Abstract P1-09-05: Re-Testing of HER2 Status in Recurring Metastatic Breast Cancer Is a Clinically Relevant and Cost-Effective Strategy

2010 ◽  
Author(s):  
M Bernow ◽  
U Wilking ◽  
J Bergh ◽  
B Jönsson ◽  
N. Wilking
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Cost Effective ◽  
Her2 Status ◽  
Effective Strategy ◽  
Cost Effective Strategy

scholarly journals Phenotypic discordance between primary and metastatic breast cancer in the large-scale real-life multicenter French ESME cohort

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Thomas Grinda ◽  
Natacha Joyon ◽  
Amélie Lusque ◽  
Sarah Lefèvre ◽  
Laurent Arnould ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Large Scale ◽  
Tumour Progression ◽  
Primary Tumour ◽  
Multivariable Analysis ◽  
Real Life ◽  
Metastatic Breast ◽  
Her2 Status ◽  
Risk Of Death

AbstractExpression of hormone receptor (HR) for estrogens (ER) and progesterone (PR) and HER2 remains the cornerstone to define the therapeutic strategy for breast cancer patients. We aimed to compare phenotypic profiles between matched primary and metastatic breast cancer (MBC) in the ESME database, a National real-life multicenter cohort of MBC patients. Patients with results available on both primary tumour and metastatic disease within 6 months of MBC diagnosis and before any tumour progression were eligible for the main analysis. Among the 16,703 patients included in the database, 1677 (10.0%) had available biopsy results at MBC diagnosis and on matched primary tumour. The change rate of either HR or HER2 was 27.0%. Global HR status changed (from positive = either ER or PR positive, to negative = both negative; and reverse) in 14.2% of the cases (expression loss in 72.5% and gain in 27.5%). HER2 status changed in 7.8% (amplification loss in 45.2%). The discordance rate appeared similar across different biopsy sites. Metastasis to bone, HER2+ and RH+/HER2- subtypes and previous adjuvant endocrine therapy, but not relapse interval were associated with an HR discordance in multivariable analysis. Loss of HR status was significantly associated with a risk of death (HR adjusted = 1.51, p = 0.002) while gain of HR and HER2 discordance was not. In conclusion, discordance of HR and HER2 expression between primary and metastatic breast cancer cannot be neglected. In addition, HR loss is associated with worse survival. Sampling metastatic sites is essential for treatment adjustment.

Lapatinib and HER2 status: Results of a meta-analysis of randomized phase III trials in metastatic breast cancer

2010 ◽  
Vol 36 (5) ◽  
pp. 410-415 ◽  
Author(s):  
Eitan Amir ◽  
Alberto Ocaña ◽  
Bostjan Seruga ◽  
Orit Freedman ◽  
Mark Clemons
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Meta Analysis ◽  
Metastatic Breast ◽  
Phase Iii ◽  
Her2 Status ◽  
Phase Iii Trials

Is It The Time That We Can Depend on Bioscore as a New Staging System in Non-Metastatic Breast Cancer to Predict the Disease-Free Survival?

2021 ◽  
Author(s):  
Rehab Farouk Mohamed ◽  
Donia Hussein Abd El Hameed ◽  
Mohamed Alaa Eldeen Hassan
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Prognostic Value ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Metastatic Breast ◽  
Her2 Status ◽  
Free Survival ◽  
Disease Free

Abstract Purpose: Novel molecular characterization of breast cancer with cellular markers has allowed a new classification that offers prognostic value. This study investigates the prognostic value of the Bioscore among non-metastatic breast cancer patients with respect to disease free survival (DFS).Methods: This study included 317 patients with non-metastatic surgically treated breast cancer; they were identified in the period from January 2015 to December 2018 at Clinical Oncology Department of Assiut University Hospital. Many variables were used; pathologic stage (PS), T stage (T), nodal stage (N), grade (G), estrogen receptor (ER), progesterone receptors (PR), and human epidermal growth factor receptor (HER2) status. Univariate & two multivariate analyses were performed to identify which of these variables are associated with disease-free survival (DFS). Results: The only significant factors in the Univariate analysis were PS3, T2, T3, T4, N3, G2, G3, ER -ve, PR -ve, and HER2 –ve. The factors which were significant in the first multivariate analysis; PS3, G3, ER –ve, and in the second one were; T2, T4, N3, G3, and ER –ve. Two sets of models were built to determine the utility of combining variables. Models incorporating G and E status had the highest C-index (0.72) for T+N + G + ER in comparison with (0.69) for (PS+ G + ER) and the lowest AIC (953.01) for T + N + G + E and (966.9) for PS + G + E. Conclusions: This study confirms the prognostic significance of bioscore in non-metastatic breast cancer in concerning DFS.

Quantitative HER2 measurement and PI3K mutation profile in matched primary and metastatic breast cancer tissues.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 614-614
Author(s):  
Weidong Huang ◽  
Jonathan F. Lara ◽  
Richard Michaelson ◽  
Xiu Sun ◽  
Pierfranco Conte ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Catalytic Domain ◽  
Pik3ca Mutation ◽  
Metastatic Breast ◽  
Her2 Status ◽  
Her2 Positive ◽  
Pik3ca Mutations ◽  
Meta Analyses ◽  
Negative Conversion

614 Background: HER2 status of primary breast cancer (PBC) is routinely used to determine systemic treatment for metastatic breast cancer (MBC) patients. Discordance rates of HER2 status between PBC and MBC range from 5.5% to 29% based on published meta-analyses. The clinical benefit of re-assessing HER2 in MBC tissues remains controversial. In this study, we measured quantitative HER2 expression in matched PBC and MBC tissues and correlated changes of HER2 with mutations in the catalytic domain of PI3 kinase(PIK3CA). Methods: Total HER2 protein expression (H2T) was quantified by the HERmark assay in 41 matched PBC and MBC formalin-fixed, paraffin-embedded specimens. PIK3CA mutation status in exons 9 (E545K and E542K) and 20 (H1047R) was determined using a validated pyrosequencing assay. Results: MBC samples included 5 lymph node, 13 viscera, 6 brain, and 17 soft tissue lesions (N=41). 27 (66%) cases showed higher H2T in MBC than in matched PBC; and 14 (34%) cases had higher H2T in PBC than in matched MBC, indicating an overall increase of H2T in matched MBC lesions (fold change 0.25-17.57; p=0.005, paired Wilcoxon rank sum test). HER2 positive conversion (HERmark negative/equivocal in PBC, but positive in matched MBC) was found in 6 (15%) cases, while HER2 negative conversion (HERmark positive in PBC, but negative/equivocal in matched MBC) was seen in 2 (5%) cases. HER2 status was unchanged in 33 (80%) cases. PIK3CA mutations were detected in 13 (32%) of PBC and 19 (46%) of MBC samples. Among the HER2 positive conversion cases, PIK3CA mutation was identified in 50% (3/6) PBC and 67% (4/6) MBC, compared to 0% (0/2, PBC or MBC) in the HER2 negative conversion cases. Among cases with unchanged HER2 status, PIK3CA mutation was observed in 30% (10/33) PBC and 42% (14/33) MBC. Conclusions: Quantitative HER2 assessment revealed a 20% discordance in HER2 status between matched PBC and MBC tissues, with more frequent conversion from low HER2 in PBC to high HER2 in MBC. PIK3CA mutation was observed more frequently in patients who converted from HER2 negative PBC to HER2 positive MBC. These results suggest that re-assessment of biomarkers in MBC tissues may better inform the selection of therapeutic options for patients with MBC.

Open-label phase III randomized controlled trial comparing taxane-based chemotherapy (Tax) with lapatinib (L) or trastuzumab (T) as first-line therapy for women with HER2+ metastatic breast cancer: Interim analysis (IA) of NCIC CTG MA.31/GSK EGF 108919.

2012 ◽  
Vol 30 (18_suppl) ◽  
pp. LBA671-LBA671 ◽  
Author(s):  
Karen A. Gelmon ◽  
Frances Boyle ◽  
Bella Kaufman ◽  
David Huntsman ◽  
Alexey Manikhas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Phase Iii ◽  
Rank Test ◽  
Her2 Status ◽  
P Value ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

LBA671 Background: The relative efficacy of L vs T when combined with Tax chemotherapy in the first-line setting of metastatic breast cancer (BC) is unknown. Methods: MA.31 compares Tax-based therapy, paclitaxel 80mg/m2 wkly or docetaxel 75mg/m2 3 wkly for 24 wks in combination with L or T. The L dose was 1,250 mg po daily with Tax followed by 1,500 mg daily (LTax/L). After a loading dose, the T dose was 2 mg/kg wkly or 6 mg/kg 3 wkly + Tax followed by T 6 mg/kg 3 wkly (TTax/T). Stratification was by prior neo/adjuvant HER2 therapy, prior neo/adjuvant Tax, planned Tax (paclitaxel vs docetaxel), and liver metastases. The primary endpoint is ITT progression-free survival (PFS), defined as time from randomization to objective progressive disease based on RECIST criteria or death from any cause. The protocol-specified IA was performed after observing 333 PFS events; the trial was to stop if the 2-sided p-value from the stratified log-rank test was less than 0.03. The NCIC CTG’s independent DSMC reviewed IA results and recommended disclosure because the superiority boundary was crossed. A secondary analysis utilized central laboratory-confirmed HER2 + status. Results: Between July 17 2008 and Dec 1 2011, 652 pts were accrued. Data from 636 pts (525 HER2 centrally confirmed) were included in the IA with clinical cutoff date of Nov 7 2011 and database lock of Apr 13 2012. Median follow-up was 13.6 mos, 12.9 mos for LTax/L pts and 14.0 mos for TTax/T patients. In the ITT analysis, PFS was inferior with LTax/L compared to TTax/T hazard ratio (HR) =1.33; 95% CI 1.06-1.67; p=0.01. LTax/L had median PFS 8.8 mos (95% CI 8.3-10.6) compared to TTax/T 11.4 mos (95% CI 10.8-13.7). PFS in the centrally confirmed HER2+ had HR 1.48 (95%CI 1.15-1.92; p=0.003) (LTax/L to TTax/T). No difference in overall survival was detected (LTax/L to TTax/T) HR= 1.1 (95% CI 0.75-1.61; p=0.62). More grade 3-4 diarrhea and rash was observed with LTax/L (p<0.001). Conclusions: LTax/L therapy is associated with a shorter PFS compared to TTax/T as first line therapy for HER2+ metastatic BC. ClinicalTrials.gov: NCT00667251. CCSRI grant: 021039. Supported by GlaxoSmithKline.

Effect of tumor subtype on overall survival in brain metastatic breast cancer patients treated with cranial irradiation.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 74-74
Author(s):  
Vipin Das Villgran ◽  
Aju Mathew ◽  
Margaret Quinn Rosenzweig ◽  
Shira Abberbock ◽  
Rohan Dilipbhai Naik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Metastatic Breast Cancer ◽  
Breast Cancer Subtype ◽  
Metastatic Breast ◽  
Her2 Status ◽  
Tumor Subtype ◽  
Prognostic Role ◽  
Tumor Subtypes ◽  
Significant Difference

74 Background: Brain metastatic breast cancer (BMBC) is often treated with whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS) or both. Breast cancer tumor subtypes defined by hormone receptor (HR) and HER2 status have an important prognostic role in metastatic disease. It is unclear if tumor subtypes have a prognostic role in patients receiving WBRT or SRS. We aimed to investigate the association between breast cancer subtype and overall survival (OS) among BMBC patients treated with WBRT and SRS. Methods: In a single-institution cohort study, BMBC patients treated with WBRT/SRS during 1997-2013 were identified. Clinico-pathological characteristics and survival information were prospectively collected. Tumor subtype category were defined as HR+/HER2-, HER2+/HR+, HER2+/HR- and triple negative (TN). WBRT category patients received that modality and SRS category patients, only SRS for treatment of brain metastases. OS is defined as time from diagnosis of brain metastasis to death or last follow-up. We conducted univariate analyses using the Kaplan-Meier method and log-rank tests and multivariate analysis using Cox proportional hazards models. Results: Among 193 BMBC patients who received WBRT or SRS, 62 received just SRS, and among them, 45% was HR+/HER2-. The distribution of subtypes was similar in WBRT patients. The median OS in SRS group was 15 months (95% CI 11-18) compared to WBRT with 10 months (95% CI 7-14) (p=0.03). Among patients receiving WBRT, median OS in HER2+/HR- tumor was 30 months (95% CI 13-37), HER2+/HR+ tumor - 14 months (95% CI 5-24), HER2-/HR+ tumor - 8 months (95% CI 4-11) and TN - 5 months (95% CI 3-9) (P=0.0003). There was no significant difference in OS between the breast cancer subtypes among SRS patients: median OS among patients with HER2+/HR- tumor was 11 months (95% CI 5–27), HER2+/HR+ tumor - 25 months (95% CI 7-32), HER2-/HR+ tumor - 18 months (95% CI 14-32), and TN - 12 months (95% CI 3-24) (p=0.07). Conclusions: Among patients with BMBC,tumor subtype is a prognostic factor for survival in those who received WBRT. Tumor subtype provided no prognostic information for those who were treated with only SRS.

Prognostic role of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in metastatic breast cancer (MBC) patients: First clues for cost-effective biomarkers.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e13079-e13079 ◽  
Author(s):  
Giacomo Pelizzari ◽  
Lorenzo Gerratana ◽  
Debora Basile ◽  
Maria Grazia Vitale ◽  
Michele Bartoletti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Alkaline Phosphatase ◽  
Metastatic Breast Cancer ◽  
Lactate Dehydrogenase ◽  
Metastatic Breast ◽  
Cost Effective ◽  
Prognostic Role

Utilization of anti-HER2 regimens among HER2-positive metastatic breast cancer patients.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 282-282
Author(s):  
Sandhya Mehta ◽  
Jinlin Song ◽  
Melissa Pavilack ◽  
Jipan Xie ◽  
Xiaoyu Nie ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Targeted Therapies ◽  
Metastatic Breast ◽  
Cancer Registries ◽  
Additional Treatment ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Her2 Positive

282 Background: HER2-positive (+) metastatic breast cancer (mBC) has a poor prognosis and many patients require multiple lines of HER2 targeted regimens. This study aims to examine the treatment sequencing of anti-HER2 regimens for HER2+ mBC among Medicare beneficiaries. Methods: A retrospective study was conducted using linked 1999-2016 Surveillance, Epidemiology, and End Results (SEER) cancer registries and Medicare claims. Adults patients who had mBC diagnosis, HER2+ status documented in SEER or claims of ≥1 anti-HER2 drug, continuous enrollment in Medicare from the date of mBC diagnosis until end of study period/death, and 2 anti-HER2 regimens with or without chemotherapy (Ch) or hormonal therapy (HT) were included. Discontinuation of anti-HER2 regimen was defined as the absence of claims for all anti-HER2 drugs for >60 days, or initiation of a different anti-HER2 drug. Re-initiation of the same regimen after >60 days was considered as a new regimen. The first two anti-HER2 regimens and subsequent therapies were summarized. Results: 804 patients with 2 anti-HER2 regimens were included. Trastuzumab (T) based regimen (defined as: T±Ch/HT; without other anti-HER2 drugs) was the most common 1st regimen (82%), followed by T+ pertuzumab (P) (14%) and lapatinib (L) (3%). For the 2nd regimen, T (52%) was most common, followed by T+P (18%), L (11%), trastuzumab emtansine (T-DM1) (11%) and T+L (7%). After a 2nd regimen, 578 (72%) initiated a subsequent therapy, with over half switching to non-targeted therapies [52%; HT alone (35%), Ch±HT (17%)] followed by T (17%), T-DM1 (12%) and T+P (7%). Among those with subsequent therapy, 2 T-based regimens followed by HT alone (21%) was the most common sequence. After the 1st regimen, 52% patients reused the same anti-HER2 drugs in the 2nd regimen, 21% added another anti-HER2 drug and 27% switched to a different anti-HER2 regimen. After the 2nd regimen, 14% reused anti-HER2 drugs and 6% added another anti-HER2 drug, 25% switched to a different anti-HER2 regimen; 15% reused anti-HER2 drugs from the 1st regimen. Conclusions: Trastuzumab based regimen was the mainstay of anti-HER2 drug regimens during the study timeframe. Despite availability of multiple anti-HER2 drugs, reuse of prior anti-HER2 drugs and switching to non-targeted therapies alone were common after using 2 anti-HER2 regimens. These findings underscore the unmet needs in later lines of therapy. Recently approved anti-HER2 agents may provide additional treatment options for pre-treated HER2+ metastatic breast cancer patients.

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