Abstract P3-07-03: Real-world comparison of safety and effectiveness of dose dense (2-weekly) versus weekly paclitaxel given with trastuzumab as neoadjuvant treatment in HER2-positive early stage breast cancer
Notice bibliographique
Résumé
Abstract Background: Traditionally, trastuzumab-based chemotherapy combinations used in HER2-positive early-stage breast cancer are delivered as 21-day cycles, either comprising weekly paclitaxel or 3-weekly docetaxel). In Ontario, Canada, an alternative dose-dense protocol allows the administration of 4 cycles of doxorubicin and cyclophosphamide (AC) followed by 2-weekly paclitaxel concurrently with trastuzumab over 4 cycles. Little is known about the effectiveness or safety of this schedule. Methods: A single institution, retrospective chart review of patients with HER2-positive early-stage breast cancer treated with neoadjuvant AC-Paclitaxel chemotherapy between the years 2015-2019 was performed. Comparative effectiveness of AC followed by 2-weekly (dose dense) or weekly paclitaxel regimens was assessed as the proportion of patients achieving pathologic complete response (pCR). Safety was assessed as the proportion of patients completing the course of treatment and of patients with cardiac toxicity defined by the ESC guidelines. Differences between regimens were evaluated as the test of 2 proportions (Z-test). Statistical significance was defined as p<0.05. Results: The initial analysis comprised 70 patients; 45 treated with 4 doses of paclitaxel 175mg/m2 every 2 weeks and 25 treated with 12 doses of paclitaxel 80mg/m2 weekly. Trastuzumab was given as an 8mg/kg loading dose and 6mg/kg maintenance dose, the latter either every 2 weeks or every 3 weeks based on paclitaxel schedule. The median age in the 2-weeks regimen was 54 years (30-77) and 55 years (35-71) in the weekly treatment. The 2-weekly regimen demonstrated a pCR proportion of 68% (31/45), while for weekly treatment, pCR was observed in 40% (10/25). This difference was statistically significant (p=0.023). Treatment completion rates were 100% (45/45) for the 2-weekly group and 64% (16/25) for the weekly group (p<0.001). There were no differences in the cardiotoxicity profiles between the protocols (p=0.68). The 2-weekly regimen resulted in cardiotoxicity in 6% (3/45) of patients, moderate cardiotoxicity in 2% (1/45), and no cases of severe cardiotoxicity. The weekly regimen reported mild cardiotoxicity in 4% (1/25) of patients, no moderate cardiotoxicity, and severe cardiotoxicity in 8% (2/25). Conclusion: In this retrospective study, both completion rates and pathologic complete response (pCR) rates were more favourable when AC was followed by 2-weekly paclitaxel/trastuzumab regimen compared to weekly paclitaxel/3-weekly trastuzumab. There was no difference between cardiac toxicity between the two schedules. An expanded dataset as well as an analysis of healthcare delivery costs, will be reported at the meeting. Citation Format: Yael Berner-Wygoda, Eitan Amir, Chloe Perlon, Diego Malon, Michelle B. Nadler, Jacqueline Savill, Meredith Li, Massimo Di Iorio, Neha Pathak. Real-world comparison of safety and effectiveness of dose dense (2-weekly) versus weekly paclitaxel given with trastuzumab as neoadjuvant treatment in HER2-positive early stage breast cancer [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P3-07-03.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».