TY - JOUR
T1 - Outcome of patients with HER2-positive advanced breast cancer progressing during trastuzumab-based therapy
AU - Montemurro, Filippo
AU - Donadio, Michela
AU - Clavarezza, Matteo
AU - Redana, Stefania
AU - Jacomuzzi, Maria Elena
AU - Valabrega, Giorgio
AU - Danese, Saverio
AU - Vietti-Ramus, Guido
AU - Durando, Antonio
AU - Venturini, Marco
AU - Aglietta, Massimo
PY - 2006/4
Y1 - 2006/4
N2 - We sought to describe patterns of treatment and clinical outcome in patients with HER2-positive advanced breast cancer progressing on trastuzumab-based therapy. One hundred eighty-four consecutive HER2-positive advanced breast cancer patients received trastuzumab-based therapy between September 1999 and September 2004. Patients were followed up until death or May 2005. For patients progressing on trastuzumab-based therapy, we calculated the response rate (RR) to the first post-progression treatment, overall survival (OS) from the first administration of trastuzumab, time to second progression (TT-SP), and post-progression survival (PPS), according to treatment. At the time of this analysis, 132 patients had progressed on trastuzumab-based therapy, and 89 had died. Of the progressing patients, 21 experienced rapid progression and could not receive additional anticancer treatments; 40 patients continued trastuzumab either alone (12 patients with isolated central nervous system progression), with chemotherapy (23 patients), or with endocrine therapy (5 patients); and 71 stopped trastuzumab and received chemotherapy (61 patients) or endocrine therapy (10 patients) as the first post-progression treatment. Excluding patients with rapid progression, clinical outcomes were similar whether trastuzumab was continued or not, in terms of RR (18% and 27%, respectively), OS (31 and 30 months, respectively), TT-SP (6 and 7 months, respectively), and PPS (21 and 19 months, respectively). The clinical outcome of patients with HER2-positive advanced breast cancer progressing during trastuzumab-based therapy might not be influenced by continuing trastuzumab. The optimal therapeutic strategy in this setting of patients needs evaluation in randomized trials.
AB - We sought to describe patterns of treatment and clinical outcome in patients with HER2-positive advanced breast cancer progressing on trastuzumab-based therapy. One hundred eighty-four consecutive HER2-positive advanced breast cancer patients received trastuzumab-based therapy between September 1999 and September 2004. Patients were followed up until death or May 2005. For patients progressing on trastuzumab-based therapy, we calculated the response rate (RR) to the first post-progression treatment, overall survival (OS) from the first administration of trastuzumab, time to second progression (TT-SP), and post-progression survival (PPS), according to treatment. At the time of this analysis, 132 patients had progressed on trastuzumab-based therapy, and 89 had died. Of the progressing patients, 21 experienced rapid progression and could not receive additional anticancer treatments; 40 patients continued trastuzumab either alone (12 patients with isolated central nervous system progression), with chemotherapy (23 patients), or with endocrine therapy (5 patients); and 71 stopped trastuzumab and received chemotherapy (61 patients) or endocrine therapy (10 patients) as the first post-progression treatment. Excluding patients with rapid progression, clinical outcomes were similar whether trastuzumab was continued or not, in terms of RR (18% and 27%, respectively), OS (31 and 30 months, respectively), TT-SP (6 and 7 months, respectively), and PPS (21 and 19 months, respectively). The clinical outcome of patients with HER2-positive advanced breast cancer progressing during trastuzumab-based therapy might not be influenced by continuing trastuzumab. The optimal therapeutic strategy in this setting of patients needs evaluation in randomized trials.
KW - HER2
KW - Metastatic breast cancer
KW - Survival
KW - Time to progression
KW - Trastuzumab
KW - Tumor progression
UR - http://www.scopus.com/inward/record.url?scp=33645792831&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33645792831&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.11-4-318
DO - 10.1634/theoncologist.11-4-318
M3 - Article
C2 - 16614227
AN - SCOPUS:33645792831
VL - 11
SP - 318
EP - 324
JO - Oncologist
JF - Oncologist
SN - 1083-7159
IS - 4
ER -