Therapeutic Evaluation Of HER2-positive Breast Cancer With Neoadjuvant Chemotherapy Combined With Targeted Therapy

Objectives:Breast cancer with HER2 high-expression can improve the efficacy and prognosis through targeted therapy.Preoperative chemotherapy is commonly used to treat locally advanced breast cancer.The purpose of this study was to investigate the efficacy of neoadjuvant chemotherapy combined with trastuzumab in breast cancer patients with HER2 high-expression,and to analyze the factors affecting the efficacy,briefly.Methods:Retrospective analysis was performed on 184 cases of HER2-positive breast cancer receiving neoadjuvant chemotherapy in Breast Center of the fourth hospital of Hebei Medical University from January 2017 to December 2018,70 patients received chemotherapy combined with herceptin(targeted therapy group),and 114 patients received chemotherapy alone(chemotherapy alone group).The tumor size was assessed by ultrasound and physical examination every 2 cycles during neoadjuvant chemotherapy.The efficacy of all cases was evaluated by pathological methods after surgery.Results:Overall response rate in the 184 cases was 82.07%(151/184),including 84.29%(59/70)response rate in targeted therapy group,the number of patients achieving the pathological complete response(pathological complete response,pCR)was 19,pCR rate was 27.14%,and 80.70%(92/114)response rate in chemotherapy alone group,the number of patients achieving the pCR was 7,pCR rate was 6.14%,the difference was statistically significant(P < 0.001).The cases got clinic complete response(cCR)in the patients with targeted therapy group was 11,with a cCR rate of 15.71%,the cases got cCR in the patients with chemotherapy alone group was 3,with a cCR rate of 2.63%,and the difference was statistically significant(P = 0.001).In the targeted therapy group,the pCR rates of different chemotherapy regimens were compared,the pCR rate of TCbH was higher than TAH and AC-TH,but the difference was not statistically significant(42.11%,23.53%,21.88%,P = 0.267).In the targeted therapy group,the pCR rates of different tumor sizes were compared,The pCR rate of patients with the maximum tumor diameter ?3cm was 31.43%,and pCR rate of patients with the maximum tumor diameter>3cm was 22.86%,with no significant difference(P = 0.420).Conclusions:The pCR rate of neoadjuvant chemotherapy in HER2-positive breast cancer can be significantly improved by combined targeted therapy.Chemotherapy regimen and tumor size were not factors affecting the efficacy of neoadjuvant chemotherapy combined with targeted therapy for HER2 positive breast cancer.