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A Retrospective Study on the Efficacy of Trastuzumab in HER2-Positive and Tamoxifen-Refractory Breast Cancer with Brain Metastasis

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Abstract

Background and Objective

The role of trastuzumab in breast cancer with brain metastasis is still in discussion. This study was conducted to investigate the efficacy of trastuzumab in the management of human epidermal growth factor receptor 2 (HER2)–positive, tamoxifen-refractory breast cancer with brain metastasis.

Methods

This retrospective study was conducted between January 2008 and December 2012. A total of 33 patients receiving trastuzumab treatment for HER2-positive, tamoxifen-refractory breast cancer with brain metastasis were assigned to the experimental group, while a matched group of 35 patients who received systemic therapy without trastuzumab were assigned to the control group. Data on the patient characteristics and clinical outcomes were collected and evaluated.

Results

Patients in the trastuzumab group showed a significantly better response to treatment than those in the control group (p = 0.025). Univariate and multivariate Cox proportional regression analyses indicated that progression-free survival was significantly longer in patients receiving trastuzumab therapy than in the control group (hazard ratio [HR] 2.213 [p = 0.003] and HR 3.056 [p < 0.001], respectively) and significantly shorter in patients with two or more extracranial metastases (HR 0.417 [p = 0.002] and HR 0.317 [p < 0.001], respectively). Furthermore, patients on trastuzumab treatment experienced longer overall survival than patients in the control group (HR 2.844 [p < 0.001] and HR 4.017 [p < 0.001], respectively), while shorter overall survival was seen in patients with two or more extracranial metastases (HR 0.524 [p = 0.021] and HR 0.430 [p = 0.005], respectively) and in those receiving capecitabine-based therapy as compared with anthracycline-based therapy (HR 0.558 [p = 0.030] and HR 0.449 [p = 0.011], respectively).

Conclusion

Trastuzumab was found to benefit patients with HER2-positive, tamoxifen-refractory breast cancer with brain metastasis by improving progression-free and overall survival.

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Acknowledgments

We would like to express our thanks to Dr. Zhi Cao for his advice on how to organize and write the manuscript.

Author contributions

Chongjian Zhang and Shude Cui designed the study, and Chongjian Zhang, Lu Wang, and Lina Wang collected the clinical and follow-up information. Chongjian Zhang and Lu Wang analyzed and discussed the data. Shude Cui supervised the project. Chongjian Zhang wrote the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Breast Cancer Center, Affiliated Cancer Hospital of Zhengzhou University, No. 127 Dongming Road, Zhengzhou, 450008, China

    Chongjian Zhang, Lu Wang, Lina Wang & Shude Cui

Authors
  1. Chongjian Zhang
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  2. Lu Wang
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  3. Lina Wang
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  4. Shude Cui
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Corresponding author

Correspondence to Shude Cui.

Ethics declarations

The study was performed in accordance with the ethical standards of the Declaration of Helsinki.

Ethical approval

The study was approved by the ethics committee at our hospital.

Conflict of interest

There is no conflict of interest to declare.

Funding

There was no funding for the present study.

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Zhang, C., Wang, L., Wang, L. et al. A Retrospective Study on the Efficacy of Trastuzumab in HER2-Positive and Tamoxifen-Refractory Breast Cancer with Brain Metastasis. BioDrugs 30, 33–40 (2016). https://doi.org/10.1007/s40259-015-0156-z

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