breast cancer
LRR= loco-regional recurrence rate, DMFS= distal metastasis free survival, OS= overall survival
Follow-up still shorter for those getting herceptin, so must wait for 4,5,6 year results to be sure herceptin did not just delay recurrence. Will try to read and check if all got chemo concurrently with herceptin
Alaska Angel, Jean, and others:
Cancer. 2011 Jun 16. doi: 10.1002/cncr.26171. [Epub ahead of print]
Adjuvant trastuzumab with chemotherapy is effective in women with small, node-negative, HER2-positive breast cancer.
McArthur HL, Mahoney KM, Morris PG, Patil S, Jacks LM, Howard J, Norton L, Hudis CA.
Source
Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
mcarthuh@mskcc.org.
Abstract
BACKGROUND:
Several large, randomized trials established the benefits of adjuvant trastuzumab with chemotherapy. However, the benefit for women with small, node-negative HER2-positive (HER2+) disease is unknown, as these patients were largely excluded from these trials. Therefore, a retrospective, single-institution, sequential cohort study of women with small, node-negative, HER2+ breast cancer who did or did not receive adjuvant trastuzumab was conducted.
METHODS:
Women with ≤2 cm, node-negative, HER2+ (immunohistochemistry 3+ or fluorescence in situ hybridization ≥2) breast cancer were identified through an institutional database. A "no-trastuzumab" cohort of 106 trastuzumab-untreated women diagnosed between January 1, 2002 and May 14, 2004 and a "trastuzumab" cohort of 155 trastuzumab-treated women diagnosed between May 16, 2005 and December 31, 2008 were described. Survival and recurrence outcomes were estimated by Kaplan-Meier methods.
RESULTS:
The cohorts were similar in age, median tumor size, histology, hormone receptor status, hormone therapy, and locoregional therapy. Chemotherapy was administered in 66% and 100% of the "no trastuzumab" and "trastuzumab" cohorts, respectively. The median recurrence-free and survival follow-up was: 6.5 years (0.7-8.5) and 6.8 years (0.7-8.5), respectively, for the "no trastuzumab" cohort and 3.0 years (0.5-5.2) and 3.0 years (0.6-5.2), respectively, for the "trastuzumab" cohort. The 3-year locoregional invasive recurrence-free, distant recurrence-free, invasive disease-free, and overall survival were 92% versus 98% (P = .0137), 95% versus 100% (P = .0072), 82% versus 97% (P < .0001), and 97% versus 99% (P = .18) for the "no trastuzumab" and "trastuzumab" cohorts, respectively.
CONCLUSIONS:
Women with small, node-negative, HER2+ primary breast cancers likely derive significant benefit from adjuvant trastuzumab with chemotherapy. Cancer 2011;. © 2011 American Cancer Society.
Copyright © 2011 American Cancer Society.
PMID: 21681735 [PubMed - as supplied by publisher]
Concluding comment in the article:
Although we lack, and are unlikely to ever obtain, randomized data addressing the role of trastuzumab in women with small, node-negative, HER2þ primary inva- sive breast cancers, our study suggests that these women have excellent outcomes after adjuvant chemotherapy with trastuzumab compared with a similar population of trastuzumab-untreated women. The critical issue is that approximately 10% of the approximately 200,000 new cases of invasive breast cancer anticipated in the United States in 201116 will be otherwise low risk but HER2þ is associated with an estimated 20% 5-year recurrence risk.3-5 Therefore, if our results are correct, broad use of trastuzumab with chemotherapy in this under- studied population would have an important public health impact. Our data support consideration of adjuvant trastuzumab-chemotherapy for women with small, node-negative, HER2 positive breast cancer.
Linear Mode
