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Adjuvant Short-Course Trastuzumab in Breast Cancer

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Introduction

The standard duration of adjuvant trastuzumab is 1 year. But the decision to use for 1 year was chosen arbitrarily in clinical trials. Many patients from developing countries like India cannot afford 1 year of adjuvant trastuzumab.

Methods

We retrospectively analysed 70 patients with HER2-positive breast cancer, who received short-course trastuzumab, and compared them with a matched historical cohort (n = 65) of HER2-positive breast cancer patients who did not receive trastuzumab.

Results

The 1-year DFS and OS of patients who received short-course trastuzumab were 91% and 96%, respectively. This cohort was matched for age, stage and menopausal status with a historical cohort (N = 65) of HER2-positive breast cancer who did not receive trastuzumab. The 1-year DFS (94 vs 71%, p = 0.045) and 1-year OS (94 vs 80%, p = 0.006) were superior for those who received short-course trastuzumab.

Conclusion

Adjuvant short-course trastuzumab (weekly for 9 weeks) improved survival in HER2-positive breast cancer as compared to the historical cohort without trastuzumab.

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References

  1. Bray F, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424.

    Article  Google Scholar 

  2. Kumar V, Tewari M, Singh U, Shukla HS. Significance of Her-2/neu protein over expression in Indian breast cancer patients. Indian J Surg. 2007;69:122–8.

    Article  Google Scholar 

  3. Boekhout AH, Beijnen JH, Schellens JHM. Trastuzumab. Oncologist. 2011;16:800–10.

    Article  CAS  Google Scholar 

  4. Cameron D, et al. 11 years’ follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive early breast cancer: final analysis of the HERceptin Adjuvant (HERA) trial. Lancet. 2017;389:1195–205.

    Article  CAS  Google Scholar 

  5. Perez EA, et al. Trastuzumab plus adjuvant chemotherapy for human epidermal growth factor receptor 2-positive breast cancer: planned joint analysis of overall survival from NSABP B-31 and NCCTG N9831. J Clin Oncol. 2014;32:3744–52.

    Article  CAS  Google Scholar 

  6. Pernas S, Barroso-Sousa R, Tolaney SM. Optimal treatment of early stage HER2-positive breast cancer. Cancer. 2018;124:4455–66.

    Article  CAS  Google Scholar 

  7. Earl HM, et al. PERSEPHONE: 6 versus 12 months (m) of adjuvant trastuzumab in patients (pts) with HER2 positive (+) early breast cancer (EBC): Randomised phase 3 non-inferiority trial with definitive 4-year (yr) disease-free survival (DFS) results. J Clin Oncol. 2018;36:506–506.

    Article  Google Scholar 

  8. Mavroudis D, et al. Six versus 12 months of adjuvant trastuzumab in combination with dose-dense chemotherapy for women with HER2-positive breast cancer: a multicenter randomized study by the Hellenic Oncology Research Group (HORG). Ann Oncol. 2015;26:1333–40.

    CAS  PubMed  Google Scholar 

  9. Pivot X, et al. 6 months versus 12 months of adjuvant trastuzumab for patients with HER2-positive early breast cancer (PHARE): a randomised phase 3 trial. Lancet Oncol. 2013;14:741–8.

    Article  CAS  Google Scholar 

  10. Joensuu H, et al. Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med. 2006;354:809–20.

    Article  CAS  Google Scholar 

  11. Joensuu H, et al. Effect of adjuvant trastuzumab for a duration of 9 weeks vs 1 year with concomitant chemotherapy for early human epidermal growth factor receptor 2-positive breast cancer: the SOLD randomized clinical trial. JAMA Oncol. 2018;4:1199–206.

    Article  Google Scholar 

  12. Conte P, et al. Nine weeks versus 1 year adjuvant trastuzumab in combination with chemotherapy: final results of the phase III randomized short-HER study‡. Ann Oncol. 2018;29:2328–33.

    Article  CAS  Google Scholar 

  13. Ghosh J, et al. Estrogen, progesterone and HER2 receptor expression in breast tumors of patients, and their usage of HER2-targeted therapy, in a tertiary care centre in India. Indian J Cancer. 2011;48:391–6.

    Article  CAS  Google Scholar 

  14. Duggan MA, Anderson WF, Altekruse S, Penberthy L, Sherman ME. The surveillance, epidemiology and end results (SEER) program and pathology: towards strengthening the critical relationship. Am J Surg Pathol. 2016;40:e94–102.

    Article  Google Scholar 

  15. Leyland-Jones B, et al. Pharmacokinetics, safety, and efficacy of trastuzumab administered every three weeks in combination with paclitaxel. J Clin Oncol. 2003;21:3965–71.

    Article  CAS  Google Scholar 

  16. Levêque D, Gigou L, Bergerat JP. Clinical pharmacology of trastuzumab. Curr Clin Pharmacol. 2008;3:51–5.

    Article  Google Scholar 

  17. Baselga J, Norton L, Albanell J, Kim YM, Mendelsohn J. Recombinant humanized anti-HER2 antibody (Herceptin) enhances the antitumor activity of paclitaxel and doxorubicin against HER2/neu overexpressing human breast cancer xenografts. Cancer Res. 1998;58:2825–31.

    CAS  PubMed  Google Scholar 

  18. Goldhirsch A, et al. 2 years versus 1 year of adjuvant trastuzumab for HER2-positive breast cancer (HERA): an open-label, randomised controlled trial. Lancet. 2013;382:1021–8.

    Article  CAS  Google Scholar 

  19. Earl HM, et al. 6 versus 12 months of adjuvant trastuzumab for HER2-positive early breast cancer (PERSEPHONE): 4-year disease-free survival results of a randomised phase 3 non-inferiority trial. Lancet. 2019;393:2599–612.

    Article  CAS  Google Scholar 

  20. Chen L, et al. Short-duration versus 1-year adjuvant trastuzumab in early HER2 positive breast cancer: a meta-analysis of randomized controlled trials. Cancer Treat Rev. 2019;75:12–9.

    Article  CAS  Google Scholar 

  21. von Minckwitz G, et al. Adjuvant pertuzumab and trastuzumab in early HER2-positive breast cancer. N Engl J Med. 2017;377:122–31.

    Article  Google Scholar 

  22. Piccart-Gebhart M, et al. Adjuvant lapatinib and trastuzumab for early human epidermal growth factor receptor 2-positive breast cancer: results from the randomized phase III adjuvant lapatinib and/or trastuzumab treatment optimization trial. J Clin Oncol. 2016;34:1034–42.

    Article  CAS  Google Scholar 

  23. Martin M, et al. Neratinib after trastuzumab-based adjuvant therapy in HER2-positive breast cancer (ExteNET): 5-year analysis of a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2017;18:1688–700.

    Article  CAS  Google Scholar 

  24. von Minckwitz G, et al. Trastuzumab emtansine for residual invasive HER2-positive breast cancer. N Engl J Med. 2019;380:617–28.

    Article  Google Scholar 

  25. Hingmire SS, et al. Efficacy and safety of short course adjuvant trastuzumab combination chemotherapy in breast cancer. South Asian J Cancer. 2017;6:47.

    PubMed  PubMed Central  Google Scholar 

  26. Perez EA, et al. Sequential versus concurrent trastuzumab in adjuvant chemotherapy for breast cancer. J Clin Oncol. 2011;29:4491–7.

    Article  CAS  Google Scholar 

  27. Spielmann M, et al. Trastuzumab for patients with axillary-node-positive breast cancer: results of the FNCLCC-PACS 04 trial. J Clin Oncol. 2009;27:6129–34.

    Article  CAS  Google Scholar 

  28. Gianni L, et al. Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet. 2010;375:377–84.

    Article  CAS  Google Scholar 

  29. Seidman A, et al. Cardiac dysfunction in the trastuzumab clinical trials experience. J Clin Oncol. 2002;20:1215–21.

    Article  CAS  Google Scholar 

  30. Joensuu H, et al. Fluorouracil, epirubicin, and cyclophosphamide with either docetaxel or vinorelbine, with or without trastuzumab, as adjuvant treatments of breast cancer: final results of the FinHer trial. J Clin Oncol. 2009;27:5685–92.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Oncology, Cancer Institute (WIA), Chennai, 38, Sardar Patel Road, Chennai, 600036, India

    Taha Sethjiwala, Manikandan Dhanushkodi, Venkatraman Radhakrishnan, Jayachandran Perumal Kalaiarasi, Nikita Mehra, Archit Joshi, Arun Kumar Rajan, Gangothri Selvarajan, Tenali Gnana Sagar & Trivadi S. Ganesan

  2. Department of Radiation Oncology, Cancer Institute (WIA), Chennai, India

    Balasubramanian Ananthi, Priya Iyer, Geetha Senguttuvan, Bharathi Srilatha & Selvaluxmy Ganesarajah

  3. Department of Epidemiology Biostatistics and Tumor Registry, Cancer Institute (WIA), Chennai, India

    Rama Ranganathan

  4. Department of Oncopathology, Cancer Institute (WIA), Chennai, India

    Shirley Sundersingh

  5. Department of Surgical Oncology, Cancer Institute (WIA), Chennai, India

    Arvind Krishnamurthy, Sridevi Velusamy & Hemanth Raj

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  1. Taha Sethjiwala
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  2. Manikandan Dhanushkodi
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Correspondence to Manikandan Dhanushkodi.

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Sethjiwala, T., Dhanushkodi, M., Radhakrishnan, V. et al. Adjuvant Short-Course Trastuzumab in Breast Cancer. Indian J Gynecol Oncolog 17, 68 (2019). https://doi.org/10.1007/s40944-019-0313-2

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  • DOI: https://doi.org/10.1007/s40944-019-0313-2

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