Efficacy of trastuzumab in unselected patients with HER2-positive metastatic breast cancer: a retrospective analysis

• Published in: Tumori 2014-07, Vol.100 (4), p.426-431
• Main Authors: Collovà, Elena, Ferzi, Antonella, Scandurra, Giuseppa, Aurilio, Gaetano, Torri, Valter, Porcu, Luca, Sanò, Maria Vita, Taibi, Eleonora, Foglietta, Jennifer, Generali, Daniele, Andreis, Daniele, Dazzani, Maria Chiara, Bramati, Annalisa, Marcon, Ilaria, Atzori, Francesco, Cinieri, Saverio, Tondulli, Luca, Grasso, Donatella, Nolè, Franco, Petrella, Maria Cristina, Gori, Stefania, La Verde, Nicla
• Format: Article
• Language: English
• ISSN: 2038-2529
• DOI: 10.1700/1636.17902

AIMS AND BACKGROUNDThe addition of trastuzumab to chemotherapy for HER2-positive metastatic breast cancer has significantly improved progression-free survival and overall survival, although most patients develop resistance or have a primarily resistant disease. The aim of the study was to describe the efficacy and safety of a first-line treatment in unselected metastatic HER2-positive breast cancer patients, treated according to clinical practice.METHODSFrom 2000 to 2009, we conducted a retrospective multi-institutional analysis of 182 consecutive patients with HER2-positive metastatic breast cancer who underwent first-line treatment with trastuzumab. The primary end points were progression-free survival and overall survival; the secondary end points were survival after progression in patients treated with second-line chemotherapy with or without trastuzumab and safety. A total of 172 patients were analyzed.RESULTSMedian progression-free survival and overall survival were 1.2 (95% CI, 1.1-1.4) and 4.4 years (95% CI, 3.6-5.4), respectively. For 100 patients who received second-line chemotherapy, median survival after progression was significantly longer in those who also received trastuzumab: 2.8 (95% CI, 2.1-4.0) versus 1.2 years (95% CI, 0.6-1.9).CONCLUSIONSAlthough based on retrospective data, the study confirms the role of trastuzumab as first-line treatment in metastatic breast cancer outside of a controlled trial. Moreover, information obtained on the use of trastuzumab beyond disease progression supports its use in this setting.