate was obtained with non-anthracycline-based PGH therapy for HER2-positive stage II/III breast cancer. Adverse events were mild with few incidences of febrile neutropenia.

Keywords

Preoperative chemotherapyTrastuzumabPaclitaxelGemcitabineHER2-positive Breast Cancer

Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Seock-Ah Im
    • 1
  • Keun Seok Lee
    • 2
  • Jungsil Ro
    • 2
  • Eun Sook Lee
    • 2
  • Youngmee Kwon
    • 2
  • Jin-Hee Ahn
    • 3
  • Jin Seok Ahn
    • 4
  • Jee Hyun Kim
    • 5
  • Han Sung Kang
    • 2
  • Kyung Hwan Shin
    • 2
  • Dong-Young Noh
    • 6
  • In-Ae Park
    • 7
  • Sung-Bae Kim
    • 3
  • Young Hyuck Im
    • 4
  • Sung Whan Ha
    • 8
  1. 1.Department of Internal Medicine, Seoul National University Hospital, Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  2. 2.Center for Breast CancerNational Cancer CenterGoyang-siRepublic of Korea
  3. 3.Department of Oncology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  4. 4.Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  5. 5.Department of Internal Medicine, Seoul National University Bundang Hospital, Cancer Research InstituteSeoul National University College of MedicineSeongnamKorea
  6. 6.Department of Surgery, Seoul National University Hospital, Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  7. 7.Department of Pathology, Seoul National University Hospital, Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  8. 8.Department of Radiation Oncology, Seoul National University Hospital, Cancer Research InstituteSeoul National University College of MedicineSeoulKorea