average survival after dx of Stage IV stats improved since herceptin in use

[Lani]

Many of those on this forum have survived far longer --I think these stats are continuing to improve and the literature will take a while to catch up with the new numbers--this study only looked at those with Stage IV treated up to 2005

Predictors of survival in patients with HER2+ metastatic breast cancer (MBC) treated with trastuzumab.


Sub-category:
HER2+

Category:
Breast Cancer - HER2/ER

Meeting:
2011 ASCO Annual Meeting

Abstract No:
e11100

Citation:
J Clin Oncol 29: 2011 (suppl; abstr e11100)


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): E. M. Olson, J. S. Najita, J. Sohl, A. Arnaout, E. P. Winer, N. U. Lin; Dana-Farber Cancer Institute, Boston, MA


Abstract Disclosures


Abstract:

Background: Trastuzumab (T) is associated with improvements in overall survival (OS) among patients (pts) with HER2+ MBC; however disease course in individual pts is highly variable. We aimed to identify predictors of OS in pts with HER2+ MBC who were treated with a T-based regimen. Methods: Using pharmacy records, 113 HER2+ pts diagnosed with MBC from January 1999 to May 2005 who received T-based therapy at Dana-Farber Cancer Institute were retrospectively identified to allow for a minimum of 5 years (yrs) of follow up. Median OS and 95% CI were determined using Kaplan-Meier methods; group comparisons utilized the log-rank test. Hazard ratios (HR) were obtained using a Cox proportional hazards model adjusting for age at recurrence, era of first line therapy, hormone receptor status and disease-free interval (DFI). Results: Median follow up was 6.7 yrs (range 0.7-20.8) from diagnosis of primary breast cancer. Median number of metastatic T-based regimens was 3 (range 1-12). Median OS was 3.5 yrs (95% CI 3.0-4.4). On univariate analysis, median OS was worse in pts with a DFI < 2 yrs (3.0 yrs, CI 1.6-3.9) compared to ≥ 2 yrs (4.4 yrs, CI 3.1-5.5; p=0.03); and in pts with ≥ 2 metastatic sites (2.6 yrs, CI 2.0-3.3) vs. pts with only 1 site (4.1 yrs, CI 3.2-6.0; p=0.01). CNS disease at first recurrence was associated with a shorter OS compared with liver and/or lung mets or other sites (CNS: 1.9 yrs CI 0.1-5.9, liver/lung: 3.2 yrs CI 2.5-4.2, other: 4.6 yrs CI 2.7-8.0; p=0.05). CNS mets developed in 62 (55%) pts by the time of death or last follow up; of the pts alive at 1, 3 and 5 yrs, CNS disease was present in 20%, 39%, and 41% of pts respectively. To explore a potential selection bias, we evaluated a subset of 56 pts diagnosed with primary breast cancer ≥ 1999 (i.e. after the adoption of routine HER2 testing); CNS mets at first recurrence in these pts predicted for worse median OS compared to other sites (CNS: 1.1 yrs CI 0.1-2.7, liver/lung: 2.1 yrs CI 1.3-3.5, other: 4.4 yrs CI 0.5-6.3; p=0.004) with a HR 6.3 (CI 1.2-33.0; p=0.03). Conclusions: The natural history of HER2+ MBC has evolved with T-based therapy, with median OS now exceeding 3 yrs. CNS metastases are common, and the presence of CNS disease predicts for a worse outcome.