EBC: early trastuzumab initiation tied to superior outcomes

  • Gullo G & al.
  • Br J Cancer
  • 18 May 2018

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Earlier initiation of trastuzumab (≤12 weeks from diagnosis) is associated with lower recurrence risk and longer DFS and OS than initiation >12 weeks from diagnosis in patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (EBC).

Why this matters

  • Study supports neoadjuvant trastuzumab over adjuvant trastuzumab.

Study design

  • Retrospective cohort (n=506) drawn from a large institutional database, the One Thousand HER2 Patients Project.
  • Study included stages I-III HER2+ patients with a minimum follow-up of 3 years.
  • The date of the first breast biopsy was defined as the time of initial diagnosis.
  • Funding: Cancer Clinical Research Trust.

Key results

  • Median follow-up was 73.3 months.
  • Recurrence risk was nearly 2-fold higher in the median time-to-first trastuzumab (mTFT) >12 weeks group than the ≤12 weeks group (HR, 1.96; P=.008).
  • 5-year DFS was shorter in the mTFT >12 weeks group (81%; 95% CI, 75%-86%) than the ≤12 weeks group (91%; 95% CI, 86%-94%).
  • 5-year OS was shorter in the mTFT >12 weeks group (91%; 95% CI, 86%-94%) than the ≤12 weeks group (97%; 95% CI, 93%-98%).
  • The neoadjuvant group had shorter mTFT (4.4 weeks) than the adjuvant group (14 weeks) (P<.00001>

Limitations

  • Retrospective design.

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