R.N. Safin1, R.Sh. Khasanov2, A.M. Gimranov1, A.R. Amirova3
1Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic named after prof. M.Z. Sigal, Kazan
2Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan
3Kazan State Medical University, Kazan
Safin Rustem N. ― oncologist, head of chemotherapy department №1 of the Republican Clinical Oncology Dispensary of Ministry of Healthcare of Tatarstan Republic named after prof. M.Z. Sigal
29 Sibirskiy Trakt, Kazan, 420029, Russian Federation, tel. +7-917-272-79-93, e-mail: rustem1408@mail.ru, ORCID ID: 0000-0003-0585-7727
Abstract. Breast cancer consistently ranks first in terms of prevalence among malignant neoplasms in the female population worldwide. The standard is combined or complex treatment with a choice of tactics based on the stage of the disease and molecular genetic characteristics of the tumor. In the case of primary metastatic breast cancer, as well as with lesions of regional lymph nodes, neoadjuvant drug treatment is indicated. Anthracycline-taxane-containing and platinum-taxane-containing regimens in combination with anti-Her2 drugs are used for neoadjuvate therapy. This article presents and analyzes the results of treatment of 67 patients with locally advanced Her2-positive breast cancer T1-4N1-3M0 stages aged 31 to 69 years, who underwent neoadjuvant therapy using carboplatin+docetaxel in combination with anti-Her2 drugs followed by surgical treatment and morphological examination of the removed the drug. In 82% of patients (n=55) who received neoadjuvant treatment according to the scheme carboplatin+docetaxel+trastuzumab+pertuzumab, when examining the removed drug, therapeutic tumor pathomorphosis of IV-V degree according to Miller ― Payne was revealed, which corresponded to a complete pathomorphological response and RCB I. No dependence of the degree of drug pathomorphosis on the receptor status of the tumor was revealed during the analysis of the results obtained. However, the relationship between the number of complete pathomorphological responses (V degree of therapeutic pathomorphosis) and the stage of the disease was revealed. In this study, the effectiveness of platinum-taxane-containing regimens with double anti-Her2 blockade in the neoadjuvant treatment of breast cancer in patients with an unfavorable prognosis group was shown, which allows for improved overall and relapse-free survival.
Key words: Her2-positive breast cancer, neoadjuvant chemotherapy, carboplatin, pathomorphological response, trastuzumab, pertuzumab, luminal B Her2-positive breast cancer, non-luminal Her2-positive breast cancer.