Autoimmunity and Benefit from Trastuzumab Treatment in Breast Cancer: Results from the HERA Trial

This study sought to determine whether an autoimmune background could identify patients with HER2-positive early breast cancer (EBC) who derive differential benefit from primary adjuvant trastuzumab-based therapy. HERA is an international randomized trial of 5,102 women with HER2-positive EBC, who w...

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Bibliographic Details
Published in:Anticancer research 2019-02, Vol.39 (2), p.797-802
Main Authors: Sonnenblick, Amir, Bailey, Andrew, Uziely, Beatrice, Untch, Michael, Smith, Ian, Gianni, Luca, Baselga, Jose, Jackisch, Christian, Cameron, David, Bell, Richard, Zardavas, Dimitrios, Al-Sakaff, Nedal, Gelber, Richard D, Dowsett, Mitch, Leyland-Jones, Brian, Piccart-Gebhart, Martine J, DE Azambuja, Evandro
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Agents, Immunological - therapeutic use
Autoimmune diseases
Autoimmune Diseases - complications
Breast cancer
Breast Neoplasms - complications
Breast Neoplasms - drug therapy
Breast Neoplasms - immunology
Cancer
Chemotherapy, Adjuvant - adverse effects
Disease-Free Survival
ErbB-2 protein
Family medical history
Female
Humans
Immunotherapy
International Cooperation
Middle Aged
Monoclonal antibodies
Patients
Proportional Hazards Models
Risk
Survival
Targeted cancer therapy
Trastuzumab
Trastuzumab - therapeutic use
Treatment Outcome
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Summary:This study sought to determine whether an autoimmune background could identify patients with HER2-positive early breast cancer (EBC) who derive differential benefit from primary adjuvant trastuzumab-based therapy. HERA is an international randomized trial of 5,102 women with HER2-positive EBC, who were enrolled to either receive adjuvant trastuzumab or not. In this exploratory analysis, the interaction between autoimmune history and the magnitude of trastuzumab benefit was evaluated. A total of 5,099 patients were included in the current analysis. Among them, 325 patients (6.4%) had autoimmune disease history, 295 of whom had active disease. Patients were randomly assigned to trastuzumab or no-trastuzumab groups. Similar reductions in the risk of events in patients with and without autoimmune history were observed (interaction p=0.95 for disease-free survival, and p=0.62 for overall survival). No evidence of a differential benefit from trastuzumab in patients with a medical history of autoimmune disease was found.
ISSN:0250-7005
1791-7530
DOI:10.21873/anticanres.13177