Cancers (Sep 2022)
Primary Chemoradiotherapy Treatment (PCRT) for HER2+ and Triple Negative Breast Cancer Patients: A Feasible Combination
- Raquel Ciérvide,
- Ángel Montero,
- Eduardo García-Rico,
- Mariola García-Aranda,
- Mercedes Herrero,
- Jessica Skaarup,
- Leticia Benassi,
- Maria José Barrera,
- Estela Vega,
- Beatriz Rojas,
- Raquel Bratos,
- Ana Luna,
- Manuela Parras,
- María López,
- Ana Delgado,
- Paloma Quevedo,
- Silvia Castilla,
- Margarita Feyjoo,
- Ana Higueras,
- Mario Prieto,
- Ana Suarez-Gauthier,
- Lina Garcia-Cañamaque,
- Nieves Escolán,
- Beatriz Álvarez,
- Xin Chen,
- Rosa Alonso,
- Mercedes López,
- Ovidio Hernando,
- Jeannette Valero,
- Emilio Sánchez,
- Eva Ciruelos,
- Carmen Rubio
Affiliations
- Raquel Ciérvide
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Ángel Montero
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Eduardo García-Rico
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
- Mariola García-Aranda
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Mercedes Herrero
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
- Jessica Skaarup
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
- Leticia Benassi
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
- Maria José Barrera
- Department of Gynecology and Obstetrics, HM Hospitales, 28050 Madrid, Spain
- Estela Vega
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
- Beatriz Rojas
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
- Raquel Bratos
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
- Ana Luna
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
- Manuela Parras
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
- María López
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
- Ana Delgado
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
- Paloma Quevedo
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
- Silvia Castilla
- Department of Radiology, HM Hospitales, 28050 Madrid, Spain
- Margarita Feyjoo
- Department of Medical Oncology, Hospital Sanitas La Moraleja, 28050 Madrid, Spain
- Ana Higueras
- Department of Gynecology and Obstetrics, Hospital Sanitas La Moraleja, 28050 Madrid, Spain
- Mario Prieto
- Department of Pathology, HM Hospitales, 28050 Madrid, Spain
- Ana Suarez-Gauthier
- Department of Pathology, HM Hospitales, 28050 Madrid, Spain
- Lina Garcia-Cañamaque
- Department of Nuclear Medicine, HM Hospitales, 28050 Madrid, Spain
- Nieves Escolán
- Department of Plastic Surgery, HM Hospitales, 28050 Madrid, Spain
- Beatriz Álvarez
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Xin Chen
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Rosa Alonso
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Mercedes López
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Ovidio Hernando
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Jeannette Valero
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Emilio Sánchez
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- Eva Ciruelos
- Department of Medical Oncology, HM Hospitales, 28050 Madrid, Spain
- Carmen Rubio
- Department of Radiation Oncology, HM Hospitales, 28050 Madrid, Spain
- DOI
- https://doi.org/10.3390/cancers14184531
- Journal volume & issue
-
Vol. 14,
no. 18
p. 4531
Abstract
Primary systemic treatment (PST) downsizes the tumor and improves pathological response. The aim of this study is to analyze the feasibility and tolerance of primary concurrent radio–chemotherapy (PCRT) in breast cancer patients. Patients with localized TN/HER2+ tumors were enrolled in this prospective study. Radiation was delivered concomitantly during the first 3 weeks of chemotherapy, and it was based on a 15 fractions scheme, 40.5 Gy/2.7 Gy per fraction to whole breast and nodal levels I-IV. Chemotherapy (CT) was based on Pertuzumab–Trastuzumab–Paclitaxel followed by anthracyclines in HER2+ and CBDCA-Paclitaxel followed by anthracyclines in TN breast cancers patients. A total of 58 patients were enrolled; 25 patients (43%) were TN and 33 patients HER2+ (57%). With a median follow-up of 24.2 months, 56 patients completed PCRT and surgery. A total of 35 patients (87.5%) achieved >90% loss of invasive carcinoma cells in the surgical specimen. The 70.8% and the 53.1% of patients with TN and HER-2+ subtype, respectively, achieved complete pathological response (pCR). This is the first study of concurrent neoadjuvant treatment in breast cancer in which three strategies were applied simultaneously: fractionation of RT (radiotherapy) in 15 sessions, adjustment of CT to tumor phenotype and local planning by PET. The pCR rates are encouraging.
Keywords