The benefits of trastuzumab in the treatment of HER2+ breast cancer as a function of exposure time

20 Jan 2022
Felipe Andrés Cordero da Luz, Eduarda da Costa Marinho, Camila Piqui Nascimento, Lara de Andrade Marques, Patrícia Ferreira Ribeiro Delfino, Rafael Mathias Antonioli, Marcelo José Barbosa Silva, Rogério Agenor de Araújo

Background: Breast cancer is a heterogeneous disease with overexpression of several receptors, such as human epidermal receptor 2 (HER2), which is a prognostic and predictive biomarker for treatment with the anti-HER2 monoclonal antibody trastuzumab. This study aimed to test the contribution of this regimen in patients with overexpression/amplification of HER2 for periods shorter than the 1-year treatment recommendation.

Methods: A retrospective single-centre study involving 155 patients with non-metastatic (stages I–III) invasive ductal HER2+ breast carcinoma, with a median follow-up of 48.9 months after completion of adjuvant therapy, except endocrine therapy.

Results: About 60% of patients received trastuzumab therapy for a median time of 365 days. Although the use of trastuzumab for a short period has provided some benefit, analyses of survival with a continuous dependent variable have revealed a minimum time for improved survival. In the multivariate analysis by Cox regression, trastuzumab use duration exceeding 9 weeks resulted in protection against distant metastasis (adjusted HR: 0.307 (0.139–0.678), p = 0.004), disease progression (adjusted hazard ratio (HR) 0.353 (0.175–0.714), p = 0.004) and death (adjusted HR: 0.267 (0.105–0.678), p = 0.005), being superior to multimodal systemic therapy with chemotherapy and to endocrine therapy without trastuzumab, but inferior to almost 1 year of administration of this monoclonal antibody, especially regarding overall survival (adjusted HR: 0.203 (0.069–0.596), p = 0.004).

Conclusion: Despite showing some benefits, the protective effect derived from a suboptimal time of trastuzumab exposure is inferior to the standard course of 1 year.

Related Articles

Maya M Hicks, Kenneth Chanda, Mulindi Mwanahamuntu, Monica B Jones, Anissa R Mattison, Krista S Pfaendler, Leeya F Pinder, Groesbeck P Parham, Michael L Hicks
Michael L Hicks, Mulindi Mwanahamuntu, Raleigh Butler, Homer Bloomfield, Alex Mutombo, Mukanya Mpalata Anaclet, Mulumba Kapuka Sylvain, Lameck Chinula, James Kachingwe, Groesbeck P Parham
Caddie Laberiano-Fernández, Joan Moreno Luján, Bruno de Carvalho Dornelas, Magali Franco Benites, Patricia Gutiérrez Quispe, Valeria Aguilar Vásquez, Andric Guerrero Espinoza, Elsa Guerra Guerra, Gabriela Gil-Arroyo Álvarez, Juan Astigueta-Pérez, María Teresa García de Davila, Sandro Casavilca Zambrano, Tatiana Casavilca Zambrano, Alejandro Mariños, Emmanuel S González, Rossana Lazcano, Ricardo R Lastra, Isabel Alvarado-Cabrero, Henry Guerra Miller, Ricardo H Bardales, Milagros Abad-Licham
Vijay Patil, George Abraham, Madala Ravikrishna, Atanu Bhattacharjee, Vanita Noronha, Deevyashali Parekh, Nandini Menon, Jyoti Bajpai, Kumar Prabhash
Lucas Walz, Deqo Mohamed, Adam Haibah, Nikhil Harle, Samir Al-Ali, Ayan Aden Moussa, Jude Alawa, Mohamed Abdullahi Awale, Kaveh Khoshnood
Muibat Haruna, Adetola Olubunmi Daramola, Nicholas Awodele Awolola, Nahla Mustafa Badr, Adekunbiola Aina Fehintola Banjo, Abeer Shaaban