ecancermedicalscience

Research

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

Eduardo Cazap, Benjamin O Anderson, Giuseppe Curigliano, Sandeep Sehdev, Fatima Cardoso, Ana Rita Gonzalez, Emad Shash, Cheng-Har Yip, André Mattar, Yanin Chavarri-Guerra, Miriam Mutebi, Yongmei Yin, João Victor Rocha, Ilaria Lucibello, Namita Srivastava
Mayank Chhabra, Somika Meet, Gandhar Tendulkar, Kunal Oswal, Milan Toraskar, Sai Murali, Bharat Kumar Sarvepalli, Sripriya Rao, Ramachandran Venkataramanan, Yogesh Jain
Vanlaltluangi, Lalengkimi Ralte, John Zothanzama, Lalrammawia Tochhawng, Ruby Zothankimi Ralte, Harvey Vanlalpeka, Nachimuthu Senthil Kumar
Atul Budukh, Sonali Bagal, Deepak Gupta, Sharyu Mhamane, Ravikant Singh, Burhanuddin Qayyumi, Abha Rani Sinha, Sanjay Kumar Singh, Satyajit Pradhan, Pankaj Chaturvedi, Rajendra Badwe, Sudeep Gupta
Sasongko Hadi Priyono, Winardi Budiwinata, Budianto Tedjowitono, Effendy, Muhamad Daffa Ibnurasy Pratama