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-   -   THE ABSOLUTE LATEST stats 4 her2+ tumors<2cm ER+,ER-, node+ node- with/without vitamH (https://her2support.org/vbulletin/showthread.php?t=63384)

Lani 06-24-2015 01:17 PM

THE ABSOLUTE LATEST stats 4 her2+ tumors<2cm ER+,ER-, node+ node- with/without vitamH
 
"vitamin H" short for herceptin

this metaanalysis combined randomized adjuvant Herceptin trials to get these stats

not sure I agree with the last sentence--depends what thet call less agressive treatment ER+ her2+ tumors and < or= 1 node may need additional targetted treatment rather than less "agressive" treatment altogether

Send to:
J Clin Oncol. 2015 Jun 22. pii: JCO.2015.60.8620. [Epub ahead of print]
Efficacy of Adjuvant Trastuzumab for Patients With Human Epidermal Growth Factor Receptor 2-Positive Early Breast Cancer and Tumors ≤ 2 cm: A Meta-Analysis of the Randomized Trastuzumab Trials.
O'Sullivan CC1, Bradbury I2, Campbell C2, Spielmann M2, Perez EA2, Joensuu H2, Costantino JP2, Delaloge S2, Rastogi P2, Zardavas D2, Ballman KV2, Holmes E2, de Azambuja E2, Piccart-Gebhart M2, Zujewski JA2, Gelber RD2.

Abstract

PURPOSE:
We compared efficacy of trastuzumab versus no trastuzumab in patients with small (≤ 2 cm) human epidermal growth factor receptor 2 (HER2) -positive breast cancer treated in randomized trials.

METHODS:
A meta-analysis was conducted using data from five of the six adjuvant trastuzumab trials. Efficacy end points were disease-free survival (DFS) and overall survival (OS). Separate analyses were prospectively planned for hormone receptor (HR) -positive and HR-negative cohorts. Random effect models and Yusuf-Peto fixed effects models assessed the impact of heterogeneity on baseline hazards and treatment effects across studies. Peto-Pike cumulative incidence estimates were stratified by study and nodal status.
RESULTS:
Median follow-up time was 8 years. For 2,263 patients with HR-positive disease, 8-year cumulative incidence rates comparing trastuzumab versus no trastuzumab were 17.3% versus 24.3% (P < .001) for DFS and 7.8% versus 11.6% (P = .005) for OS, respectively; for 1,092 HR-positive patients with zero or one positive lymph nodes, results were 12.7% versus 19.4% (P = .005) for DFS and 5.3% versus 7.4% (P = .12) for OS, respectively. For 1,957 patients with HR-negative disease, 8-year cumulative incidence rates were 24.0% versus 33.4% (P < .001) for DFS and 12.4% versus 21.2% (P < .001) for OS, respectively; for 1,040 HR-negative patients with zero or one positive lymph nodes, results were 20.4% versus 26.3% (P = .05) for DFS and 8.2% versus 12.2% (P = .084) for OS, respectively.
CONCLUSION:
Women with HER2-positive tumors ≤ 2 cm in the randomized trastuzumab trials derived substantial DFS and OS benefit from adjuvant trastuzumab. Trastuzumab-treated patients with HR-positive disease and ≤ one positive lymph node may be candidates for trials assessing less aggressive treatment approaches.
© 2015 by American Society of Clinical Oncology.

LeahM 06-24-2015 02:44 PM

Re: THE ABSOLUTE LATEST stats 4 her2+ tumors<2cm ER+,ER-, node+ node- with/without vi
 
Does this mean my 8mm tumor 1 pos node would NOT need H or am I reading this wrong?

hestko76 06-24-2015 04:44 PM

Re: THE ABSOLUTE LATEST stats 4 her2+ tumors<2cm ER+,ER-, node+ node- with/without vi
 
The way I read the conclusion makes you right...... ">" with a "-" under means less than or equal to. Since my tumor was less than 1 cm, no positive nodes, and I was ER- , I would receive Herceptin. Interesting outcome.....

Lien 06-25-2015 02:28 PM

Re: THE ABSOLUTE LATEST stats 4 her2+ tumors<2cm ER+,ER-, node+ node- with/without vi
 
I'm 11 years and 6 months out from diagnosis, never had Herceptin, because it was not yet available in my country for people with such small tumors. I had hormonal tx though. So far no recurrences.

So for those who didn't get Vit H and worry about it: there's a small benefit, but there's still a good chance that you will do fine without it.

Having said that, I think people should have a choice. My doc said that I was lucky that I didn't qualify, because I might have developed heart problems unnecessarily. But if it had been available, I probably would have opted to try it.

Jacqueline


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