Open AccessOutcome of Patients with HER2‐Positive Advanced Breast Cancer Progressing During Trastuzumab‐Based Therapy
Author(s) -
Montemurro Filippo,
Donadio Michela,
Clavarezza Matteo,
Redana Stefania,
Jacomuzzi Maria Elena,
Valabrega Giorgio,
Danese Saverio,
ViettiRamus Guido,
Durando Antonio,
Venturini Marco,
Aglietta Massimo
Publication year - 2006
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.11-4-318
Subject(s) - trastuzumab , medicine , breast cancer , oncology , chemotherapy , clinical trial , cancer
We sought to describe patterns of treatment and clinical outcome in patients with HER2‐positive advanced breast cancer progressing on trastuzumab‐based therapy. One hundred eighty‐four consecutive HER2‐positive advanced breast cancer patients received trastuzumab‐based therapy between September 1999 and September 2004. Patients were followed up until death or May 2005. For patients progressing on trastuzumab‐based therapy, we calculated the response rate (RR) to the first post‐progression treatment, overall survival (OS) from the first administration of trastuzumab, time to second progression (TT‐SP), and post‐progression survival (PPS), according to treatment. At the time of this analysis, 132 patients had progressed on trastuzumab‐based therapy, and 89 had died. Of the progressing patients, 21 experienced rapid progression and could not receive additional anticancer treatments;40 patients continued trastuzumab either alone (12 patients with isolated central nervous system progression), with chemotherapy (23 patients), or with endocrine therapy (5 patients); and 71 stopped trastuzumab and received chemotherapy (61 patients) or endocrine therapy (10 patients) as the first post‐progression treatment. Excluding patients with rapid progression, clinical outcomes were similar whether trastuzumab was continued or not, in terms of RR (18% and 27%, respectively), OS (31 and 30 months, respectively), TT‐SP (6 and 7 months, respectively), and PPS (21 and 19 months, respectively). The clinical outcome of patients with HER2‐positive advanced breast cancer progressing during trastuzumab‐based therapy might not be influenced by continuing trastuzumab. The optimal therapeutic strategy in this setting of patients needs evaluation in randomized trials.