Effectiveness of adjuvant trastuzumab in daily clinical practice

Abstract

BackgroundHuman epidermal growth factor receptor 2 (HER2) positive breast cancer is an entity with aggressive behaviour. One year of adjuvant trastuzumab significantly improves the disease free survival in the range of 40–50% and reduces the risk of dying from HER2 positive breast cancer by one third. Adjuvant treatment with trastuzumab became available in Slovenia in 2005 and the aim of this study is to explore, if the exceptional results reported in adjuvant clinical trials are achieved also in daily clinical practice.Patients and methods.An analysis of tumour and patient characteristics, type of treatment and outcome (relapse free and overall survival) of 313 patients (median age 52 years) treated at the Institute of Oncology Ljubljana in years 2005–2009 was performed.ResultsMedian follow-up was 4.4 years. Sixty-one patients relapsed and 24 died. Three and four years relapse free survival was 84.2% and 80.8% and the overall survival was 94.4% and 92.5%, respectively. Independent prognostic factors for relapse were tumour grade (HR 2.10; 95% CI 1.07–4.14; p = 0.031) and nodal stage (HR 1.35; 1.16–1.56; p < 0.0001) and for the overall survival nodal stage only (HR 1.36; 1.05–1.78; p = 0.021).ConclusionsThe outcome in patients with adjuvant trastuzumab in daily clinical practice, treated by medical oncologists, is comparable to results obtained in international adjuvant studies.

Pathological complete response and prognosis after neoadjuvant chemotherapy for HER2-positive breast cancers before and after trastuzumab era: results from a real-life cohort

“…Our study confirms that patients with pCR have excellent DFS and OS. Several studies documented trastuzumab benefits in real-world practice in the adjuvant ( Vici et al , 2014 ; Matos et al , 2014 ; Inwald et al , 2014 ; Bonifazi et al , 2014 ; Seferina et al , 2015 ; Jackisch et al , 2014 ) and in the metastatic setting ( Olson et al , 2013 ; Karam et al , 2013 ; Park et al , 2009 ; Jackisch et al , 2014 ). Most of these authors found that the magnitude of trastuzumab benefits was equivalent to what was observed in clinical trials (improvement the relative risk for DFS by approximately 50% and OS by 30%).…”

Predicting the Efficacy of HER2-Targeted Therapies: A Look at the Host

“…A retrospective Italian study, GHEA, which analyzed 1002 patients who were treated per the HERA protocol, recorded 107 BC relapses (overall frequency, 10.67%), with a 3-year DFS of 87% [ 72 ], similar to what was observed in the HERA trial (4-year DFS: 78.6%). A similar study in 313 patients in Slovenia reported an 81% 4-year DFS and a 92% OS with trastuzumab plus chemotherapy [ 73 ].…”

Early cardiotoxicity after adjuvant concomitant treatment with radiotherapy and trastuzumab in patients with breast cancer

“… 1 The current standard adjuvant systemic treatment of early HER2-positive breast cancer consists of chemotherapy (CT) plus 12 months of trastuzumab, with or without endocrine therapy. 2 , 3 , 4 The patients treated with adjuvant radiotherapy (RT) of the breast or chest wall receive trastuzumab concurrently with RT. Treatment with trastuzumab results in a small to modest cardiotoxicity risk.…”