HER2 expression and efficacy of dose-dense anthracycline-containing adjuvant chemotherapy in breast cancer patients

L. Del Mastro, P. Bruzzi, G. Nicolo, G. Cavazzini, A. Contu, M. D'Amico, A. Lavarello, F. Testore, B. Castagneto, E. Aitini, L. Perdelli, C. Bighin, R. Rosso, Marco Venturini

Research output: Contribution to journalArticlepeer-review

Abstract

No data are available on the role of HER2 overexpression in predicting the efficacy of dose-dense anthracycline-containing adjuvant chemotherapy in breast cancer patients. We retrospectively evaluated this role in patients enrolled in a phase III study comparing standard FEC21 (5-fluorouracil, epirubicin, and cyclophosphamide, administered every 3 weeks) vs dose-dense FEC14 (the same regimen repeated every 2 weeks). HER2 status was determined for 731 of 1214 patients. Statistical analyses were performed to test for interaction between treatment and HER2 status with respect to event-free survival (EFS) and overall survival (OS); EFS and OS were compared within each HER2 subgroup and within each treatment arm. Median follow-up was 6.7 years. Among FEC21-treated patients, both EFS (HR = 2.07; 95% CI 1.27-3.38) and OS (HR = 2.47; 95% CI 1.34-4.57) were significantly worse in HER2+ patients than in HER2- patients. Among FEC14-treated patients, differences in either EFS (HR = 1.21; 95% CI 0.65-2.24) or OS (HR = 1.85; 95% CI 0.88-3.89) between HER2+ and HER2- patients were not statistically significant. Interaction analysis suggested that the use of dose-dense FEC14 might remove the negative prognostic effect of HER2 overexpression on EFS and OS. Our data suggest a potential role of HER-2 overexpression in predicting the efficacy of dose-dense epirubicin-containing chemotherapy and the need to confirm this hypothesis in future prospective studies.

Original languageEnglish
Pages (from-to)7-14
Number of pages8
JournalBritish Journal of Cancer
Volume93
Issue number1
DOIs
Publication statusPublished - Jul 11 2005

Keywords

  • Dose density
  • ErbB-2
  • Predictive factors
  • Prognosis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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