Abstract
Although outcomes for women with breast cancers may vary by biologic subtype, patients with T1a,b N0M0 tumors have an excellent prognosis across all subgroups. HER2 overexpression occurs in 15-20% of primary breast tumors, and is associated with diminished disease-free and overall survival. The anti-HER2 monoclonal antibody trastuzumab in combination with chemotherapy is an effective treatment for all stages of HER2 positive breast cancer (bc). However, the absolute benefit decreases as the risk of recurrence lessens and no available randomized adjuvant trial has evaluated the role of trastuzumab in women with pT1a,b N0M0, HER2-positive breast tumors. These findings may explain the debate about the appropriate indication for adjuvant chemotherapy plus trastuzumab in this setting of patients. The aim of this review was to describe known and novel prognostic risk factors to be used for tailored treatment decision in pT1a,b N0M0 HER2-positive tumors. Whether patients with small HER2-positive bc may be suitable for (chemo)therapy reduction strategies, the current available data cannot exclude the need for a more aggressive treatment in a small subset of these subjects. Novel clinical prognostic factors such as interval cancer (IC) detection may help to address this clinically important controversy. A multicenter population-based cancer registry study is currently evaluating whether IC detection may identify patients with pT1a N0M0 HER2-positive tumors in whom the rate of recurrence justifies consideration for use of conventional, trastuzumab-based chemotherapy regimens.
| Original language | English |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | Cancer Treatment Reviews |
| Volume | 43 |
| DOIs | |
| Publication status | Published - 2016 |
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Keywords
- Breast cancer
- HER2-positive
- Interval cancer risk
- Prognostic factors
- PT1a,b
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
Cite this
Prognostic risk factors for treatment decision in pT1a,b N0M0 HER2-positive breast cancers. / Musolino, Antonino; Boggiani, Daniela; Sikokis, Angelica; Rimanti, Anita; Pellegrino, Benedetta; Vattiato, Rosa; Sgargi, Paolo; Falcini, Fabio; Caminiti, Caterina; Michiara, Maria; Leonardi, Francesco.
In: Cancer Treatment Reviews, Vol. 43, 2016, p. 1-7.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic risk factors for treatment decision in pT1a,b N0M0 HER2-positive breast cancers
AU - Musolino, Antonino
AU - Boggiani, Daniela
AU - Sikokis, Angelica
AU - Rimanti, Anita
AU - Pellegrino, Benedetta
AU - Vattiato, Rosa
AU - Sgargi, Paolo
AU - Falcini, Fabio
AU - Caminiti, Caterina
AU - Michiara, Maria
AU - Leonardi, Francesco
PY - 2016
Y1 - 2016
N2 - Although outcomes for women with breast cancers may vary by biologic subtype, patients with T1a,b N0M0 tumors have an excellent prognosis across all subgroups. HER2 overexpression occurs in 15-20% of primary breast tumors, and is associated with diminished disease-free and overall survival. The anti-HER2 monoclonal antibody trastuzumab in combination with chemotherapy is an effective treatment for all stages of HER2 positive breast cancer (bc). However, the absolute benefit decreases as the risk of recurrence lessens and no available randomized adjuvant trial has evaluated the role of trastuzumab in women with pT1a,b N0M0, HER2-positive breast tumors. These findings may explain the debate about the appropriate indication for adjuvant chemotherapy plus trastuzumab in this setting of patients. The aim of this review was to describe known and novel prognostic risk factors to be used for tailored treatment decision in pT1a,b N0M0 HER2-positive tumors. Whether patients with small HER2-positive bc may be suitable for (chemo)therapy reduction strategies, the current available data cannot exclude the need for a more aggressive treatment in a small subset of these subjects. Novel clinical prognostic factors such as interval cancer (IC) detection may help to address this clinically important controversy. A multicenter population-based cancer registry study is currently evaluating whether IC detection may identify patients with pT1a N0M0 HER2-positive tumors in whom the rate of recurrence justifies consideration for use of conventional, trastuzumab-based chemotherapy regimens.
AB - Although outcomes for women with breast cancers may vary by biologic subtype, patients with T1a,b N0M0 tumors have an excellent prognosis across all subgroups. HER2 overexpression occurs in 15-20% of primary breast tumors, and is associated with diminished disease-free and overall survival. The anti-HER2 monoclonal antibody trastuzumab in combination with chemotherapy is an effective treatment for all stages of HER2 positive breast cancer (bc). However, the absolute benefit decreases as the risk of recurrence lessens and no available randomized adjuvant trial has evaluated the role of trastuzumab in women with pT1a,b N0M0, HER2-positive breast tumors. These findings may explain the debate about the appropriate indication for adjuvant chemotherapy plus trastuzumab in this setting of patients. The aim of this review was to describe known and novel prognostic risk factors to be used for tailored treatment decision in pT1a,b N0M0 HER2-positive tumors. Whether patients with small HER2-positive bc may be suitable for (chemo)therapy reduction strategies, the current available data cannot exclude the need for a more aggressive treatment in a small subset of these subjects. Novel clinical prognostic factors such as interval cancer (IC) detection may help to address this clinically important controversy. A multicenter population-based cancer registry study is currently evaluating whether IC detection may identify patients with pT1a N0M0 HER2-positive tumors in whom the rate of recurrence justifies consideration for use of conventional, trastuzumab-based chemotherapy regimens.
KW - Breast cancer
KW - HER2-positive
KW - Interval cancer risk
KW - Prognostic factors
KW - PT1a,b
UR - http://www.scopus.com/inward/record.url?scp=84962033872&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84962033872&partnerID=8YFLogxK
U2 - 10.1016/j.ctrv.2015.11.010
DO - 10.1016/j.ctrv.2015.11.010
M3 - Article
C2 - 26827687
AN - SCOPUS:84962033872
VL - 43
SP - 1
EP - 7
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
SN - 0305-7372
ER -