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Effects of hormone receptor status on the durable response of trastuzumab-based therapy in metastatic breast cancer

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Abstract

Purpose

Trastuzumab-based treatment is the standard care for patients with HER2+ metastatic breast cancer (MBC). About 10% of HER2+ MBC showed a long-term durable response (progression-free survival, PFS > 3 years) to trastuzumab-based therapy. The aim of this study is to identify clinico-pathologic factors for a durable response to trastuzumab-based therapy in HER2-positive MBC.

Methods

In the Yonsei Breast Cancer MBC Database, we identified 1218 MBC patients who were diagnosed from 2006 to 2015. Among them, 294 had HER2+ disease, and 153 received trastuzumab plus taxane chemotherapy as first-line treatment. Clinico-pathologic factors, such as hormone receptor (HR) status and metastatic sites, were reviewed. To evaluate a durable response, landmark analysis was performed.

Results

The median follow-up time was 28 months (95% CI 4.4–83.0 months). Of 153 HER2+ patients, there were 73 HR- patients (47.7%), and bone was the most common metastatic site. The median PFS and overall survival (OS) were 12 and 39 months, respectively. HR- patients showed a tendency toward longer PFS (median, 13 vs. 11 months, P = 0.160) compared with HR+ patients. Patients with non-visceral metastases had longer median PFS and OS than those with visceral disease (median PFS, 15 vs. 11 months, P = 0.012; median OS, 75 vs. 34 months, P = 0.03). Landmark analysis at 9 months suggested that the PFS of HR- patients was significantly longer than that of HR+ patients (median, 19 vs. 9 months, P = 0.008).

Conclusions

Among patients with HER2+ MBC, HR status is a possible predictive biomarker of a durable response to trastuzumab-based therapy.

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Acknowledgements

I appreciate the data manager’s help for the collection and analysis of the clinical data.

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Correspondence to Gun Min Kim.

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The author(s) have no potential conflicts of interest or financial disclosures.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Park, H.S., Sohn, J., Kim, S.I. et al. Effects of hormone receptor status on the durable response of trastuzumab-based therapy in metastatic breast cancer. Breast Cancer Res Treat 163, 255–262 (2017). https://doi.org/10.1007/s10549-017-4175-y

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  • DOI: https://doi.org/10.1007/s10549-017-4175-y

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