Magnitude of trastuzumab benefit in patients with HER2-positive, invasive lobular breast carcinoma: results from the HERA trial.

Otto Metzger-Filho, Marion Procter, Evandro de Azambuja, Brian Leyland-Jones, Richard D. Gelber, Mitchell Dowsett, Sherene Loi, Kamal S. Saini, David Cameron, Michael Untch, Ian Smith, Luca Gianni, Jose Baselga, Christian Jackisch, Richard Bell, Christos Sotiriou, Giuseppe Viale, Martine Piccart-Gebhart

Research output: Contribution to journalArticle

Abstract

To evaluate the benefit of adjuvant trastuzumab in patients diagnosed with human epidermal growth factor receptor 2 (HER2) -positive invasive lobular carcinoma (ILC) enrolled onto the Herceptin Adjuvant (HERA) trial. Patients randomly assigned to receive one year of trastuzumab and one year of observation in the HERA trial were included (n = 3,401). Centrally reviewed estrogen receptor (ER), progesterone receptor (PgR), and HER2 copy numbers were used. First site-specific relapse pattern was evaluated for ILC and invasive ductal carcinoma (IDC). The magnitude of trastuzumab benefit was assessed using the Cox proportional hazards model for disease-free survival (DFS) and overall survival (OS). Median follow-up time was 4 years. A total of 187 ILC and 3,213 IDC patients were included. High Allred scores (6 to 8) were more common in patients with ILC than IDC for both ER (36.9% v 22.7%) and PgR (44.1% v 28.5%). A trend toward decreased HER2 copy number was observed in the ILC group. The ILC and IDC subgroups had similar patterns of first site of disease relapse. DFS hazard ratios (HRs) comparing 1 year of trastuzumab versus observation were 0.63 for ILC (95% CI, 0.34 to 1.15) and 0.77 for IDC (95% CI, 0.67 to 0.89; P for interaction = .49). The OS HRs comparing 1 year of trastuzumab versus observation were 0.60 for ILC (95% CI, 0.27 to 1.31) and 0.86 for IDC (95% CI, 0.71 to 1.06; P for interaction = .29). In this retrospective analysis, there was no suggestion that patients in the ILC cohort experienced a different magnitude of benefit from adjuvant trastuzumab than those in the IDC cohort.

Original languageEnglish
Pages (from-to)1954-1960
Number of pages7
JournalJournal of Clinical Oncology
Volume31
Issue number16
DOIs
Publication statusPublished - Jun 1 2013

ASJC Scopus subject areas

  • Medicine(all)

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    Metzger-Filho, O., Procter, M., de Azambuja, E., Leyland-Jones, B., Gelber, R. D., Dowsett, M., Loi, S., Saini, K. S., Cameron, D., Untch, M., Smith, I., Gianni, L., Baselga, J., Jackisch, C., Bell, R., Sotiriou, C., Viale, G., & Piccart-Gebhart, M. (2013). Magnitude of trastuzumab benefit in patients with HER2-positive, invasive lobular breast carcinoma: results from the HERA trial. Journal of Clinical Oncology, 31(16), 1954-1960. https://doi.org/10.1200/JCO.2012.46.2440