Abstract
Purpose: Trastuzumab and chemotherapy is the current standard of care in HER2+ early or locally advanced breast cancer, but there are scanty literature data of its real world effectiveness. Methods: We retrospectively reviewed 205 patients with HER2+ breast cancer diagnosed in 10 Italian Medical Oncology Units between July 2003 and October 2011. All patients received neoadjuvant systemic therapy (NST) with trastuzumab in association with chemotherapy. Many different chemotherapy regimens were used, even if 90 % of patients received schemes including anthracyclines and 99 % received taxanes. NST was administered for more than 21 weeks (median: 24) in 130/205 (63.4 %) patients, while trastuzumab was given for more than 12 weeks (median: 12 weeks) in 101/205 (49.3 %) patients. pCR/0 was defined as ypT0+ypN0, and pCR/is as ypT0/is+ypN0. Results: pCR/0 was obtained in 24.8 % and pCR/is in 46.8 % of the patients. At multivariate logistic regression, nonluminal/HER2+ tumors (P <0.0001) and more than 12 weeks of neoadjuvant trastuzumab treatment (P = 0.03) were independent predictors of pCR/0. Median disease-free survival (DFS) and cancer-specific survival (CSS) have not been reached at the time of analysis. At multivariate analysis, nonluminal/HER2+ subclass (DFS: P = 0.01 and CSS: P = 0.01) and pathological stage II-III at surgery (DFS: P <0.0001 and CSS: P = 0.001) were the only variables significantly associated with a worse long-term outcome. Conclusions: Our data set the relevance of molecular subclasses and residual tumor burden after neoadjuvant as the most relevant prognostic factors for survival in this cohort of patients.
| Original language | English |
|---|---|
| Pages (from-to) | 1229-1240 |
| Number of pages | 12 |
| Journal | Journal of Cancer Research and Clinical Oncology |
| Volume | 139 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 2013 |
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Keywords
- Breast cancer
- HER2
- Neoadjuvant
- Pathological complete response
- Survival
- Trastuzumab
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Effectiveness of neoadjuvant trastuzumab and chemotherapy in HER2-overexpressing breast cancer. / Natoli, Clara; Vici, Patrizia; Sperduti, Isabella; Grassadonia, Antonino; Bisagni, Giancarlo; Tinari, Nicola; Michelotti, Andrea; Zampa, Germano; Gori, Stefania; Moscetti, Luca; De Tursi, Michele; Panebianco, Michele; Mauri, Maria; Ferrarini, Ilaria; Pizzuti, Laura; Ficorella, Corrado; Samaritani, Riccardo; Mentuccia, Lucia; Iacobelli, Stefano; Gamucci, Teresa.
In: Journal of Cancer Research and Clinical Oncology, Vol. 139, No. 7, 07.2013, p. 1229-1240.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effectiveness of neoadjuvant trastuzumab and chemotherapy in HER2-overexpressing breast cancer
AU - Natoli, Clara
AU - Vici, Patrizia
AU - Sperduti, Isabella
AU - Grassadonia, Antonino
AU - Bisagni, Giancarlo
AU - Tinari, Nicola
AU - Michelotti, Andrea
AU - Zampa, Germano
AU - Gori, Stefania
AU - Moscetti, Luca
AU - De Tursi, Michele
AU - Panebianco, Michele
AU - Mauri, Maria
AU - Ferrarini, Ilaria
AU - Pizzuti, Laura
AU - Ficorella, Corrado
AU - Samaritani, Riccardo
AU - Mentuccia, Lucia
AU - Iacobelli, Stefano
AU - Gamucci, Teresa
PY - 2013/7
Y1 - 2013/7
N2 - Purpose: Trastuzumab and chemotherapy is the current standard of care in HER2+ early or locally advanced breast cancer, but there are scanty literature data of its real world effectiveness. Methods: We retrospectively reviewed 205 patients with HER2+ breast cancer diagnosed in 10 Italian Medical Oncology Units between July 2003 and October 2011. All patients received neoadjuvant systemic therapy (NST) with trastuzumab in association with chemotherapy. Many different chemotherapy regimens were used, even if 90 % of patients received schemes including anthracyclines and 99 % received taxanes. NST was administered for more than 21 weeks (median: 24) in 130/205 (63.4 %) patients, while trastuzumab was given for more than 12 weeks (median: 12 weeks) in 101/205 (49.3 %) patients. pCR/0 was defined as ypT0+ypN0, and pCR/is as ypT0/is+ypN0. Results: pCR/0 was obtained in 24.8 % and pCR/is in 46.8 % of the patients. At multivariate logistic regression, nonluminal/HER2+ tumors (P <0.0001) and more than 12 weeks of neoadjuvant trastuzumab treatment (P = 0.03) were independent predictors of pCR/0. Median disease-free survival (DFS) and cancer-specific survival (CSS) have not been reached at the time of analysis. At multivariate analysis, nonluminal/HER2+ subclass (DFS: P = 0.01 and CSS: P = 0.01) and pathological stage II-III at surgery (DFS: P <0.0001 and CSS: P = 0.001) were the only variables significantly associated with a worse long-term outcome. Conclusions: Our data set the relevance of molecular subclasses and residual tumor burden after neoadjuvant as the most relevant prognostic factors for survival in this cohort of patients.
AB - Purpose: Trastuzumab and chemotherapy is the current standard of care in HER2+ early or locally advanced breast cancer, but there are scanty literature data of its real world effectiveness. Methods: We retrospectively reviewed 205 patients with HER2+ breast cancer diagnosed in 10 Italian Medical Oncology Units between July 2003 and October 2011. All patients received neoadjuvant systemic therapy (NST) with trastuzumab in association with chemotherapy. Many different chemotherapy regimens were used, even if 90 % of patients received schemes including anthracyclines and 99 % received taxanes. NST was administered for more than 21 weeks (median: 24) in 130/205 (63.4 %) patients, while trastuzumab was given for more than 12 weeks (median: 12 weeks) in 101/205 (49.3 %) patients. pCR/0 was defined as ypT0+ypN0, and pCR/is as ypT0/is+ypN0. Results: pCR/0 was obtained in 24.8 % and pCR/is in 46.8 % of the patients. At multivariate logistic regression, nonluminal/HER2+ tumors (P <0.0001) and more than 12 weeks of neoadjuvant trastuzumab treatment (P = 0.03) were independent predictors of pCR/0. Median disease-free survival (DFS) and cancer-specific survival (CSS) have not been reached at the time of analysis. At multivariate analysis, nonluminal/HER2+ subclass (DFS: P = 0.01 and CSS: P = 0.01) and pathological stage II-III at surgery (DFS: P <0.0001 and CSS: P = 0.001) were the only variables significantly associated with a worse long-term outcome. Conclusions: Our data set the relevance of molecular subclasses and residual tumor burden after neoadjuvant as the most relevant prognostic factors for survival in this cohort of patients.
KW - Breast cancer
KW - HER2
KW - Neoadjuvant
KW - Pathological complete response
KW - Survival
KW - Trastuzumab
UR - http://www.scopus.com/inward/record.url?scp=84879217353&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879217353&partnerID=8YFLogxK
U2 - 10.1007/s00432-013-1436-y
DO - 10.1007/s00432-013-1436-y
M3 - Article
C2 - 23604446
AN - SCOPUS:84879217353
VL - 139
SP - 1229
EP - 1240
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
SN - 0171-5216
IS - 7
ER -