Metastatic breast cancer: 3 features predict long-term trastuzumab response

  • Kaczmarek E & al.
  • Breast Cancer Res Treat
  • 5 Sep 2019

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

  • Long-term trastuzumab responders (LTR) with human epidermal growth factor receptor 2 (HER2)+ metastatic breast cancer have twice the survival as non-LTR.
  • Factors predictive of LTR include number of metastatic sites, taxane-based chemotherapy, and maintenance endocrine therapy. 

Why this matters

  • One of the first real-life studies to compare LTRs with non-LTRs.

Study design

  • A retrospective cohort (n=422) of the French Epidemiological Strategy and Medical Economics (ESME) Program-Institute Curie breast database.
  • ESME was analyzed from 2008 to 2014; Institute Curie from 2004 to 2008. Both were maintained by a single institute.
  • LTR was defined as nonprogressive disease for ≥2 years on first-line trastuzumab.
  • Funding: None disclosed.

Key results

  • Median follow-up was 48 months.
  • 111 of 422 subjects were LTR (26.3%).
  • LTR had a median OS of 110 (95% CI, 95-not reached) months vs 56 (95% CI, 47-68) months among non-LTR.
  • Multivariate predictive factors for LTR included:
    • Fewer number of metastatic sites (≤2 vs >2; P=.01).
    • Receipt of taxane-based first-line chemotherapy (vs no receipt) for primary breast cancer (P=.003).
    • Receipt of maintenance endocrine therapy+trastuzumab (vs no receipt; P=.001).

Limitations

  • Single-center study.
  • Retrospective, observational design.

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