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Comparative Study
. 2010 Feb 1:10:28.
doi: 10.1186/1471-2407-10-28.

Trastuzumab with either docetaxel or vinorelbine as first-line treatment for patients with HER2-positive advanced breast cancer: a retrospective comparison

Stefania Redana  1 , Michela Donadio, Franco Nolè, Maria Elena Jacomuzzi, Alessandra Beano, Rossella Martinello, Anna Sapino, Giuseppe Viale, Massimo Aglietta, Filippo Montemurro
Affiliations
Comparative Study

Trastuzumab with either docetaxel or vinorelbine as first-line treatment for patients with HER2-positive advanced breast cancer: a retrospective comparison

Stefania Redana et al. BMC Cancer. .

Abstract

Background: Combinations of trastuzumab with either docetaxel or vinorelbine are considered valuable treatment options for HER2-positive metastatic breast cancer patients. We performed a retrospective comparison of the clinical outcomes associated with either one of these combinations.

Methods: From a multi-institutional database we retrieved 179 patients treated with either docetaxel or vinorelbine plus trastuzumab as first-line therapy for HER2-positive advanced breast cancer.

Results: Docetaxel-trastuzumab was superior to vinorelbine-trastuzumab in terms of response rate (RR: 77 vs 57%, p = 0.01) and median overall survival (OS: 35 vs 23 months, p = 0.04), but not in median time to progression (TTP: 12 vs 10 months, p = 0.53). At multivariate analysis, type of treatment was not associated with TTP but was an independent predictor of OS, with a significant reduction in the risk of death in favor of docetaxel-trastuzumab (HR 0.474, 95% IC 0,303-0.742, p < 0.01).

Conclusion: Docetaxel or vinorelbine, when combined with trastuzumab, provide excellent rates of tumor control in patients with previously untreated HER2-positive advanced breast cancer. Docetaxel may offer some advantage in terms of response rate and resulted in a significantly prolonged overall survival, which, because of the retrospective design of our study, deserves further investigation in prospective trials.

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Figures

Figure 1
Figure 1
Kaplan-Meier estimate of time to progression according to type of chemotherapy associated with trastuzumab. The solid line represents patients receiving docetaxel and the dashed line those receiving vinorelbine.
Figure 2
Figure 2
Kaplan-Meier estimate of overall survival according to type of chemotherapy associated with trastuzumab. The solid line represents patients receiving docetaxel and the dashed line those receiving vinorelbine.
Figure 3
Figure 3
Kaplan-Meier estimates of time to second progression, measured from the date of second-line therapy initiation to that of tumor progression or death in the absence of progression in patients whose initial treatment was docetaxel plus trastuzumab (solid line) or vinorelbine plus trastuzumab (dashed line). The analysis is based on 69 and 49 events occurring in 80 and 57 patients who had initially received trastuzumab with docetaxel or vinorelbine, respectively.
See this image and copyright information in PMC

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