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Open Access 01-10-2014 | Clinical trial

Outcomes of HER2-positive early breast cancer patients in the pre-trastuzumab and trastuzumab eras: a real-world multicenter observational analysis. The RETROHER study

Authors: Patrizia Vici, Laura Pizzuti, Clara Natoli, Luca Moscetti, Lucia Mentuccia, Angela Vaccaro, Domenico Sergi, Luigi Di Lauro, Patrizia Trenta, Patrizia Seminara, Daniele Santini, Laura Iezzi, Nicola Tinari, Ilaria Bertolini, Valentina Sini, Marcella Mottolese, Diana Giannarelli, Francesco Giotta, Marcello Maugeri-Saccà, Maddalena Barba, Paolo Marchetti, Andrea Michelotti, Isabella Sperduti, Teresa Gamucci

Published in: Breast Cancer Research and Treatment | Issue 3/2014

Abstract

Addition of trastuzumab to adjuvant chemotherapy has dramatically reduced the risk of recurrence and has become the standard of care for human epidermal growth factor receptor 2 (HER2)-positive early breast cancer patients. Since most data on trastuzumab benefits come from clinical trials, conducted in selected patient populations, we performed a retrospective analysis of HER2-positive early breast cancer patients treated in the “pre-trastuzumab” and “trastuzumab” eras, with the aim to determine patients' outcomes in real-world practice. 925 consecutive HER2-positive breast cancer patients treated with adjuvant chemotherapy in ten Italian oncologic centers were identified. Patients who had received adjuvant chemotherapy alone (cohort A, 352 patients), and patients who had received adjuvant chemotherapy followed or combined with trastuzumab (cohort B, 573 patients) were analyzed. Relapse rate at 3 years, relapse-free survival, and overall survival were significantly more unfavorable in the cohort A than in the cohort B (p < 0.0001). In multivariate analysis, factors related to relapse were younger age, advanced stage at diagnosis, absence of hormonal and of trastuzumab therapy. The benefit derived from the addition of trastuzumab was independent of nodal status and hormonal receptors expression. A subgroup analysis including 163 “triple positive” tumors with high levels of estrogen and progesterone receptor (TP50) suggested that addition of trastuzumab to adjuvant chemotherapy and hormonal therapy did not translate into better outcomes. In our analysis, trastuzumab benefit was confirmed in all but a small subset of TP50 tumors subgroups. In this subset further investigations are needed.

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Title: Outcomes of HER2-positive early breast cancer patients in the pre-trastuzumab and trastuzumab eras: a real-world multicenter observational analysis. The RETROHER study
Authors: Patrizia Vici
Laura Pizzuti
Clara Natoli
Luca Moscetti
Lucia Mentuccia
Angela Vaccaro
Domenico Sergi
Luigi Di Lauro
Patrizia Trenta
Patrizia Seminara
Daniele Santini
Laura Iezzi
Nicola Tinari
Ilaria Bertolini
Valentina Sini
Marcella Mottolese
Diana Giannarelli
Francesco Giotta
Marcello Maugeri-Saccà
Maddalena Barba
Paolo Marchetti
Andrea Michelotti
Isabella Sperduti
Teresa Gamucci
Publication date: 01-10-2014
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2014
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-014-3133-1

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