Adjuvant trastuzumab with chemotherapy is effective in women with small, node-negative, HER2-positive breast cancer Journal Article
| Authors: | Mcarthur, H. L.; Mahoney, K. M.; Morris, P. G.; Patil, S.; Jacks, L. M.; Howard, J.; Norton, L.; Hudis, C. A. |
| Article Title: | Adjuvant trastuzumab with chemotherapy is effective in women with small, node-negative, HER2-positive breast cancer |
| Abstract: | BACKGROUND: Several large, randomized trials established the benefits of adjuvant trastuzumab with chemotherapy. However, the benefit for women with small, node-negative HER2-positive (HER2+) disease is unknown, as these patients were largely excluded from these trials. Therefore, a retrospective, single-institution, sequential cohort study of women with small, node-negative, HER2+ breast cancer who did or did not receive adjuvant trastuzumab was conducted. METHODS: Women with ≤2 cm, node-negative, HER2+ (immunohistochemistry 3+ or fluorescence in situ hybridization ≥2) breast cancer were identified through an institutional database. A " cohort of 106 trastuzumab-untreated women diagnosed between January 1, 2002 and May 14, 2004 and a " cohort of 155 trastuzumab-treated women diagnosed between May 16, 2005 and December 31, 2008 were described. Survival and recurrence outcomes were estimated by Kaplan-Meier methods. RESULTS: The cohorts were similar in age, median tumor size, histology, hormone receptor status, hormone therapy, and locoregional therapy. Chemotherapy was administered in 66% and 100% of the "no trastuzumab" and " cohorts, respectively. The median recurrence-free and survival follow-up was: 6.5 years (0.7-8.5) and 6.8 years (0.7-8.5), respectively, for the "no trastuzumab" cohort and 3.0 years (0.5-5.2) and 3.0 years (0.6-5.2), respectively, for the " cohort. The 3-year locoregional invasive recurrence-free, distant recurrence-free, invasive disease-free, and overall survival were 92% versus 98% (P =.0137), 95% versus 100% (P =.0072), 82% versus 97% (P <.0001), and 97% versus 99% (P =.18) for the "no trastuzumab" and " cohorts, respectively. CONCLUSIONS: Women with small, node-negative, HER2+ primary breast cancers likely derive significant benefit from adjuvant trastuzumab with chemotherapy. Copyright © 2011 American Cancer Society. |
| Keywords: | immunohistochemistry; adult; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; overall survival; histopathology; cancer recurrence; doxorubicin; fluorouracil; drug efficacy; paclitaxel; adjuvant therapy; cancer radiotherapy; disease free survival; chemotherapy, adjuvant; methotrexate; follow up; lymph node metastasis; lymphatic metastasis; neoplasm staging; multiple cycle treatment; cohort studies; breast cancer; mastectomy; tumor volume; antineoplastic combined chemotherapy protocols; epidermal growth factor receptor 2; cohort analysis; randomized controlled trials as topic; cyclophosphamide; breast neoplasms; retrospective study; age; fluorescence in situ hybridization; partial mastectomy; receptor, erbb-2; kaplan meier method; estrogen receptor; progesterone receptor; trastuzumab; absence of side effects; treatment refusal; her2; oncogene neu; node-negative; antibodies, monoclonal, humanized |
| Journal Title: | Cancer |
| Volume: | 117 |
| Issue: | 24 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2011-12-15 |
| Start Page: | 5461 |
| End Page: | 5468 |
| Language: | English |
| DOI: | 10.1002/cncr.26171 |
| PROVIDER: | scopus |
| PUBMED: | 21681735 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 3 January 2012" - "CODEN: CANCA" - "Source: Scopus" |
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