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Long-term responders to trastuzumab among patients with HER2-positive metastatic breast cancer.


Sub-category:
HER2+

Category:
Breast Cancer - HER2/ER

Meeting:
2011 ASCO Annual Meeting

Abstract No:
e11062

Citation:
J Clin Oncol 29: 2011 (suppl; abstr e11062)


Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2011 Annual Meeting but not presented at the Meeting, can be found online only.

The publication-only abstracts are not included in the print or USB versions of the ASCO Annual Meeting Proceedings Part I, but they are citable to the Journal of Clinical Oncology as a supplement (see citation on left).

Author(s): J. Barrière, V. Mari, P. Follana, R. Largillier, E. Chamorey, W. Lescaut, B. Flipo, F. Ettore, I. Raoust, I. Peyrottes, A. Figl, M. Marcy, T. Ihrai, A. Courdi, J. Ferrero; Centre Antoine-Lacassagne, Nice, France


Abstract Disclosures


Abstract:

Background: Since its approval in Europe in 2000, trastuzumab (T) has changed HER2-positive metastatic breast cancer (MBC) prognosis. After a durable controlled disease under T based therapy, no data are available about T maintenance duration and long-term potential side effects. The purpose of this retrospective study was to explore the pattern of outcome in a cohort of HER2-positive MBC patients (pts) with no disease progression after 3 years of T in a single institution. Methods: HER2-positive (IHC 3+ or FISH +) MBC women treated with T between 2001 to 2007 were identified from our database. We isolated long-term responders (LTR) defined as pts with a progression free survival (PFS) of more than 3 years under a first metastatic line with T. Results: We identified 124 HER2-positive MBC treated with T. There were 16 LTR (12.9%). Median age was 61.7 years (yrs). Median follow-up was 59.6 months (mths). Primary sites of metastases were bones (n=9), the liver (n=5), lungs (n=3), lymph nodes (n=3) and the skin (n=1). Five pts had 2 metastatic sites but none had more. T was associated with a taxane in first line chemotherapy (CT) in 14 pts and to an aromatase inhibitor (AI) in 2 pts. T maintenance began after a median number of CT cycles of 5 (range: 3-9), associated with AI in 5 cases. Best clinical response was 6 complete responses (CR), 3 partial responses, 5 stable diseases. Two pts had no measurable disease. The median PFS was 48.3 mths (38.4-83.3) with 9 pts (58.8%) who progressed (brain=4, bone=2, adrenal gland=1, lymph node=1, skin =1). The median overall survival was not reached with 3 deaths (3 progressions). Long-term administration of T was well tolerated with only 2 grade I reversible left ventricular dysfunction. One pt with initial bone metastases in CR stopped T after 7.5 years with no relapse after 2 yrs of follow-up. One pt in CR after 7 yrs of T has shown no will to stop by fear of progression. Conclusions: T should not be stopped after 3 years of durable response because late progression can occur, in particular in the brain. The question of T maintenance after a 5-year durable response is unsolved and may be a major source of anxiety among LTR if proposed. Regular brain imaging should be considered, even among LTR.