Hormone-receptor expression and activity of trastuzumab with chemotherapy in HER2-positive advanced breast cancer patients

Filippo Montemurro, Valentina Rossi, Maria Cossu Rocca, Rossella Martinello, Elena Verri, Stefania Redana, Laura Adamoli, Giorgio Valabrega, Anna Sapino, Massimo Aglietta, Giuseppe Viale, Aron Goldhirsch, Franco Nolè

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The relationship between quantitative immunohistochemical hormone receptor expression and response to the combination of trastuzumab with chemotherapy in HER2-positive advanced breast cancer is currently unknown. METHODS: Estrogen receptor (ER) and progesterone receptor expression was studied both as a dichotomous variable (positivity set at ≥1% of positive cells) and as a continuous variable. The effect of hormone receptor expression on overall response rate and progression-free survival in patients receiving trastuzumab-based treatment was studied by univariate and multivariate analysis. RESULTS: One hundred eleven of 227 consecutive advanced breast cancer patients treated at 2 Institutions had hormone receptor-positive tumors (49%). High expression of ER (≥30% of tumor cells) predicted reduced probability of tumor response to trastuzumab plus chemotherapy (multivariate odds ratio, 0.422; 95% confidence interval [CI], 0.222-0.803; P =.009). In patients with hormone receptor-positive tumors (≥1% of tumor cells), maintenance endocrine therapy added to trastuzumab upon the completion of chemotherapy was associated with a significant progression-free survival benefit (hazard ratio, 0.521; 95% CI, 0.3325-0.836; P =.007). CONCLUSIONS: Our results suggest a predictive role of hormone receptor expression in HER2-positive tumors. Further investigation in this patient subset is warranted to optimize the use of HER2-targeting agents, chemotherapy, and endocrine therapy.

Original languageEnglish
Pages (from-to)17-26
Number of pages10
JournalCancer
Volume118
Issue number1
DOIs
Publication statusPublished - Jan 1 2012

Keywords

  • breast neoplasms
  • chemotherapy
  • endocrine therapy
  • estrogen receptor
  • HER2
  • trastuzumab

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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