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01-08-2017 | Gynecologic Oncology

Trastuzumab and survival of patients with metastatic breast cancer

Authors: Karin Kast, Olaf Schoffer, Theresa Link, Almuth Forberger, Andrea Petzold, Antje Niedostatek, Carmen Werner, Stefanie J. Klug, Andreas Werner, Axel Gatzweiler, Barbara Richter, Gustavo Baretton, Pauline Wimberger

Published in: Archives of Gynecology and Obstetrics | Issue 2/2017

Abstract

Introduction

Prognosis of Her2-positive breast cancer has changed since the introduction of trastuzumab for treatment in metastatic and early breast cancer. It was described to be even better compared to prognosis of Her2-negative metastatic breast cancer. The purpose of this study was to evaluate the effect of trastuzumab in our cohort. Besides the effect of adjuvant pretreatment with trastuzumab on survival of patients with metastatic Her2-positive breast cancer was analyzed.

Methods

All patients with primary breast cancer of the Regional Breast Cancer Center Dresden diagnosed during the years 2001–2013 were analyzed for treatment with or without trastuzumab in the adjuvant and in the metastatic treatment setting using Kaplan–Meier survival estimation and Cox regression. Age and tumor stage at time of first diagnosis of breast cancer as well as hormone receptor status, grading, time, and site of metastasis at first diagnosis of distant metastatic disease were analyzed.

Results

Of 4.481 female patients with primary breast cancer, 643 presented with metastatic disease. Her2-positive status was documented in 465 patients, including 116 patients with primary or secondary metastases. Median survival of patients with Her2-positive primary metastatic disease was 3.0 years (95% CI 2.3–4.0). After adjustment for other factors, survival was better in patients with Her2-positive breast cancer with trastuzumab therapy compared to Her2-negative metastatic disease (HR 2.10; 95% CI 1.58–2.79). Analysis of influence of adjuvant therapy with and without trastuzumab by Kaplan–Meier showed a trend for better survival in not pretreated patients. Median survival was highest in hormone receptor-positive Her2-positive (triple-positive) primary metastatic breast cancer patients with 3.3 years (95% CI 2.3–4.6).

Conclusion

Prognosis of patients with Her2-positive metastatic breast cancer after trastuzumab treatment is more favorable than for Her2-negative breast cancer. The role of adjuvant chemotherapy with or without trastuzumab warrants further research. Survival is best in triple-positive metastatic breast cancer. This will effect counseling at the time of first diagnosis of metastatic breast cancer.

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Title: Trastuzumab and survival of patients with metastatic breast cancer
Authors: Karin Kast
Olaf Schoffer
Theresa Link
Almuth Forberger
Andrea Petzold
Antje Niedostatek
Carmen Werner
Stefanie J. Klug
Andreas Werner
Axel Gatzweiler
Barbara Richter
Gustavo Baretton
Pauline Wimberger
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 2/2017
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-017-4421-x

At a glance: The STEP trials

Springer Medicine

Trastuzumab and survival of patients with metastatic breast cancer

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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