Autoimmunity and benefit from trastuzumab treatment in breast cancer: Results from the HERA trial

Amir Sonnenblick, Andrew Bailey, Beatrice Uziely, Michael Untch, Ian Smith, Luca Gianni, Jose Baselga, Christian Jackisch, David Cameron, Richard Bell, Dimitrios Zardavas, Nedal Al-Sakaff, Richard D. Gelber, Mitch Dowsett, Brian Leyland-Jones, Martine J. Piccart-Gebhart, Evandro D.E. Azambuja

Research output: Contribution to journalArticlepeer-review


Background/Aim: This study sought to determine whether an autoimmune background could identify patients with HER2-positive early breast cancer (EBC) who derive differential benefit from primary adjuvant trastuzumab-based therapy. Patients and Methods: HERA is an international randomized trial of 5,102 women with HER2-positive EBC, who were enrolled to either receive adjuvant trastuzumab or not. In this exploratory analysis, the interaction between autoimmune history and the magnitude of trastuzumab benefit was evaluated. Results: A total of 5,099 patients were included in the current analysis. Among them, 325 patients (6.4%) had autoimmune disease history, 295 of whom had active disease. Patients were randomly assigned to trastuzumab or no-trastuzumab groups. Similar reductions in the risk of events in patients with and without autoimmune history were observed (interaction p=0.95 for disease-free survival, and p=0.62 for overall survival). Conclusion: No evidence of a differential benefit from trastuzumab in patients with a medical history of autoimmune disease was found.

Original languageEnglish
Pages (from-to)797-802
Number of pages6
JournalAnticancer Research
Issue number2
Publication statusPublished - Feb 2019


  • Autoimmunity
  • Breast cancer
  • HER2
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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