Anaemia and pathologic complete response rate according to carboplatin dose in HER2+ breast cancer treated with neoadjuvant TCHP. (15th July 2022)

• Record Type: Journal Article
• Authors: Ji, Jung Hwan; Bae, Soong June; Kim, Seul‐Gi; Kim, Min Hwan; Kim, Gun‐Min; Sohn, Joohyuk; Jeong, Joon; Kim, Jee Hung; Ahn, Sung Gwe
• Is Part Of: Cancer medicine. Volume 12:Number 2(2023)
• Page Start: 1409
• Page End: 1417
• Publication Date: 2022-07-15
• Subjects: anaemia -- breast cancer -- carboplatin -- neoadjuvant chemotherapy -- pathologic complete response; 616.994005
• DOI: 10.1002/cam4.5022
• Languages: English
• ISSNs: 2045-7634

Abstract

Abstract: Grade 3/4 anaemia, which is mainly induced by carboplatin, frequently occurs in patients treated with neoadjuvant docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP). However, dose reduction of carboplatin may raise concerns about the oncological outcome. This study investigated the pathologic complete response (pCR) rate, occurrence of grade 3/4 anaemia, and transfusion rate according to carboplatin dose in patients treated with neoadjuvant TCHP. We retrospectively analysed 294 patients treated with neoadjuvant TCHP between April 2015 and December 2020. Case matching was performed using propensity score matching. Among patients treated with neoadjuvant TCHP, carboplatin area under the plasma concentration–time curve 6 (AUC6) was used in 234 patients (79.6%) and upfront carboplatin AUC5 was used in 60 patients (20.4%). No significant difference in pCR rate was found between the two groups (AUC6: 70.9%, AUC5: 80.0%). In both oestrogen receptor‐positive (ER+) and ER‐ patients, no significant differences were observed between the AUC6 and AUC5 groups (ER+: 54.3% vs. 50.0%, ER‐: 81.7% vs. 86.0%). The case‐matched cohort showed consistent findings. The AUC5 group had lower frequencies of grade 3/4 anaemia (18.3% vs. 34.2%) and transfusion events (10.0% vs. 21.8%) than the AUC6 group. Compared with AUC5, carboplatin at AUC6 would associate with a 2.7‐fold increased risk of grade 3 or 4 chemotherapy‐induced anaemia. Carboplatin AUC5 has comparable cytotoxic effects to carboplatin AUC6 in patients with HER2+ breast cancer treated with six cycles of neoadjuvant TCHP, with fewer complications associated with clinically meaningful anaemia. AUC5 may be the optimal carboplatin dose to reduce TCHP‐induced anaemia in patients with HER2+ breast cancer treated with TCHP. Abstract : Carboplatin AUC5 can provide a comparable cytotoxic effect to carboplatin AUC6 in terms of pathologic complete response in patients with HER2+ breast cancer receiving neoadjuvant docetaxel/carboplatin/trastuzumab/pertuzumab (TCHP), with fewer complications associated with grade 3/4 anemia. We suggest that AUC5 can be considered the optimal dose of carboplatin for patients with HER2+ breast cancer treated with TCHP.