When Should Trastuzumab be Stopped after Achieving Complete Response in Her2-Positive Metastatic Breast Cancer Patients?

2007 ◽  
Vol 93 (5) ◽  
pp. 491-492 ◽  
Author(s):  
Manuela Beda ◽  
Umberto Basso ◽  
Cristina Ghiotto ◽  
Silvio Monfardini
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Complete Remission ◽  
Randomized Trials ◽  
Metastatic Breast ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Multiple Liver Metastases ◽  
The Brain

We report the case of a woman with HER2-positive metastatic breast cancer who achieved prolonged complete remission of multiple liver metastases after treatment with weekly trastuzumab plus paclitaxel but relapsed in the brain soon after stopping trastuzumab maintenance therapy which had been prosecuted for almost three years. In the absence of randomized trials, the optimal duration of trastuzumab administration after achieving complete remission of metastatic breast cancer remains questionable.

Radiological complete remission in HER2-positive metastatic breast cancer patients: what to do with trastuzumab?

2019 ◽  
Vol 178 (3) ◽  
pp. 597-605 ◽  
Author(s):  
T. G. Steenbruggen ◽  
N. I. Bouwer ◽  
C. H. Smorenburg ◽  
H. N. Rier ◽  
A. Jager ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Complete Remission ◽  
Cancer Patients ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Her2 Positive

scholarly journals Clinical benefit of treatment after trastuzumab emtansine for HER2-positive metastatic breast cancer: a real-world multi-centre cohort study in Japan (WJOG12519B)

Breast Cancer ◽  
2021 ◽  
Author(s):  
Takamichi Yokoe ◽  
Sasagu Kurozumi ◽  
Kazuki Nozawa ◽  
Yukinori Ozaki ◽  
Tetsuyo Maeda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Real World ◽  
Treatment Strategies ◽  
Metastatic Breast ◽  
Trastuzumab Emtansine ◽  
Breast Cancer Patients ◽  
Her2 Positive

Abstract Background Trastuzumab emtansine (T-DM1) treatment for human epidermal growth factor receptor-2 (HER2)-positive metastatic breast cancer after taxane with trastuzumab and pertuzumab is standard therapy. However, treatment strategies beyond T-DM1 are still in development with insufficient evidence of their effectiveness. Here, we aimed to evaluate real-world treatment choice and efficacy of treatments after T-DM1 for HER2-positive metastatic breast cancer. Methods In this multi-centre retrospective cohort study involving 17 hospitals, 325 female HER2-positive metastatic breast cancer patients whose post-T-DM1 treatment began between April 15, 2014 and December 31, 2018 were enrolled. The primary end point was the objective response rate (ORR) of post-T-DM1 treatments. Secondary end points included disease control rate (DCR), progression-free survival (PFS), time to treatment failure (TTF), and overall survival (OS). Results The median number of prior treatments of post-T-DM1 treatment was four. The types of post-T-DM1 treatments included (1) chemotherapy in combination with trastuzumab and pertuzumab (n = 102; 31.4%), (2) chemotherapy concomitant with trastuzumab (n = 78; 24.0%), (3), lapatinib with capecitabine (n = 63; 19.4%), and (4) others (n = 82; 25.2%). ORR was 22.8% [95% confidence interval (CI): 18.1–28.0], DCR = 66.6% (95% CI 60.8–72.0), median PFS = 6.1 months (95% CI 5.3–6.7), median TTF = 5.1 months (95% CI 4.4–5.6), and median OS = 23.7 months (95% CI 20.7–27.4). Conclusion The benefits of treatments after T-DM1 are limited. Further investigation of new treatment strategies beyond T-DM1 is awaited for HER2-positive metastatic breast cancer patients.

scholarly journals Succinate dehydrogenase B (SDHB) is differentially expressed in brain metastatic breast cancer.

2020 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Succinate Dehydrogenase ◽  
Microarray Data ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Mitochondrial Complex ◽  
Significant Differential Expression ◽  
Central Nervous System Metastases ◽  
The Brain

One study has reported a 34% incidence of central nervous system metastases, including metastasis to the brain, in breast cancer patients treated with trastuzumab (1). We mined published microarray data (2, 3) to discover genes associated with brain metastasis in breast cancer. We identified significant differential expression of the mitochondrial complex II subunit succinate dehydrogenase B, encoded by SDHB (4, 5), in the brain metastases of patients with metastatic breast cancer. SDHB may be relevant to the biology underlying colonization of the brain with metastatic breast cancer clones.

scholarly journals FGFR aberrations increase the risk of brain metastases and predict poor prognosis in metastatic breast cancer patients

2020 ◽  
Vol 12 ◽  
pp. 175883592091530
Author(s):  
Ning Xie ◽  
Can Tian ◽  
Hui Wu ◽  
Xiaohong Yang ◽  
Liping liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Brain Metastasis ◽  
Poor Prognosis ◽  
Significant Risk ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Genetic Aberrations ◽  
Increased Risk

Background: The survival status of patients with breast cancer and brain metastasis (BCBM) receiving current treatments is poor. Method: We designed a real-world study to investigate using patients’ clinical and genetic aberrations to forecast the prognoses of BCBM patients. We recruited 146 BCBM patients and analyzed their clinical features to evaluate the overall survival (OS). For genetic testing, 30 BCBM and 165 non-brain-metastatic (BM) metastatic breast cancer (MBC) patients from Hunan Cancer Hospital, and 86 BCBM and 1416 non-BM MBC patients from the Geneplus database who received circulating tumor DNA testing, were compared and analyzed. Results: Ki67 >14% and >3 metastatic brain tumors were significant risk factors associated with poor OS, while chemotherapy and brain radiotherapy were beneficial factors for better OS. Compared with non-BM MBC patients, BCBM patients had more fibroblast growth factor receptor ( FGFR) aberrations. The combination of FGFR, TP53 and FLT1 aberrations plus immunohistochemistry HER2-positive were associated with an increased risk of brain metastasis (AUC = 77.13%). FGFR aberration alone was not only a predictive factor (AUC = 67.90%), but also a significant risk factor for poor progression-free survival (Logrank p = 0.029). FGFR1 aberration was more frequent than other FGFR family genes in BCBM patients, and FGFR1 aberration was significantly higher in BCBM patients than non-BM MBC patients. Most FGFR1-amplified MBC patients progressed within 3 months of the late-line (>2 lines) treatment. Conclusion: A group of genetic events, including FGFR, TP53 and FLT1 genetic aberrations, and HER2-positivity, forecasted the occurrence of BM in breast cancers. FGFR genetic aberration alone predicted poor prognosis.

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