P1-12-16: HER-2 Testing and Treatment – Is Age a Factor?
| Autor: | K Ewing, JK Singh, Sacha J Howell, Nigel J Bundred, M Howe, A. Cramer |
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| Rok vydání: | 2011 |
| Předmět: | |
| Zdroj: | Cancer Research. 71:P1-12 |
| ISSN: | 1538-7445 0008-5472 |
| DOI: | 10.1158/0008-5472.sabcs11-p1-12-16 |
| Popis: | Aims: Elderly breast cancer patients have a poorer prognosis due to late diagnosis and sub-optimal treatment. In the UK, HER-2 testing was introduced in 2005 and we sought to determine whether HER-2 testing was performed on patients of all ages and whether HER-2 positive patients of all ages subsequently received Herceptin, from implementation in 2005 until 2008. Methods: Review of all newly diagnosed breast cancers in women over 50 in our Unit between January 2005 and December 2008 was performed. Cases were identified from the hospital pathology electronic database. Patients were considered HER-2 positive if tissue sections scored 3+ on immunohistochemical analysis (intense membranous staining) or if gene amplification was detected using fluorescence in-situ hybridisation (FISH). Patients were eligible for treatment with Herceptin if the tumour exceeded 1cm in size or if they had lymph-node positive disease, per UK guidelines. Herceptin treatment was determined for all patients. Results: In total 703 patients with a median age of 68 years (range 56 to 98) were identified and 628 (89.3%) underwent definitive surgery (mastectomies: 246; wide local excisions: 382) and axillary surgery. In total 371 patients (52.8%) underwent HER-2 testing by immunohistochemistry or FISH. HER-2 tests performed by year: 2005 (51/131; 38.9%); 2006 (59/187; 31.6%); 2007 (71/189; 37.6%) and 2008 (190/196; 96.9%). Fifty six patients (15.1%) were HER-2 positive by immunohistochemistry or FISH. Median age of HER2 positive patients was 66 years (range 57 to 98); median age of HER2 negative patients was 68 years (range 56 to 96). Forty four HER-2 positive patients (78.6%) were eligible for treatment with Herceptin; of these 28 patients (63.6%) were treated with Herceptin. HER2 testing, treatment with Herceptin and overall 5-year mortality rate for patients between 50 to 69 years and patients aged 70 years or older is summarised in Table1. Twenty percent of patients aged between 50 to 69 years and 71.4% of patients aged 70 years or older eligible for Herceptin were not treated. Reasons for non-treatment included: multiple co-morbidities (4); treatment declined by oncologists (1); no referral to oncologists (1); death prior to treatment (2) and unknown (8). Median follow up time was 43.3 months (range 0.2 to 73.8). All cause mortality was higher in the over 70 year old breast cancer group (Log Rank Test p=0.001) regardless of HER-2 status. Conclusions: National introduction of routine HER-2 testing for all newly diagnosed breast cancers led to a testing rate increase to almost 97%. Despite this only 63.6% of HER-2 positive patients eligible for treatment with Herceptin received it. Patients aged 70 years or older were less likely to receive Herceptin due to multiple factors. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-12-16. |
| Databáze: | OpenAIRE |
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