HER2+ breast cancer: trastuzumab linked to low incidence of late recurrence at years 5-10

  • Chumsri S & al.
  • J Clin Oncol
  • 17 Oct 2019

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

  • The risk for late relapse occurring 5-10 years after diagnosis is only 3%-6% among trastuzumab-treated patients with human epidermal growth factor receptor 2 (HER2+) breast cancer (BCa).
  • Similar late benefit was obtained with patients with hormone receptor (HR)+ and HR disease.

Why this matters

  • This is the first study to quantify the risk for late relapse in this population.

Study design

  • Combined analysis of 2 randomized controlled clinical trials (North Central Cancer Treatment Group N9831 [Alliance] and NRG Oncology/NSABP B-31) in which 3177 patients with HER2+ BCa were given adjuvant chemotherapy alone (12 weeks) or trastuzumab (n=52 weeks).
  • Funding: NIH; Genentech; others.

Key results

  • Overall, HR+ (vs HR) HER2+ cases, regardless of treatment type, had improved recurrence-free survival (RFS) during the first 5 years (HR, 0.65; P<.001>
  • Trastuzumab-treated patients had lower cumulative hazard for RFS in patients with HR+ (vs HR+−) disease during the first 5 years (10.96% vs 17.48%; HR, 0.60; P<.001>
  • During years 5-10 after trastuzumab treatment, no difference in RFS benefit was found by HR status (HR, 1.32; P=.12).
    • Although risk for recurrence was low for HR+ HER2+ disease, it was lowest for patients without lymph node involvement (3.23%) and slightly higher (6.39%) in patients with 1-3 positive lymph nodes.

Limitations

  • Lack of longer follow-up.

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