{"id":27031,"date":"2021-05-07T16:00:00","date_gmt":"2021-05-07T16:00:00","guid":{"rendered":"http:\/\/4eab39de912d5662029bd719b32a5248"},"modified":"2024-11-03T15:14:56","modified_gmt":"2024-11-03T15:14:56","slug":"neoadjuvant-pertuzumab-trastuzumab-demonstrates-long-term-cardiac-safety-in-her2-positive-breast-cancer","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/neoadjuvant-pertuzumab-trastuzumab-demonstrates-long-term-cardiac-safety-in-her2-positive-breast-cancer\/","title":{"rendered":"Neoadjuvant Pertuzumab\/Trastuzumab Demonstrates Long-Term Cardiac Safety in HER2-Positive Breast Cancer"},"content":{"rendered":"<p>Patients with stage IIA to III HER2-positive breast cancer demonstrated high rates of event-free survival (EFS) and a low occurrence of cardiac events at 5 years after receiving neoadjuvant\/adjuvant pertuzumab plus trastuzumab with standard anthracycline-containing therapies. Chau Dang of the Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Centre in New York, USA presented long-term findings from the BERENICE study (NCT02132949) at the <a href=\"https:\/\/www.esmo.org\/meetings\/esmo-breast-2021-virtual\" class>ESMO Breast Cancer Virtual Congress&nbsp;2021<\/a>, held 5 to 8 May.<\/p>\n<p>Dr. Dang presented data related to the secondary objective, safety and efficacy outcomes at 5-years, which represented the end-of-study analysis with a clinical cut-off date of 25 August 2020.<\/p>\n<p>The multicentre, open-label, non-comparative phase II BERENICE study enrolled patients with stage IIA to III HER2-positive breast cancer and a left ventricular ejection fraction (LVEF) \u226555%. According to physician&#8217;s choice patients were assigned to be treated with dose-dense doxorubicin\/cyclophosphamide every 2 weeks for 4 cycles plus 4 weekly cycles of paclitaxel for 12 cycles (cohort A: n=199) or to receive 5-fluorouracil, epirubicin, cyclophosphamide every 3 weeks for 4 cycles and 4 cycles of docetaxel every 3 weeks (cohort B; n=201). Pertuzumab\/trastuzumab every 3 weeks was initiated from the start of taxanes and continued after surgery for a total of 17 cycles.<\/p>\n<p>The primary objective of BERENICE was to illustrate the cardiac safety of neoadjuvant pertuzumab\/trastuzumab with anthracycline-containing chemotherapies.<\/p>\n<h4>High rates of event-free survival were observed<\/h4>\n<p>The 5-year EFS rates were 90.8% (95% confidence interval [CI] 86.5-95.2) in cohort A and 89.2% (95% CI 84.8-93.6) in cohort B, while the 5-year overall survival rates were 96.1% (95% CI 93.3-98.9) and 93.8% (95% CI 90.3-97.2), respectively.<\/p>\n<p>PAM50 classification was available for 339 patients which showed that the majority (51.6%) of patients had HER2-enriched tumours; the 5-year EFS rates in these patients were 93.1% (95% CI 87.2-98.9) in cohort A and 88.3% (95% CI 81.8-94.8) in cohort B.<\/p>\n<p>No new cardiac safety issues were observed during folllow-up. In addition, few events were observed in the treatment-free period and a low incidence of class III\/IV congestive heart failure was reported.<\/p>\n<p>The safety analysis comprised 199 cohort A and 198 cohort B patients. Among these patients, no LVEF episodes occurred during the treatment-free period.<\/p>\n<p>During the treatment interval, 27 (13.6%) patients had at least one LVEF decrease to \u226510% and 12 (6.0%) patients experienced LVEF &lt;50% in cohort A, whereas in cohort B 24 (12.1%) and 7 (3.5%) patients reported these respective LVEF events.<\/p>\n<p>No episodes of New York Heart Association class III\/IV congestive heart failure were observed in cohort A and one (0.5%) episode occurred in cohort B during the treatment-free follow-up period. On treatment, in cohorts A and B, 3 (1.5%) and 2 (1.0%) patients, respectively, experienced New York Heart Association class III\/IV congestive heart failure. A total of 3 patients in cohort B did not have available safety data.<\/p>\n<p>Dr. Evandro de Azambuja of the Jules Bordet Institute in Brussels, Belgium who discussed the study findings commented about favourable long-term efficacy outcomes with pertuzumab\/trastuzumab-based (neo)adjuvant regimens. However, the chemotherapy backbone\u2019s contribution cannot be assessed, due to the non-randomised study design. An anthracycline-free regimen was not evaluated in the present study. He said that the low incidence of cardiac events with the pertuzumab\/trastuzumab-based regimen given before and after surgery was maintained during the 5-year follow-up. No new safety concerns arose during long-term follow-up, but additional information on cardiac medications\/co-morbidities are needed. He also questioned if LVEF assessment by echocardiography is enough to assess cardiac safety.<\/p>\n<h4>Conclusions<\/h4>\n<p>The investigators noted that the BERENICE study demonstrated favourable long-term efficacy outcomes, and sustained cardiac safety in patients with early HER2-positive breast cancer. They stated that these findings support the use of neoadjuvant\/adjuvant pertuzumab plus trastuzumab with standard anthracycline-containing therapies in this patient population.<\/p>\n<p>The study was funded by F. Hoffmann-La Roche.<\/p>\n<h4>Reference<\/h4>\n<p>43O \u2013 Dang C, Ewer MS, Delaloge S, <em>et al.<\/em> Pertuzumab\/Trastuzumab in Early Stage HER2-positive Breast Cancer: 5-year and Final Analysis of the BERENICE Trial. <a href=\"https:\/\/www.esmo.org\/meetings\/esmo-breast-2021-virtual\" class>ESMO Breast Cancer Virtual Congress&nbsp;2021<\/a> (5-8 May).<\/p>\n<p><a href=\"http:\/\/www.esmo.org\/oncology-news\/neoadjuvant-pertuzumab-trastuzumab-demonstrates-long-term-cardiac-safety-in-her2-positive-breast-cancer\">Source<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Patients with stage IIA to III HER2-positive breast cancer demonstrated high rates of event-free survival (EFS) and a low occurrence of cardiac events at 5 years after receiving neoadjuvant\/adjuvant pertuzumab plus trastuzumab with standard anthracycline-containing therapies. Chau Dang of the Department of Medicine, Breast Medicine Service, Memorial Sloan Kettering Cancer Centre in New York, USA [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-27031","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27031","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=27031"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27031\/revisions"}],"predecessor-version":[{"id":43824,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/27031\/revisions\/43824"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=27031"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=27031"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=27031"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}