Pertuzumab/Docetaxel/Carboplatin/Trastuzumab Regimen in Human Epidermal Growth Factor Receptor 2-Positive Early, Locally Advanced, and Oligometastatic Breast Cancer: Real-World Outcomes From India.

Abstract

The study evaluated the real-world outcomes of the pertuzumab/docetaxel/carboplatin/trastuzumab (PTCH) regimen in Indian patients with human epidermal growth factor receptor 2-positive (HER2+) early, locally advanced, and oligometastatic breast cancer (BC). Data from patients treated with neoadjuvant PTCH between January 2015 and December 2024 were retrospectively reviewed. The primary end point was the pathologic complete response (pCR) rate, with secondary end points including disease-free survival (DFS) and toxicity. Kaplan-Meier analysis assessed survival; Cox regression and logistic regression were used for multivariate analyses. A total of 152 patients were included (median age: 47 years; range: 23-72 years): 45 patients (29.6%) had stage II, 89 (58.55%) had stage III, and 18 (11.84%) had oligometastatic disease. Overall, 68 (44.7%) patients had hormone receptor-positive disease, and 94 (61.8%) were premenopausal. The overall pCR rate was 83 (54.6%). The pCR rate of the hormone receptor-negative group (68%) was higher than that of the hormone receptor-positive group (45.1%). With a median follow-up of 33 months, the 3-year DFS was 47.5%, 58% in patients who achieved pCR, and 33.5% in those who did not achieve pCR (<i>P</i> = .001). The most common adverse events (grade 3/4) were diarrhea (17.1%) and thrombocytopenia (7.8%). In the multivariate analyses, lower odds of achieving pCR were associated with recurrence (odds ratio, 0.383, <i>P</i> = .018). An improved DFS was observed in the age group of 31-45 years. The PTCH regimen demonstrated efficacy and a tolerable safety profile in patients with HER2+ BC in an Indian real-world setting. Achieving pCR is a significant predictor of improved DFS. The PTCH regimen obviates the need for adjuvant trastuzumab emtansine after surgery, making it a cost-effective strategy in a limited-resource setting.