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. 2024 Jun 19;10(1):49.
doi: 10.1038/s41523-024-00652-4.

The survival benefit of adjuvant trastuzumab with or without chemotherapy in the management of small (T1mic, T1a, T1b, T1c), node negative HER2+ breast cancer

Kai C C Johnson  1 , Ai Ni  2 , Dionisia Quiroga  1 , Ashley C Pariser  1 , Preeti K Sudheendra  1 , Nicole O Williams  1 , Sagar D Sardesai  1 , Mathew Cherian  1 , Daniel G Stover  1 , Margaret Gatti-Mays  1 , Bhuvaneswari Ramaswamy  1 , Maryam Lustberg  3 , Sachin Jhawar  1 , Roman Skoracki  1 , Robert Wesolowski  4
Affiliations

The survival benefit of adjuvant trastuzumab with or without chemotherapy in the management of small (T1mic, T1a, T1b, T1c), node negative HER2+ breast cancer

Kai C C Johnson et al. NPJ Breast Cancer. .

Abstract

There is limited data regarding the added benefit of adjuvant systemic therapy in the management of small, node-negative, HER2+ breast cancer. In a multi-institutional retrospective analysis using the American Society of Clinical Oncology CancerLinQ database, we compared survival outcomes among T1a-c N0 HER2+ patients diagnosed between 2010 to 2021 who received locoregional therapy alone or in combination with adjuvant trastuzumab (+/- chemotherapy). Primary outcomes were invasive disease-free survival (iDFS) and overall survival (OS). Of the 1,184 patients, 436 received locoregional therapy alone. We found a statistically significant improvement in iDFS (HR 0.73, P = 0.003) and OS (HR 0.63, P = 0.023) on univariate analysis with adjuvant trastuzumab with or without chemotherapy which remained statistically significant on multivariate analysis. Three-arm univariate analysis found that iDFS was significantly improved with trastuzumab monotherapy (P = 0.003) and combination therapy (P = 0.027) compared to observation. Subgroup data suggests that T1b/c tumors derive the greatest benefit.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Survival outcomes with or without systemic therapy for T1N0 HER2+ breast cancer.
Univariate analysis of iDFS (a) and OS (b) in our two-group comparison of adjuvant trastuzumab with or without systemic chemotherapy versus locoregional therapy alone.
Fig. 2
Fig. 2. Survival outcomes for T1N0 HER2+ breast cancer following locoregional therapy alone versus trastuzumab monotherapy versus combination therapy.
Univariate analysis of iDFS (a) and OS (b) in our three-group comparison of locoregional therapy alone versus trastuzumab monotherapy versus chemotherapy with trastuzumab.
Fig. 3
Fig. 3. Survival outcomes for T1N0 HER2+ breast cancer based on T1 subgroup following locoregional therapy alone versus trastuzumab monotherapy versus combination therapy.
Subgroup analysis of iDFS (a, b) and OS (c, d) within the 3-arm treatment comparison with an overall test of treatment effect based on T1a (a, c) and T1b/c (b, d) tumor sub-categorization.
See this image and copyright information in PMC

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