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Long-term survival in HER2-positive metastatic breast cancer treated with first-line trastuzumab: results from the french real-life curie database

  • E. KaczmarekEmail author
  • C. Saint-Martin
  • J.-Y. Pierga
  • E. Brain
  • R. Rouzier
  • A. Savignoni
  • E. Mouret-Fourme
  • V. Dieras
  • I. Piot
  • C. Dubot
  • M. Carton
  • F. Lerebours
Review
  • 101 Downloads

Abstract

Background

Outcome of HER2-positive metastatic breast cancer (MBC) patients has improved since the use of trastuzumab. However, most HER2-positive MBC patients will progress within 1 year of trastuzumab-based therapy. Only limited data are available concerning long-term responders.

Methods

The primary objective of this study was to compare overall survival (OS) of HER2+ MBC patients with long-term response to first-line trastuzumab with overall survival of those with non-long-term response, based on two institutional databases: the French Epidemiological Strategy and Medical Economics program and the Breast Database. Long-term responders (LTR) were defined as patients with non-progressive disease for ≥ 2 years on first-line trastuzumab. Secondary objectives included progression-free survival (PFS), and predictive factors for LTR status.

Results

From 2004 to 2014, 422 HER2-positive MBC patients received first-line trastuzumab. With a median follow-up of 48 months, median OS and PFS were 63 months (CI95%, 50–71), and 18 months (CI95%, 15–21) respectively. In 111 patients (26.3%) classified as LTR, median OS was 110 months (CI95%, 95-not reached) versus 56 months in non-LTR patients (CI95%, 47–68). In multivariate logistic regressions, the following factors were independently associated with LTR status: number of metastatic sites (≤ 2 versus > 2, p = 0.01); endocrine therapy for metastatic disease (p = 0.001) and taxane-based first-line chemotherapy (p = 0.003).

Conclusion

Several features are associated with long-term response to trastuzumab: few metastatic sites, taxane-based chemotherapy and maintenance endocrine therapy in HR+ patients. Further studies are needed to identify patients in whom trastuzumab can be stopped after several years of sustained response.

Keywords

Trastuzumab Long-term responders Metastatic breast cancer 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants performed by any of the authors.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • E. Kaczmarek
    • 1
    • 2
    • 3
    • 4
    • 5
    Email author
  • C. Saint-Martin
    • 1
    • 2
    • 3
    • 4
    • 5
  • J.-Y. Pierga
    • 1
    • 2
    • 3
    • 4
    • 5
  • E. Brain
    • 1
    • 2
    • 3
    • 4
    • 5
  • R. Rouzier
    • 1
    • 2
    • 3
    • 4
    • 5
  • A. Savignoni
    • 1
    • 2
    • 3
    • 4
    • 5
  • E. Mouret-Fourme
    • 1
    • 2
    • 3
    • 4
    • 5
  • V. Dieras
    • 1
    • 2
    • 3
    • 4
    • 5
  • I. Piot
    • 1
    • 2
    • 3
    • 4
    • 5
  • C. Dubot
    • 1
    • 2
    • 3
    • 4
    • 5
  • M. Carton
    • 1
    • 2
    • 3
    • 4
    • 5
  • F. Lerebours
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.Department of Medical OncologyOscar Lambret CenterLilleFrance
  2. 2.Department of BiostatisticsInstitut CurieParisFrance
  3. 3.Department of Medical OncologyInstitut CurieParisFrance
  4. 4.Department of Surgical OncologyInstitut CurieParisFrance
  5. 5.R&D, UnicancerUCBGParisFrance

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