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. 2022 Sep;195(2):171-180.
doi: 10.1007/s10549-022-06678-1. Epub 2022 Jul 22.

Trastuzumab therapy duration in HER2-positive de novo metastatic breast cancer: 1999-2018

Henry G Kaplan  1 , Judith A Malmgren  2   3 , Boya Guo  3 , Mary K Atwood  4
Affiliations

Trastuzumab therapy duration in HER2-positive de novo metastatic breast cancer: 1999-2018

Henry G Kaplan et al. Breast Cancer Res Treat. 2022 Sep.

Abstract

Purpose: The optimal duration of first-line trastuzumab (T) treatment for de novo stage IV HER2-positive metastatic breast cancer (MBC) patients after complete response (CR) is not known.

Methods: A retrospective cohort study of de novo stage IV HER2-positive MBC patients who had trastuzumab included in their initial treatment (n = 69), 1999-2018, was conducted with follow-up for CR, progressive disease (PD), vital status, and disease-specific survival (DSS). Statistics included Kaplan-Meier plots and Cox proportional hazards models.

Results: Mean trastuzumab treatment time was 4.1 years (range 0.1-15). 54% of patients experienced CR at average time 9 months on treatment (n = 37). Eight CR patients discontinued T treatment after 18 months average post-CR time (range 0-86) and twenty-nine stayed on T treatment post CR [average 65 months (range 10-170)]. Average follow-up was 6 years, range 1-15 years. 5-year DSS was 92% for CR on T patients (N = 29); 88% CR off T (n = 8); 73% No CR on T (n = 14); and 29% No CR off T (n = 18) (p < 0.001). In forward Cox proportional hazards modeling, CR = yes [HzR = 0.31, (95% CI 0.14, 0.73), p = 0.007], continuous T treatment > 2 years [HzR = 0.24, (95% CI 0.10, 0.62), p = 0.003], and age < 65 [HzR = 0.29, (95% CI 0.11, 0.81), p = 0.018] were significantly associated with better DSS.

Conclusion: Maximum trastuzumab treatment time to CR was 27 months with 2 or more years trastuzumab treatment independently associated with better survival. Survival comparisons and hazard modeling both indicate as good or better survival associated with continuous trastuzumab treatment regardless of CR status. Word count (n = 250).

Keywords: Complete response; HER2; Metastatic breast cancer; Survival; Trastuzumab; Treatment duration.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Consort diagram
Fig. 2
Fig. 2
Swimmer plot of trastuzumab duration and patient outcomes
Fig. 3
Fig. 3
HER2 positive de novo MBC trastuzumab-treated patients 5-year DSS by CR status (yes/no) (n=69)
Fig. 4
Fig. 4
HER2 positive de novo MBC trastuzumab-treated patients 5-year DSS by 4 category CR/T treatment status (n=69)
See this image and copyright information in PMC

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References

    1. Gong Y, Liu Y-R, Ji P, Hu X, Shao Z-M. Impact of molecular subtypes on metastatic breast cancer patients: a SEER population-based study. Sci Rep. 2017;7:45411. doi: 10.1038/srep45411. - DOI - PMC - PubMed
    1. Swain SM, Baselga J, Kim SB, Ro J, Semiglazov V, Campone M, Ciruelos E, CLEOPATRA Study Group et al. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. N Engl J Med. 2015;372(8):724–734. doi: 10.1056/NEJMoa1413513. - DOI - PMC - PubMed
    1. Wong Y, Raghavendra AS, Hatzis C, Irizarry JP, Vega T, Horowitz N, et al. Long-term survival of de novo stage IV human epidermal growth receptor 2 (HER2) positive breast cancers treated with HER2-targeted therapy. Oncologist. 2019;24(3):313–318. doi: 10.1634/theoncologist.2018-0213. - DOI - PMC - PubMed
    1. Malmgren JA, Mayer M, Atwood MK, Kaplan HG. Differential presentation and survival of de novo and recurrent metastatic breast cancer over time: 1990–2010. Breast Cancer Res Treat. 2018;67(2):579–590. doi: 10.1007/s10549-017-4529-5. - DOI - PMC - PubMed
    1. National Comprehensive Cancer Network. Breast Cancer (Version 2.2022). https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed Jan 27 2022