Recently, the team led by Professor Kun Wang from the Second Breast Oncology Department under the Oncology Center of our hospital has published a research paper titled “Anthracycline-containing Versus Carboplatin-containing Neoadjuvant Chemotherapy in Combination with Trastuzumab for HER2-positive Breast Cancer: the NeoCARH Phase II Randomized Clinical Trial” in the Therapeutic Advances in Medical Oncology, revealing that in the neoadjuvant therapy of early HER2-positive breast cancer, the earlier the anti-HER2 targeted therapy was used, the better the efficacy.
The research was first reported by Professor Kun Wang as early as September 2019 at the annual meeting of the Chinese Society of Clinical Oncology, China's largest academic conference, and then was selected as an abstract and shown to the public by the American Society of Clinical Oncology in June 2020 at its annual meeting - the world's largest academic conference. Later it was published on the Therapeutic Advances in Medical Oncology in April 2021, marking the research findings of the team led by Professor Kun Wang have been highly recognized in the academic world！
Initiated by Professor Wang Kun, this NeoCARH research (NCT03140553) was a prospective, multicenter, randomized, controlled Phase II clinical trial which compared for the first time the 6 cycles of docetaxel/carboplatin/trastuzumab (TCH) neoadjuvant setting to the 4 cycles of standard EC (epirubicin/cyclophosphamide) followed by 4 cycles of TH (docetaxel/trastuzumab) for operable HER2-positive breast cancer. The research was led by Professor Wang Kun from Guangdong Provincial People's Hospital and the enrolled patients were from 10 research centers from all parts of the country, including Guangdong Provincial People’s Hospital, Shantou Central Hospital, the First Affiliated Hospital, Sun Yat-sen University, Zhejiang Provincial People's Hospital, Dongguan Municipal People's Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, Henan Provincial Cancer Hospital, Jiangxi Provincial Cancer Hospital, the First Affiliated Hospital, Zhejiang University, and Baotou Municipal Cancer Hospital. From May 2017 when the study was started to November 2019 when the study was ended, 140 patients were selected randomly and 135 patients were included in the study for analysis. The total pCR rate of the experimental group treated with TCH (docetaxel + carboplatin + trastuzumab) for 6 cycles was 55.9% (38/68)(95% CI, 43.3–67.9), significantly higher than 37.3%(25/67)(95% CI 25.8–50.0)(p=0.032) of the control group treated with 4EC-4TH (4-cycle epirubicin + cyclophosphamide followed by 4-cycle therapy with docetaxel + trastuzumab). In the analysis of adverse reactions, the 4EC-4TH group showed a higher proportion of decline in neutrophile granulocytes while the 6TCH group showed a higher proportion of reduction in anemia and blood platelets. This was the first prospective, randomized, controlled, Phase II study, a head-to-head clinical study by comparing 6TCH with 4EC-4TH as a neoadjuvant therapy for HER2-positive breast cancer. It was found that there was no statistical difference in the incidence rates of adverse reactions between the two groups, but a higher pCR rate in the 6TCH group.
This research presented for the first time that using targeted therapy as early as possible at the neoadjuvant phase of HER2-positive breast cancer can further increase pCR rate and the research results are possible to change the current neoadjuvant treatment strategies for HER2-positive early breast cancer. Based on the development strategy of mutual promotion between clinical practice and scientific research, the team led by Professor Wang Kun from the Breast Oncology Department has conducted a series of studies on neoadjuvant therapy of breast cancer and the findings of these studies have been constantly shown in the international arena and recognized by the academic world, representing the voice of China, the voice of Guangdong Provincial People’s Hospital, and finally bringing benefits to lots of patients!
