A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer

Michele De Laurentiis, Grazia Arpino, Erminia Massarelli, Angela Ruggiero, Chiara Carlomagno, Fortunato Ciardiello, Giampaolo Tortora, Diego D'Agostino, Francesca Caputo, Giuseppe Cancello, Emilia Montagna, Luca Malorni, Luigia Zinno, Rossella Lauria, Angelo Raffaele Bianco, Sabino De Placido

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Abstract

Purpose: Experimental data suggest a complex cross-talk between HER-2 and estrogen receptor, and it has been hypothesized that HER-2-positive tumors may be less responsive to certain endocrine treatments. Clinical data, however, have been conflicting. We have conducted a meta-analysis on the interaction between the response to endocrine treatment and the overexpression of HER-2 in metastatic breast cancer. Experimental Design: Studies have been identified by searching the Medline, Embase, and American Society of Clinical Oncology abstract databases. Selection criteria were (a) metastatic breast cancer, (b) endocrine therapy (any line of treatment), and (c) evaluation of HER-2 expression (any method). For each study, the relative risk for treatment failure for HER-2-positive over HER-2-negative patients with 95% confidence interval was calculated as an estimate of the predictive effect of HER-2. Pooled estimates of the relative risk were computed by the Mantel-Haenszel method. Results: Twelve studies (n = 2,379 patients) were included in the meta-analysis. The overall relative risk was 1.42 (95% confidence interval, 1.32-1.52; P <0.00001; test for heterogeneity = 0.380). For studies involving tamoxifen, the pooled relative risk was 1.33 (95% confidence interval, 1.20-1.48; P <0.00001; test for heterogeneity = 0.97); for studies involving other hormonal drugs, a pooled relative risk of 1.49 (95% confidence interval, 1.36-164; P <0.00001; test for heterogeneity = 0.08) was estimated. A second meta-analysis limited to tumors that were either estrogen receptor positive, estrogen receptor unknown, or estrogen receptor negative/progesterone receptor positive yielded comparable results. Conclusions: HER-2-positive metastatic breast cancer is less responsive to any type of endocrine treatment. This effect holds in the subgroup of patients with positive or unknown steroid receptors.

Original languageEnglish
Pages (from-to)4741-4748
Number of pages8
JournalClinical Cancer Research
Volume11
Issue number13
DOIs
Publication statusPublished - Jul 1 2005

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Meta-Analysis
Estrogen Receptors
Breast Neoplasms
Confidence Intervals
Therapeutics
Steroid Receptors
Progesterone Receptors
Tamoxifen
Treatment Failure
Patient Selection
Neoplasms
Research Design
Databases
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer. / De Laurentiis, Michele; Arpino, Grazia; Massarelli, Erminia; Ruggiero, Angela; Carlomagno, Chiara; Ciardiello, Fortunato; Tortora, Giampaolo; D'Agostino, Diego; Caputo, Francesca; Cancello, Giuseppe; Montagna, Emilia; Malorni, Luca; Zinno, Luigia; Lauria, Rossella; Bianco, Angelo Raffaele; De Placido, Sabino.

In: Clinical Cancer Research, Vol. 11, No. 13, 01.07.2005, p. 4741-4748.

Research output: Contribution to journalArticle

De Laurentiis, M, Arpino, G, Massarelli, E, Ruggiero, A, Carlomagno, C, Ciardiello, F, Tortora, G, D'Agostino, D, Caputo, F, Cancello, G, Montagna, E, Malorni, L, Zinno, L, Lauria, R, Bianco, AR & De Placido, S 2005, 'A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer', Clinical Cancer Research, vol. 11, no. 13, pp. 4741-4748. https://doi.org/10.1158/1078-0432.CCR-04-2569
De Laurentiis, Michele ; Arpino, Grazia ; Massarelli, Erminia ; Ruggiero, Angela ; Carlomagno, Chiara ; Ciardiello, Fortunato ; Tortora, Giampaolo ; D'Agostino, Diego ; Caputo, Francesca ; Cancello, Giuseppe ; Montagna, Emilia ; Malorni, Luca ; Zinno, Luigia ; Lauria, Rossella ; Bianco, Angelo Raffaele ; De Placido, Sabino. / A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer. In: Clinical Cancer Research. 2005 ; Vol. 11, No. 13. pp. 4741-4748.
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abstract = "Purpose: Experimental data suggest a complex cross-talk between HER-2 and estrogen receptor, and it has been hypothesized that HER-2-positive tumors may be less responsive to certain endocrine treatments. Clinical data, however, have been conflicting. We have conducted a meta-analysis on the interaction between the response to endocrine treatment and the overexpression of HER-2 in metastatic breast cancer. Experimental Design: Studies have been identified by searching the Medline, Embase, and American Society of Clinical Oncology abstract databases. Selection criteria were (a) metastatic breast cancer, (b) endocrine therapy (any line of treatment), and (c) evaluation of HER-2 expression (any method). For each study, the relative risk for treatment failure for HER-2-positive over HER-2-negative patients with 95{\%} confidence interval was calculated as an estimate of the predictive effect of HER-2. Pooled estimates of the relative risk were computed by the Mantel-Haenszel method. Results: Twelve studies (n = 2,379 patients) were included in the meta-analysis. The overall relative risk was 1.42 (95{\%} confidence interval, 1.32-1.52; P <0.00001; test for heterogeneity = 0.380). For studies involving tamoxifen, the pooled relative risk was 1.33 (95{\%} confidence interval, 1.20-1.48; P <0.00001; test for heterogeneity = 0.97); for studies involving other hormonal drugs, a pooled relative risk of 1.49 (95{\%} confidence interval, 1.36-164; P <0.00001; test for heterogeneity = 0.08) was estimated. A second meta-analysis limited to tumors that were either estrogen receptor positive, estrogen receptor unknown, or estrogen receptor negative/progesterone receptor positive yielded comparable results. Conclusions: HER-2-positive metastatic breast cancer is less responsive to any type of endocrine treatment. This effect holds in the subgroup of patients with positive or unknown steroid receptors.",
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T1 - A meta-analysis on the interaction between HER-2 expression and response to endocrine treatment in advanced breast cancer

AU - De Laurentiis, Michele

AU - Arpino, Grazia

AU - Massarelli, Erminia

AU - Ruggiero, Angela

AU - Carlomagno, Chiara

AU - Ciardiello, Fortunato

AU - Tortora, Giampaolo

AU - D'Agostino, Diego

AU - Caputo, Francesca

AU - Cancello, Giuseppe

AU - Montagna, Emilia

AU - Malorni, Luca

AU - Zinno, Luigia

AU - Lauria, Rossella

AU - Bianco, Angelo Raffaele

AU - De Placido, Sabino

PY - 2005/7/1

Y1 - 2005/7/1

N2 - Purpose: Experimental data suggest a complex cross-talk between HER-2 and estrogen receptor, and it has been hypothesized that HER-2-positive tumors may be less responsive to certain endocrine treatments. Clinical data, however, have been conflicting. We have conducted a meta-analysis on the interaction between the response to endocrine treatment and the overexpression of HER-2 in metastatic breast cancer. Experimental Design: Studies have been identified by searching the Medline, Embase, and American Society of Clinical Oncology abstract databases. Selection criteria were (a) metastatic breast cancer, (b) endocrine therapy (any line of treatment), and (c) evaluation of HER-2 expression (any method). For each study, the relative risk for treatment failure for HER-2-positive over HER-2-negative patients with 95% confidence interval was calculated as an estimate of the predictive effect of HER-2. Pooled estimates of the relative risk were computed by the Mantel-Haenszel method. Results: Twelve studies (n = 2,379 patients) were included in the meta-analysis. The overall relative risk was 1.42 (95% confidence interval, 1.32-1.52; P <0.00001; test for heterogeneity = 0.380). For studies involving tamoxifen, the pooled relative risk was 1.33 (95% confidence interval, 1.20-1.48; P <0.00001; test for heterogeneity = 0.97); for studies involving other hormonal drugs, a pooled relative risk of 1.49 (95% confidence interval, 1.36-164; P <0.00001; test for heterogeneity = 0.08) was estimated. A second meta-analysis limited to tumors that were either estrogen receptor positive, estrogen receptor unknown, or estrogen receptor negative/progesterone receptor positive yielded comparable results. Conclusions: HER-2-positive metastatic breast cancer is less responsive to any type of endocrine treatment. This effect holds in the subgroup of patients with positive or unknown steroid receptors.

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