"Triple positive" early breast cancer

An observational multicenter retrospective analysis of outcome

Patrizia Vici, Laura Pizzuti, Isabella Sperduti, Antonio Frassoldati, Clara Natoli, Teresa Gamucci, Silverio Tomao, Andrea Michelotti, Luca Moscetti, Stefania Gori, Editta Baldini, Francesco Giotta, Alessandra Cassano, Daniele Santini, Diana Giannarelli, Luigi Di Lauro, Domenico Cristiano Corsi, Paolo Marchetti, Valentina Sini, Domenico Sergi & 13 others Maddalena Barba, Marcello Maugeri-Saccà, Michelangelo Russillo, Lucia Mentuccia, Loretta D'Onofrio, Laura Iezzi, Angelo Fedele Scinto, Lucia Da Ros, Ilaria Bertolini, Maria Luisa Basile, Valentina Rossi, Ruggero De Maria, Filippo Montemurro

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

We recently found that trastuzumab benefit may be lower in a small subset of early breast cancer (BC) patients (pts) with tumors expressing high levels of both hormonal receptors (HRs), i.e. triple positive (TP). To better investigate the role of HRs in HER2 positive BC, we retrospectively identified 872 TP BC pts treated with adjuvant chemotherapy alone (cohort A-366 pts), or plus trastuzumab (cohort B-506 pts). Relapse-free-survival (RFS) and breast-cancer-specific-survival (BCSS) were evaluated. Trastuzumab improved RFS and BCSS in all the subsets analyzed, but the effect on BCSS in tumors expressing both HRs in >30% of cells (TP30), and even on RFS in tumors with both HRs expressed in >50% of cells (TP50) was not significant. Distinct patterns of relapse were observed in TP50 and no-TP50 tumors, the former showing low and constant risk in the first 5 years, a late increase beyond 5 years and modest trastuzumab effect. Trastuzumab effect tended to disappear in pts whose tumors expressed ER in >50% of cells. Multivariate analysis of RFS confirmed a significant interaction between trastuzumab and ER expression, with benefit confined to pts whose tumors expressed ER in ≤50% of cells. Our data suggest that the pattern of relapse of TP tumors with high HRs is similar to that of "luminal", HER2 negative tumors, without clear benefit from adjuvant trastuzumab, which remains the standard treatment even in TP tumors. Confirmatory findings on the extent to which quantitative expression of HRs may impact clinical behavior of HER2 positive BC are warranted.

Original languageEnglish
Pages (from-to)17932-17944
Number of pages13
JournalOncotarget
Volume7
Issue number14
DOIs
Publication statusPublished - 2016

Fingerprint

Breast Neoplasms
Survival
Recurrence
Neoplasms
Adjuvant Chemotherapy
Trastuzumab
Multivariate Analysis

Keywords

  • Adjuvant breast cancer
  • Chemotherapy
  • Hormonal receptors
  • Trastuzumab
  • Triple positive

ASJC Scopus subject areas

  • Oncology

Cite this

Vici, P., Pizzuti, L., Sperduti, I., Frassoldati, A., Natoli, C., Gamucci, T., ... Montemurro, F. (2016). "Triple positive" early breast cancer: An observational multicenter retrospective analysis of outcome. Oncotarget, 7(14), 17932-17944. https://doi.org/10.18632/oncotarget.7480

"Triple positive" early breast cancer : An observational multicenter retrospective analysis of outcome. / Vici, Patrizia; Pizzuti, Laura; Sperduti, Isabella; Frassoldati, Antonio; Natoli, Clara; Gamucci, Teresa; Tomao, Silverio; Michelotti, Andrea; Moscetti, Luca; Gori, Stefania; Baldini, Editta; Giotta, Francesco; Cassano, Alessandra; Santini, Daniele; Giannarelli, Diana; Di Lauro, Luigi; Corsi, Domenico Cristiano; Marchetti, Paolo; Sini, Valentina; Sergi, Domenico; Barba, Maddalena; Maugeri-Saccà, Marcello; Russillo, Michelangelo; Mentuccia, Lucia; D'Onofrio, Loretta; Iezzi, Laura; Scinto, Angelo Fedele; Da Ros, Lucia; Bertolini, Ilaria; Basile, Maria Luisa; Rossi, Valentina; De Maria, Ruggero; Montemurro, Filippo.

In: Oncotarget, Vol. 7, No. 14, 2016, p. 17932-17944.

Research output: Contribution to journalArticle

Vici, P, Pizzuti, L, Sperduti, I, Frassoldati, A, Natoli, C, Gamucci, T, Tomao, S, Michelotti, A, Moscetti, L, Gori, S, Baldini, E, Giotta, F, Cassano, A, Santini, D, Giannarelli, D, Di Lauro, L, Corsi, DC, Marchetti, P, Sini, V, Sergi, D, Barba, M, Maugeri-Saccà, M, Russillo, M, Mentuccia, L, D'Onofrio, L, Iezzi, L, Scinto, AF, Da Ros, L, Bertolini, I, Basile, ML, Rossi, V, De Maria, R & Montemurro, F 2016, '"Triple positive" early breast cancer: An observational multicenter retrospective analysis of outcome', Oncotarget, vol. 7, no. 14, pp. 17932-17944. https://doi.org/10.18632/oncotarget.7480
Vici, Patrizia ; Pizzuti, Laura ; Sperduti, Isabella ; Frassoldati, Antonio ; Natoli, Clara ; Gamucci, Teresa ; Tomao, Silverio ; Michelotti, Andrea ; Moscetti, Luca ; Gori, Stefania ; Baldini, Editta ; Giotta, Francesco ; Cassano, Alessandra ; Santini, Daniele ; Giannarelli, Diana ; Di Lauro, Luigi ; Corsi, Domenico Cristiano ; Marchetti, Paolo ; Sini, Valentina ; Sergi, Domenico ; Barba, Maddalena ; Maugeri-Saccà, Marcello ; Russillo, Michelangelo ; Mentuccia, Lucia ; D'Onofrio, Loretta ; Iezzi, Laura ; Scinto, Angelo Fedele ; Da Ros, Lucia ; Bertolini, Ilaria ; Basile, Maria Luisa ; Rossi, Valentina ; De Maria, Ruggero ; Montemurro, Filippo. / "Triple positive" early breast cancer : An observational multicenter retrospective analysis of outcome. In: Oncotarget. 2016 ; Vol. 7, No. 14. pp. 17932-17944.
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