HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer

Yakup Ergün; Nuriye Yıldırım Özdemir; Ozan Yazıcı; Gökhan Uçar; Yusuf Açıkgöz; Öznur Bal; Doğan Uncu

doi:10.16919/bozoktip.569169

HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer

Abstract

Amaç: Trastuzumabın meme kanserinde neoadjuvan tedaviye eklenmesiyle patolojik tam yanıt (PTY) oranını arttırdığı bilinmektedir. Ancak trastuzumabın kullanım sırasıyla ilgili kısıtlı veri bulunmaktadır. HER2 pozitif lokal ileri meme kanserinde neoadjuvan trastuzumab uygulama sırasının PTY üzerine etkisi olup olmadığını incelemeyi amaçladık. Gereç ve Yöntemler: 2010-2018 yılları arasında HER2 pozitif evre 2 ve 3 meme kanseri nedeniyle neoadjuvan trastuzumab kullanan hastaların verileri retrospektif incelenmiş olup antrasiklin bazlı tedavi sonrası trastuzumab alan 30 hasta ve tam tersi sıralama ile tedavi alan 16 hasta çalışmaya alındı. Bulgular: Çalışmaya toplam 46 hasta alınmış olup ortanca takip süresi 31 aydı (aralık; 7–98). Hastaların ortanca yaşı 51 yıldı (19–72). Tüm hastaların %52’si postmenopozal, %67'si hormon reseptör pozitifti. Tüm hastalarda klinik nod pozitifliği olup %54'ü cN1 idi. Hastalar trastuzumab sıralamasına göre grupla ayrıldı. Bazal özellikler açısından gruplar arasında fark yoktu. PTY oranı trastuzumab ile tedaviye başlayanlarda %63 olup diğer grupta %37 idi (p=0.1). Üç yıllık kümülatif hastalıksız sağ kalım oranları ise sırasıyla %100 ve %80 idi (p=0.2). Tek değişkenli analizde evre 2 ve Vücut kitle indeksi (VKİ) <25 kg/m² olan grupta PTY oranı anlamlı olarak daha yüksekti. Çok değişkenli analizde ise sadece VKİ <25 kg/m² olmasının bağımsız prediktif faktör olduğu bulundu (Odds oranı: 18.1; %95 Güven aralığı 1.39–36.0, p=0.03). Sonuç: Neoadjuvan tedaviye trastuzumab ile başlanması PTY oranını sayısal olarak arttırmış olsa da fark istatistiksel olarak anlamlı değildi. Farkın istatistiksel olarak anlamlı olmamasının nedeni hasta sayımızın az olması olabilir. Trastuzumab sıralamasının PTY ile ilişkisine yönelik daha büyük hasta popülasyonuna sahip prospektif çalışmalara ihtiyaç vardır. Anahtar sözcükler: Meme kanseri; Neoadjuvan tedavi; Trastuzumab sıralaması; Patolojik tam yanıt ABSTRACT Aim: The aim of this study was to investigate the effect of neoadjuvant trastuzumab administration order on PCR in locally advanced breast cancer. Material and Method: The data of patients who had recieved neoadjuvant trastuzumab for HER 2 positive stage 2 and 3 breast cancer between 2010 and 2018 were retrospectively analyzed; 30 patients who firstly had received anthracycline treatment then trastuzumab and 16 patients who had received in reverse order included to our study. Results: A number of 46 patients included study and median follow-up time was 31 months (range; 7–98). The median age of whole group was 51 years (19–72). There was no significant difference in basal characteristics when the patients were grouped according to the order of trastuzumab. PCR rates were 63% in patients whose treatment had started with trastuzumab, 37% in the other group (p=0.1) and the 3-year cumulative disease-free survival rates were 100% and 80%, respectively (p=0.2). In the univariate analysis, the PCR ratio was significantly higher in the stage 2 and BMI<25 kg/m² group; in multivariate analysis, only having a BMI<25 kg / m² was found to be an independent predictive factor (Odds ratio: 18.1; 95% CI 1.39–36.0, p=0.03). Conclusion: Although starting neoadjuvant therapy with trastuzumab increased the rate of PCR numerically, the difference was not statistically significant. The reason of not reaching statistical significance may be the insufficient number of patients. Prospective trials are needed to assign the treatment sequence that may affect PCR. Keywords: Breast cancer; Neoadjuvant treatment; Trastuzumab sequencing; Pathologic complete response

Keywords

HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer

References

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Details

Primary Language

Turkish

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Yakup Ergün This is me
Türkiye

Nuriye Yıldırım Özdemir This is me
Türkiye

Ozan Yazıcı This is me
Türkiye

Gökhan Uçar This is me
Türkiye

Yusuf Açıkgöz This is me
Türkiye

Öznur Bal This is me
Türkiye

Doğan Uncu This is me
Türkiye

Publication Date

June 8, 2020

Submission Date

June 1, 2020

Acceptance Date

-

Published in Issue

Year 2020 Volume: 10 Number: 2

DOI

https://doi.org/10.16919/bozoktip.569169

IZ

https://izlik.org/JA89XZ72PS

Cite

RIS / Bibtex

APA

Ergün, Y., Yıldırım Özdemir, N., Yazıcı, O., Uçar, G., Açıkgöz, Y., Bal, Ö., & Uncu, D. (2020). HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer. Bozok Tıp Dergisi, 10(2), 47-54. https://doi.org/10.16919/bozoktip.569169

AMA

1.Ergün Y, Yıldırım Özdemir N, Yazıcı O, et al. HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer. Bozok Tıp Dergisi. 2020;10(2):47-54. doi:10.16919/bozoktip.569169

Chicago

Ergün, Yakup, Nuriye Yıldırım Özdemir, Ozan Yazıcı, et al. 2020. “HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The Effect of Neoadjuvant Trastuzumab Treatment Sequence on Pathologic Complete Response in HER2-Positive Locally Advanced Breast Cancer”. Bozok Tıp Dergisi 10 (2): 47-54. https://doi.org/10.16919/bozoktip.569169.

EndNote

Ergün Y, Yıldırım Özdemir N, Yazıcı O, Uçar G, Açıkgöz Y, Bal Ö, Uncu D (June 1, 2020) HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer. Bozok Tıp Dergisi 10 2 47–54.

IEEE

[1]Y. Ergün et al., “HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer”, Bozok Tıp Dergisi, vol. 10, no. 2, pp. 47–54, June 2020, doi: 10.16919/bozoktip.569169.

ISNAD

Ergün, Yakup - Yıldırım Özdemir, Nuriye - Yazıcı, Ozan - Uçar, Gökhan - Açıkgöz, Yusuf - Bal, Öznur - Uncu, Doğan. “HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The Effect of Neoadjuvant Trastuzumab Treatment Sequence on Pathologic Complete Response in HER2-Positive Locally Advanced Breast Cancer”. Bozok Tıp Dergisi 10/2 (June 1, 2020): 47-54. https://doi.org/10.16919/bozoktip.569169.

JAMA

1.Ergün Y, Yıldırım Özdemir N, Yazıcı O, Uçar G, Açıkgöz Y, Bal Ö, Uncu D. HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer. Bozok Tıp Dergisi. 2020;10:47–54.

MLA

Ergün, Yakup, et al. “HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The Effect of Neoadjuvant Trastuzumab Treatment Sequence on Pathologic Complete Response in HER2-Positive Locally Advanced Breast Cancer”. Bozok Tıp Dergisi, vol. 10, no. 2, June 2020, pp. 47-54, doi:10.16919/bozoktip.569169.

Vancouver

1.Yakup Ergün, Nuriye Yıldırım Özdemir, Ozan Yazıcı, Gökhan Uçar, Yusuf Açıkgöz, Öznur Bal, Doğan Uncu. HER2-POZİTİF LOKAL İLERİ MEME KANSERİNDE NEOADJUVAN TRASTUZUMAB SIRALAMASININ PATOLOJİK TAM YANIT ÜZERİNE ETKİSİ The effect of neoadjuvant trastuzumab treatment sequence on pathologic complete response in HER2-positive locally advanced breast cancer. Bozok Tıp Dergisi. 2020 Jun. 1;10(2):47-54. doi:10.16919/bozoktip.569169