Continuing trastuzumab beyond disease progression: outcomes analysis in patients with metastatic breast cancer
Autor: | Mario Giuliano, Emilia Montagna, Diego D'Agostino, Sabino De Placido, Giuseppe Cancello, Monica Plaitano, Giuseppe Di Lorenzo, Michele De Laurentiis, Antonio Giordano |
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Přispěvatelé: | Cancello, G., Montagna, E., D'Agostino, D., Giuliano, Mario, Giordano, A., Di Lorenzo, G., Plaitano, M., DE PLACIDO, Sabino, DE LAURENTIIS, Michelino |
Jazyk: | angličtina |
Předmět: |
Oncology
Adult medicine.medical_specialty medicine.medical_treatment Antineoplastic Agents Breast Neoplasms Antibodies Monoclonal Humanized Disease-Free Survival Breast cancer Surgical oncology Trastuzumab Internal medicine Medicine Humans Neoplasm Metastasis skin and connective tissue diseases neoplasms In Situ Hybridization Fluorescence Aged Retrospective Studies Medicine(all) Chemotherapy business.industry Hazard ratio Antibodies Monoclonal Retrospective cohort study Middle Aged medicine.disease Metastatic breast cancer Confidence interval Treatment Outcome Disease Progression Female business medicine.drug Research Article |
Zdroj: | Breast Cancer Research : BCR |
ISSN: | 1465-542X |
DOI: | 10.1186/bcr2119 |
Popis: | INTRODUCTION: We performed a retrospective analysis of HER2-overexpressing metastatic breast cancer patients to describe clinical outcomes of those who, despite progression of the disease (PD), maintained trastuzumab for multiple chemotherapy lines. We also compared survival of these patients with that of those who halted trastuzumab at first PD. METHODS: We identified 101 patients treated between July 2000 and January 2007. Nineteen were still receiving the first-line trastuzumab-based treatment without evidence of PD and were not included in this analysis. Of the remaining 82 patients, 59 retained trastuzumab for one or more additional lines of chemotherapy after PD, according to our institution policy. Twenty-three patients who changed treating institution and stopped trastuzumab at first progression were used as a control group. RESULTS: For patients retaining trastuzumab, the median follow-up was 39.6 months. Clinical outcomes showed the typical degradation between first and second lines of therapy which we would expect by halting trastuzumab at first progression. Response rates were 35\% and 16\% and median times to progression were 7.25 and 5.25 months for the first and second lines of trastuzumab therapy, respectively. The median overall survival (OS) rates were 70 months for patients who retained trastuzumab and 56 months for patients who halted the drug (hazard ratio [HR] 0.87, 95\% confidence interval [CI] 0.51 to 1.18; P = 0.52). If we consider OS from the start of trastuzumab therapy, the figures are 53.9 and 34.8 months, respectively (HR 0.78, 95\% CI 0.58 to 1.32; P = 0.2). CONCLUSION: A nonstatistically significant trend of improved survival for patients retaining trastuzumab is observed. This is in line with most retrospective analyses and recent randomized data. Retaining trastuzumab after progression is a reasonable option, but further randomized data are warranted to better define its role in comparison with other available options.. |
Databáze: | OpenAIRE |
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