scholarly journals Anti-HER2 antibody prolongs overall survival disproportionally more than progression-free survival in HER2-Positive metastatic breast cancer patients

The Breast ◽  
2021 ◽  
Author(s):  
I-Chun Chen ◽  
Fu-Chang Hu ◽  
Ching-Hung Lin ◽  
Shu-Min Huang ◽  
Dwan-Ying Chang ◽  
...  
2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11092-11092
Author(s):  
K. Leitzel ◽  
H. Y. Hou ◽  
V. Shrivastava ◽  
U. Anyanwu ◽  
S. M. Ali ◽  
...  

11092 Background: Approximately half of HER2-positive breast cancer patients will respond to first-line trastuzumab-containing therapy. However, in those patients with an initial trastuzumab response, most will progress within a year with acquired resistance. Since trastuzumab treatment is also now used in the HER2-positive adjuvant breast cancer setting, trastuzumab resistance will continue to be a vexing clinical problem, and better predictive and prognostic biomarkers are urgently needed. Methods: Serum HER2, tissue inhibitor of metalloproteinase-1 (TIMP-1), urokinase-type plasminogen activator (uPA), CA9, VEGF-165, and endoglin were measured using ELISA assays in 66 metastatic breast cancer patients before starting first-line trastuzumab-containing therapy. The HER2, TIMP-1, uPA, CA9, and VEGF-165 ELISAs were from Oncogene Science/Siemens Healthcare Diagnostics, Cambridge, MA; and the endoglin ELISA was from R&D Systems, Minneapolis, MN. Progression-free (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox modeling with continuous pretreatment serum biomarker variables. Results: Pretreatment serum HER2 (p= 0.005), TIMP-1 (p< 0.0001), uPA (p= 0.006), endoglin (p= 0.008), and CA9 (p <0.0001) were all significant as univariate continuous biomarkers for predicting PFS to first-line trastuzumab-containing therapy, but VEGF was not. In multivariate analysis for PFS with all six biomarkers, only serum CA9 (p= 0.002) was a significant independent covariate. For OS, pretreatment serum HER2 (p= 0.018), TIMP-1 (p< 0.0001), uPA (p< 0.0001), endoglin (p= 0.002), and CA9 (p< 0.0001) were all significant as univariate continuous biomarkers for prognosis, but serum VEGF was not. In multivariate analysis for OS with all six biomarkers, only serum CA9 was a significant independent prognostic covariate (p= 0.001). Conclusions: Elevated pretreatment serum CA9 (a marker of hypoxia) predicts reduced progression-free survival and overall survival in metastatic breast cancer patients treated with first-line trastuzumab-containing therapy. These serum biomarkers deserve further study in larger trials of HER2-targeted breast cancer treatment. Supported by a grant from Komen for the Cure. [Table: see text]


2021 ◽  
Vol 20 ◽  
pp. 153303382110378
Author(s):  
Xinzhao Wang ◽  
Lin Wang ◽  
Qian Yu ◽  
Zhaoyun Liu ◽  
Chao Li ◽  
...  

Background: The aim of this study was to evaluate the effectiveness of lapatinib in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. Methods: We retrospectively reviewed the medical records of patients who received lapatinib for salvage treatment at any line setting from January 1, 2007 to August 31, 2019 at Shandong Cancer Hospital and Institute. Results: A total of 115 (89.1%) patients were included in the study. In the overall cohort, the median disease-free survival (DFS) was 19.0 months; the median progression-free survival (PFS), 6.3 months; and median overall survival (OS), 88.0 months, with 32.2% of patients alive at 5 years. In the second line setting, the median PFS among trastuzumab, lapatinib, and trastuzumab plus lapatinib were 4.2 months, 5.2 months, and 7.3 months, respectively ( P = 0.004). No significant differences between the median PFSs and OSs of the different line salvage treatments with lapatinib was observed (all P > 0.05). For brain metastasis patients, the median PFSs in first line, second line, and more than 3 lines were 7.2 months, 4.5 months, and 6.3 months, respectively. Conclusions: Our findings suggest that patients would benefit more from trastuzumab plus lapatinib than from lapatinib or trastuzumab alone for second line treatment in the advanced stages of the disease. Lapatinib could be used as an alternative selection for HER2-positive metastasic breast cancer patients when there is disease progression after trastuzumab or pyrotinib treatment, which is used as part of China’s national health insurance.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1070-1070
Author(s):  
M. Artac ◽  
M. Samur ◽  
H. Bozcuk ◽  
B. Afacan ◽  
M. Ozdogan

1070 Background: Aromatase inhibitors represent a novel hormonal therapy for breast cancer. Aromatase is expressed in the ovaries, brain, bone and, adipose and breast tissue. Elevated WHR, representing a higher abdominal fat distribution, has been associated with both the development of and mortality from breast cancer. Therefore, we aimed to identify whether abdominal fat distribution could affect the outcome in metastatic breast cancer patients treated with AIs. Methods: A total of 46 metastatic breast cancer patients treated with first line hormonal therapy were enrolled in this study. Pretreatment body weight, height, BMI and WHR were measured. Estrogen, progesteron and c- erb-B2 receptor status were also evaluated in analyses. Univariate and multivariate Cox regression analyses, and Kaplan Meier survival curves subjected to log rank testing were utilized for the survival analyses. Forward likelihood ratio was used for the multivariate selection process. A P value < 0.05 was considered to be significant. Results: Median age was 51 years (range 28 - 75). 36 patients were treated with letrozole and 10 patients with anastrozole. Median body weight, height, WHR and BMI were found to be 68.5 kg (range 46 - 115), 156 cm (range 137 - 167), 0.91 (range 0.7 - 1.2), and 28.7 (range 18 - 45), respectively. Factors associated with overall survival in the univariate analysis were age, c-erb-B2 expression intensity (+++ versus others by immunohistochemistry), and WHR, whereas only WHR retained significance in the multivariate analysis. Likewise, predictors of progression free survival were c-erb-B2 expression intensity and WHR. However, none of these factors was significant in the multivariate analysis. Median overall survival figures were 472 days versus unreached for patients with a WHR of <0.92 and =0.92 (Log rank statistic = 9.76, P = 0.002). Similarly, the corresponding progression free survival figures for patients with a WHR of <0.92 and =0.92 were 423 versus 1,004 days (Log rank statistic = 6.37, P = 0.012). Conclusions: This is the first report examining and suggesting the value of abdominal fat distribution in relation with benefit from AIs in metastatic breast cancer. Our results should be validated in larger series. No significant financial relationships to disclose.


2020 ◽  
Vol 80 (11) ◽  
pp. 1134-1142
Author(s):  
Elena Laakmann ◽  
Julius Emons ◽  
Florin-Andrei Taran ◽  
Wolfgang Janni ◽  
Sabrina Uhrig ◽  
...  

Abstract Purpose Pertuzumab and T-DM1 are two efficient anti-HER2 treatments for patients with HER2-positive advanced breast cancer. While pertuzumab is usually given in first-line treatment and T-DM1 in second-line treatment, standard therapy options seem to be exhausted up to now after the treatment of patients with these two therapy options. Therefore, it is important to have data that describes the therapy situation and prognosis after T-DM1 treatment. Methods The PRAEGNANT metastatic breast cancer registry (NCT02338167) is a prospective registry for breast cancer patients with a focus on molecular biomarkers. Patients of all therapy lines with any kind of treatment are eligible. Collected data comprises therapies, adverse events, quality of life and other patient reported outcomes. Here we report on the patient characteristics and descriptive prognostic data for HER2-positive patients who have completed a treatment with T-DM1. Therapy patterns after T-DM1 and progression-free survival are reported as well as overall survival. Results A total of 85 patients were identified for the study who were prospectively observed during therapy after the termination of T-DM1. The main reason for T-DM1 termination was progress. Following T-DM1, lapatinib, trastuzumab and chemotherapy were the main therapy choices. Median progression-free survival was 4.8 months (95% CI: 3.2 – 6.3) and median overall survival was 18.4 months (95% CI: 15.5 – 21.3). Conclusions Therapy options after T-DM1 in a real-world setting seem to exhibit a relevant clinical efficacy, supporting the concept of continuous anti-HER2 treatments in the advanced therapy setting for breast cancer patients. Novel therapies are needed to improve the rather short median progression-free survival.


Oncotarget ◽  
2017 ◽  
Vol 8 (54) ◽  
pp. 92483-92496 ◽  
Author(s):  
Theresa Benezeder ◽  
Verena Tiran ◽  
Alexandra A.N. Treitler ◽  
Christoph Suppan ◽  
Christopher Rossmann ◽  
...  

Author(s):  
Yasemin Benderli Cihan

AbstractAimTo determine prognostic ratio of metastatic lymph nodes to totally removed lymph nodes (MLN/TRLN) on overall and progression-free survival with diagnosis of breast cancer.Material and methodRadiation Oncology department of Kayseri Training and Research Hospital, relationship of MLN/TRLN between prognosis and other prognostic factors was evaluated in T1-3 and N1-3 non-metastatic breast cancer patients.ResultsTwo hundred female patients and 5 male patients with an average age of 56 years were enrolled in this study. Of all patients, 63.4% of the patients were postmenopausal and modified radical mastectomy was performed in 96.6% of them. While 93.2% of the patients were diagnosed with invasive ductal carcinoma, 52.7% of them had clinical N1 disease, 62% of them were staged as T2, 94% of them received chemotherapy and 57.1% of them received hormonal therapy. Metastatic lymph node ratio below 0.2 was 48.8%, between 0.21–0.65 it was 35.1% and above 0.65% it was 16.1%. Five-year Overall survival and progression-free survival rates were 76% and 58% respectively. Statistically significant difference was found between MLN/TRLN and age (p = 0.044), chemotherapy (p = 0.039), pathological lymph nodes (p <0.001) according to Pearson's Chi-Squared test. Factor affecting overall survival was Progesterone receptor status (p = 0.021) and for progression-free survival they were gender (p = 0.003) and human epidermal growth factor receptor 2 (p = 0.018). Univariate and multivariate analysis found that gender (p = 0.04, OR 5.9, CI: 1.7–19.6) and lymph node (p = 0.05, OR: 1.4, CI: 0.9–2.1) were significant factors affecting progression-free survival.ConclusionMLN/TRLN was shown to have no effect on prognosis in non-metastatic breast cancer patients due to small number of patients and short follow-up period.


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