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Old 12-07-2013, 01:14 AM   #1
Lani
Senior Member
 
Join Date: Mar 2006
Posts: 4,778
Thumbs up Real world statistics on how her2+ early brst cancer patients are faring in herceptin

era

Only 81% got herceptin(the other 19% includes two thirds of those with subcentimeter tumors did not), but stats remarkably improved--

Curr Oncol. 2013 Dec;20(6):e539-e545.
Outcomes of her2-positive early-stage breast cancer in the trastuzumab era: a population-based study of Canadian patients.
Zurawska U, Baribeau DA, Giilck S, Victor C, Gandhi S, Florescu A, Verma S.
Source
Department of Medicine, University of Toronto, Toronto, ON.
Abstract
Breast cancer is heterogenous, with variable expression of the estrogen receptor (er), progesterone receptor (pr), and human epidermal growth factor receptor 2 (her2). Overexpression of her2 is generally considered a negative prognostic feature, but whether outcomes for her2-positive early breast cancer remain different from those for other subtypes in the era of trastuzumab-based adjuvant therapy is unknown.
METHODS:
Using a retrospective chart review, we compared overall survival (os) and relapse-free survival (rfs) in 3 groups of patients with early-stage breast cancer: er-positive or pr-positive (or both) and her2-negative ["hormone receptor-positive" (hr+)]; her2-positive (her2+); and er-negative, pr-negative, and her2-negative ["triple-negative" (tn)].
RESULTS:
In the 503 charts analyzed (332 hr+, 94 her2+, 77 tn), the 5-year os and rfs were, respectively, 94.2% and 87.2% for hr+ patients, 88.6% and 74.9% for her2+ patients, and 85.4% and 76.2% for tn patients. On multivariate analysis, the os for the her2+ subtype was similar to that for the hr+ subtype (hazard ratio:1.07; 95% confidence interval: 0.31 to 3.67 with hr+ as reference), but os was significantly worse for tn patients than for hr+ patients (hazard ratio: 4.37; 95% confidence interval: 1.56 to 12.24). In her2+ patients, the 5-year os and rfs trended better for patients with er+ or pr+ disease than for patients with er-negative and pr-negative disease (5-year os: 92.1% vs. 86.9%; 5-year rfs: 79.8% vs. 71.4%). Of her2+ patients, just 80.9% received trastuzumab, including 33.3% of her2+ patients with sub-centimetre tumours.
CONCLUSIONS:
In the trastuzumab era, patients with her2+ and hr+ early breast cancer have similar outcomes, while tn patients experience a significantly worse os than either of the foregoing groups. Outcomes for her2+ patients may differ by er and pr status. Trastuzumab was underutilized in this cohort.
KEYWORDS:
adjuvant, her2-positive breast cancer, survival, trastuzumab

PMID: 24311954 [PubMed - as supplied by publisher]
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