- Volume 14 Issue 3
DOI QR Code
Adjuvant Trastuzumab for 6 Months is Effective in Patients with HER2-positive Stage II or III Breast Cancer
- Tai, Cheng-Jeng (Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital) ;
- Pan, Chin-Kwun (Breast Center and Department of Surgery, Yuan's General Hospital) ;
- Chen, Ching-Shyang (Division of General Surgery, Department of Surgery, Taipei Medical University Hospital) ;
- Hung, Chin-Sheng (Division of General Surgery, Department of Surgery, Taipei Medical University Hospital) ;
- Wu, Chih-Hsiung (Division of General Surgery, Department of Surgery, Taipei Medical University Hospital) ;
- Chiou, Hung-Yi (School of Public Health, College of Public Health and Nutrition, Taipei Medical University)
- Published : 2013.03.30
Objective: The optimal duration of adjuvant trastuzumab treatment in patients with HER2-positive breast cancer is not known. The aim of this study was to evaluate the efficacy of 6 months of adjuvant trastuzumab treatment in patients with stage II or III HER2-positive breast cancer. Methods: The records of patients with HER2-positive stage II or III breast cancer who were admitted to the Breast Center of Taipei Medical University Hospital and Yuan's General Hospital between 2000 and 2008 were reviewed. All patients received adjuvant trastuzumab at an initial dose of 4 mg/kg followed by a maintenance dose of 2 mg/kg/week for 22 weeks in combination with chemotherapy. Results: A total of 51 patients were included with a mean age of 46.9 years. Approximately 55% of the patients had stage III disease. The mean follow-up time from initiation of treatment was 45.2 months (range, 0.9 to 85 months). During follow-up, 46 patients (90.2%) did not experience tumor recurrence. The mean estimated disease free survival was 80.2 months. The estimated 1-, 2-, 5-, and 7-year survival rates were 97.9%, 93.1%, 93.1%, and 93.1%, respectively. The most common adverse effects were gastrointestinal symptoms (21.6%), chills (17.6%), dizziness (9.8%), and bone pain (7.8%). No cardiac or hematologic adverse events occurred. Conclusion: Adjuvant therapy with trastuzumab for 6 months resulted in a clinical benefit in patients with HER2-positive breast cancer.
- Arteaga CL, Sliwkowski MX, Osborne CK, et al (2011). Treatment of HER2-positive breast cancer: current status and future perspectives. Nat Rev Clin Oncol, 9, 16-32. https://doi.org/10.1038/nrclinonc.2011.177
- Goldhirsch A, Wood WC, Coates AS, et al (2011). Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol, 22, 1736-47. https://doi.org/10.1093/annonc/mdr304
- Guarneri V, Frassoldati A, Bruzzi P, et al (2008). Multicentric, randomized phase III trial of two different adjuvant chemotherapy regimens plus three versus twelve months of trastuzumab in patients with HER2- positive breast cancer (Short-HER Trial; NCT00629278). Clin Breast Cancer, 8, 453-6. https://doi.org/10.3816/CBC.2008.n.056
- Joensuu H, Bono P, Kataja V, et al (2009). Fluorouracil, epirubicin, and cyclophosphamide with either docetaxel or vinorelbine, with or without trastuzumab, as adjuvant treatments of breast cancer: final results of the FinHer Trial. J Clin Oncol, 27, 5685-92. https://doi.org/10.1200/JCO.2008.21.4577
- Joensuu H, Kellokumpu-Lehtinen PL, Bono P, et al (2006). Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med, 354, 809-20. https://doi.org/10.1056/NEJMoa053028
- Nahta R, Esteva FJ (2007). Trastuzumab: triumphs and tribulations. Oncogene, 26, 3637-43. https://doi.org/10.1038/sj.onc.1210379
- National Comprehensive Cancer Network (NCCN) (2012). NCCN Practice Guidelines in Oncology (2012). https://subscriptions.nccn.org/gl_login.aspx?ReturnURL=http://www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Accessed on April, 26, 2012.
- Pegram MD, Pienkowski T, Northfelt DW, et al (2004). Results of two open-label, multicenter phase II studies of docetaxel, platinum salts, and trastuzumab in HER2-positive advanced breast cancer. J Natl Cancer Inst, 96, 759-69. https://doi.org/10.1093/jnci/djh133
- Piccart-Gebhart MJ, Procter M, Leyland-Jones B, et al (2005). Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med, 353, 1659-72. https://doi.org/10.1056/NEJMoa052306
- Purmonen TT, Pankalainen E, Turunen JH, et al (2011). Short-course adjuvant trastuzumab therapy in early stage breast cancer in Finland: cost-effectiveness and value of information analysis based on the 5-year follow-up results of the FinHer Trial. Acta Oncol, 50, 344-52. https://doi.org/10.3109/0284186X.2011.553841
- Romond EH, Perez EA, Bryant J, et al (2005). Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med, 353, 1673-84. https://doi.org/10.1056/NEJMoa052122
- Ross JS, Fletcher JA (1998). The HER-2/neu oncogene in breast cancer: prognostic factor, predictive factor, and target for therapy. Oncologist, 3, 237-52.
- Sato N, Sano M, Tabei T, et al (2006). Combination docetaxel and trastuzumab treatment for patients with HER-2-overexpressing metastatic breast cancer: a multicenter, phase-II study. Breast Cancer, 13, 166-71. https://doi.org/10.2325/jbcs.13.166
- Seidman A, Hudis C, Pierri MK, et al (2002). Cardiac dysfunction in the trastuzumab clinical trials experience. J Clin Oncol, 20, 1215-21. https://doi.org/10.1200/JCO.20.5.1215
- Yin W, Jiang Y, Shen Z, et al (2011). Trastuzumab in the adjuvant treatment of HER2-positive early breast cancer patients: a meta-analysis of published randomized controlled trials. PLoS One, 6, e21030. https://doi.org/10.1371/journal.pone.0021030
- Zeglinski M, Ludke A, Jassal DS, Singal PK (2011). Trastuzumabinduced cardiac dysfunction: A 'dual-hit'. Exp Clin Cardiol, 16, 70-4.
- Clinical Efficacy of Bevacizumab Concomitant with Pemetrexed in Patients with Advanced Non-small Cell Lung Cancer vol.15, pp.8, 2014, https://doi.org/10.7314/APJCP.2014.15.8.3447
- Taxane-Based Regimens as Adjuvant Treatment for Breast Cancer: a Retrospective Study in Egyptian Cancer Patients vol.16, pp.1, 2015, https://doi.org/10.7314/APJCP.2015.16.1.65
- Patients with HER2-positive Early Breast Cancer Receiving Adjuvant Trastuzumab: Clinicopathological Features, Efficacy, and Factors Affecting Survival vol.16, pp.4, 2015, https://doi.org/10.7314/APJCP.2015.16.4.1643