Optimal use of anthracycline-free perioperative chemotherapy in HER2-positive breast cancer patients
Purpose In adjuvant settings of human epidermal growth factor receptor 2 (HER2)-positive breast cancer, anthracycline-based chemotherapy followed by taxane and trastuzumab is a standard regimen. Recent studies have reported the use of anthracycline-free adjuvant chemotherapy in selected HER2-positiv...
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Veröffentlicht in: | International journal of clinical oncology 2019-07, Vol.24 (7), p.807-814 |
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container_title | International journal of clinical oncology |
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creator | Watanuki, Rurina Hayashida, Tetsu Kawai, Yuko Kikuchi, Masayuki Nakashoji, Ayako Yokoe, Takamichi Toyota, Tomoka Seki, Tomoko Takahashi, Maiko Kitagawa, Yuko |
description | Purpose
In adjuvant settings of human epidermal growth factor receptor 2 (HER2)-positive breast cancer, anthracycline-based chemotherapy followed by taxane and trastuzumab is a standard regimen. Recent studies have reported the use of anthracycline-free adjuvant chemotherapy in selected HER2-positive breast cancer patients. We conducted a single-center retrospective study to identify the characteristics of HER2-positive breast cancer patients for whom anthracyclines can be safely omitted.
Methods
A total of 238 women were diagnosed with HER2-positive breast cancer and treated with neoadjuvant and/or adjuvant chemotherapy between January 1, 2008 and December 31, 2015 at Keio University Hospital. They were divided in two cohorts: an “anthracycline” cohort of 112 anthracycline-treated women and a “no anthracycline” cohort of 126 anthracycline-untreated women. Survival outcomes were estimated by Kaplan–Meier method.
Results
The 3-year disease-free survival rates in the no-anthracycline and anthracycline cohorts were 91.3% and 93.1%, respectively (
P
= 0.692). After using a statistical method with inverse probability of treatment weighting to minimize the selection bias, no significant differences were observed between the two cohorts (adjusted hazard ratio for disease-free survival: 1.042;
P
= 0.909). Stratified by tumor size, no significant differences were observed between the two cohorts in the cT1N0 and cT2N0 subsets (
P
= 0.516 and
P
= 0.579, respectively). The recurrence rate was low among patients who achieved pathological complete response after receiving neoadjuvant chemotherapy with or without anthracyclines.
Conclusion
Our study suggests that anthracyclines can be safely omitted in selected patients with HER2-positive breast cancer, who have cT1N0 or cT2N0 and achieved pathological complete response after receiving neoadjuvant chemotherapy. |
doi_str_mv | 10.1007/s10147-019-01420-2 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2186619454</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2186437560</sourcerecordid><originalsourceid>FETCH-LOGICAL-c571t-ae4887b62821a001eb3bdac9ec88e788df2705d1bd7c7d5cec9e26877dea10d13</originalsourceid><addsrcrecordid>eNp9kUtLxDAUhYMoOo7-ARcScOMmmps-ki5FxgcMCKLrkCa3TodOW5NWmH9vnBkVXLjIi_Pdm8s5hJwBvwLO5XUADqlkHIq4UsGZ2CMTSBPJpJRiP96TFFiRi-yIHIew5BxknolDcpRwBVwVfELcUz_UK9PQMSDtKmraYeGNXdumbpFVHpH26OsubmaoP5DaBa66YRGf_ZrWLX2YPQvWd6HeqKVHEwZqTWvR0z6WYDuEE3JQmSbg6e6ckte72cvtA5s_3T_e3syZzSQMzGCqlCxzoQSYOCyWSemMLdAqhVIpVwnJMwelk1a6zGKURK6kdGiAO0im5HLbt_fd-4hh0Ks6WGwa02I3Bi1A5TkUaZZG9OIPuuxG38bpNlQ0Mct5pMSWsr4LwWOlex_d8msNXH9loLcZ6JiB3mSgRSw637UeyxW6n5Jv0yOQbIEQpfYN_e_f_7T9BJC5krg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2186437560</pqid></control><display><type>article</type><title>Optimal use of anthracycline-free perioperative chemotherapy in HER2-positive breast cancer patients</title><source>SpringerLink_现刊</source><creator>Watanuki, Rurina ; Hayashida, Tetsu ; Kawai, Yuko ; Kikuchi, Masayuki ; Nakashoji, Ayako ; Yokoe, Takamichi ; Toyota, Tomoka ; Seki, Tomoko ; Takahashi, Maiko ; Kitagawa, Yuko</creator><creatorcontrib>Watanuki, Rurina ; Hayashida, Tetsu ; Kawai, Yuko ; Kikuchi, Masayuki ; Nakashoji, Ayako ; Yokoe, Takamichi ; Toyota, Tomoka ; Seki, Tomoko ; Takahashi, Maiko ; Kitagawa, Yuko</creatorcontrib><description>Purpose
In adjuvant settings of human epidermal growth factor receptor 2 (HER2)-positive breast cancer, anthracycline-based chemotherapy followed by taxane and trastuzumab is a standard regimen. Recent studies have reported the use of anthracycline-free adjuvant chemotherapy in selected HER2-positive breast cancer patients. We conducted a single-center retrospective study to identify the characteristics of HER2-positive breast cancer patients for whom anthracyclines can be safely omitted.
Methods
A total of 238 women were diagnosed with HER2-positive breast cancer and treated with neoadjuvant and/or adjuvant chemotherapy between January 1, 2008 and December 31, 2015 at Keio University Hospital. They were divided in two cohorts: an “anthracycline” cohort of 112 anthracycline-treated women and a “no anthracycline” cohort of 126 anthracycline-untreated women. Survival outcomes were estimated by Kaplan–Meier method.
Results
The 3-year disease-free survival rates in the no-anthracycline and anthracycline cohorts were 91.3% and 93.1%, respectively (
P
= 0.692). After using a statistical method with inverse probability of treatment weighting to minimize the selection bias, no significant differences were observed between the two cohorts (adjusted hazard ratio for disease-free survival: 1.042;
P
= 0.909). Stratified by tumor size, no significant differences were observed between the two cohorts in the cT1N0 and cT2N0 subsets (
P
= 0.516 and
P
= 0.579, respectively). The recurrence rate was low among patients who achieved pathological complete response after receiving neoadjuvant chemotherapy with or without anthracyclines.
Conclusion
Our study suggests that anthracyclines can be safely omitted in selected patients with HER2-positive breast cancer, who have cT1N0 or cT2N0 and achieved pathological complete response after receiving neoadjuvant chemotherapy.</description><identifier>ISSN: 1341-9625</identifier><identifier>EISSN: 1437-7772</identifier><identifier>DOI: 10.1007/s10147-019-01420-2</identifier><identifier>PMID: 30810890</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Anthracycline ; Breast cancer ; Cancer Research ; Chemotherapy ; Epidermal growth factor ; ErbB-2 protein ; Medicine ; Medicine & Public Health ; Monoclonal antibodies ; Oncology ; Original Article ; Patients ; Surgical Oncology ; Survival ; Targeted cancer therapy ; Trastuzumab ; Womens health</subject><ispartof>International journal of clinical oncology, 2019-07, Vol.24 (7), p.807-814</ispartof><rights>Japan Society of Clinical Oncology 2019</rights><rights>International Journal of Clinical Oncology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c571t-ae4887b62821a001eb3bdac9ec88e788df2705d1bd7c7d5cec9e26877dea10d13</citedby><cites>FETCH-LOGICAL-c571t-ae4887b62821a001eb3bdac9ec88e788df2705d1bd7c7d5cec9e26877dea10d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10147-019-01420-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10147-019-01420-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30810890$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watanuki, Rurina</creatorcontrib><creatorcontrib>Hayashida, Tetsu</creatorcontrib><creatorcontrib>Kawai, Yuko</creatorcontrib><creatorcontrib>Kikuchi, Masayuki</creatorcontrib><creatorcontrib>Nakashoji, Ayako</creatorcontrib><creatorcontrib>Yokoe, Takamichi</creatorcontrib><creatorcontrib>Toyota, Tomoka</creatorcontrib><creatorcontrib>Seki, Tomoko</creatorcontrib><creatorcontrib>Takahashi, Maiko</creatorcontrib><creatorcontrib>Kitagawa, Yuko</creatorcontrib><title>Optimal use of anthracycline-free perioperative chemotherapy in HER2-positive breast cancer patients</title><title>International journal of clinical oncology</title><addtitle>Int J Clin Oncol</addtitle><addtitle>Int J Clin Oncol</addtitle><description>Purpose
In adjuvant settings of human epidermal growth factor receptor 2 (HER2)-positive breast cancer, anthracycline-based chemotherapy followed by taxane and trastuzumab is a standard regimen. Recent studies have reported the use of anthracycline-free adjuvant chemotherapy in selected HER2-positive breast cancer patients. We conducted a single-center retrospective study to identify the characteristics of HER2-positive breast cancer patients for whom anthracyclines can be safely omitted.
Methods
A total of 238 women were diagnosed with HER2-positive breast cancer and treated with neoadjuvant and/or adjuvant chemotherapy between January 1, 2008 and December 31, 2015 at Keio University Hospital. They were divided in two cohorts: an “anthracycline” cohort of 112 anthracycline-treated women and a “no anthracycline” cohort of 126 anthracycline-untreated women. Survival outcomes were estimated by Kaplan–Meier method.
Results
The 3-year disease-free survival rates in the no-anthracycline and anthracycline cohorts were 91.3% and 93.1%, respectively (
P
= 0.692). After using a statistical method with inverse probability of treatment weighting to minimize the selection bias, no significant differences were observed between the two cohorts (adjusted hazard ratio for disease-free survival: 1.042;
P
= 0.909). Stratified by tumor size, no significant differences were observed between the two cohorts in the cT1N0 and cT2N0 subsets (
P
= 0.516 and
P
= 0.579, respectively). The recurrence rate was low among patients who achieved pathological complete response after receiving neoadjuvant chemotherapy with or without anthracyclines.
Conclusion
Our study suggests that anthracyclines can be safely omitted in selected patients with HER2-positive breast cancer, who have cT1N0 or cT2N0 and achieved pathological complete response after receiving neoadjuvant chemotherapy.</description><subject>Anthracycline</subject><subject>Breast cancer</subject><subject>Cancer Research</subject><subject>Chemotherapy</subject><subject>Epidermal growth factor</subject><subject>ErbB-2 protein</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Monoclonal antibodies</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Targeted cancer therapy</subject><subject>Trastuzumab</subject><subject>Womens health</subject><issn>1341-9625</issn><issn>1437-7772</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kUtLxDAUhYMoOo7-ARcScOMmmps-ki5FxgcMCKLrkCa3TodOW5NWmH9vnBkVXLjIi_Pdm8s5hJwBvwLO5XUADqlkHIq4UsGZ2CMTSBPJpJRiP96TFFiRi-yIHIew5BxknolDcpRwBVwVfELcUz_UK9PQMSDtKmraYeGNXdumbpFVHpH26OsubmaoP5DaBa66YRGf_ZrWLX2YPQvWd6HeqKVHEwZqTWvR0z6WYDuEE3JQmSbg6e6ckte72cvtA5s_3T_e3syZzSQMzGCqlCxzoQSYOCyWSemMLdAqhVIpVwnJMwelk1a6zGKURK6kdGiAO0im5HLbt_fd-4hh0Ks6WGwa02I3Bi1A5TkUaZZG9OIPuuxG38bpNlQ0Mct5pMSWsr4LwWOlex_d8msNXH9loLcZ6JiB3mSgRSw637UeyxW6n5Jv0yOQbIEQpfYN_e_f_7T9BJC5krg</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Watanuki, Rurina</creator><creator>Hayashida, Tetsu</creator><creator>Kawai, Yuko</creator><creator>Kikuchi, Masayuki</creator><creator>Nakashoji, Ayako</creator><creator>Yokoe, Takamichi</creator><creator>Toyota, Tomoka</creator><creator>Seki, Tomoko</creator><creator>Takahashi, Maiko</creator><creator>Kitagawa, Yuko</creator><general>Springer Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20190701</creationdate><title>Optimal use of anthracycline-free perioperative chemotherapy in HER2-positive breast cancer patients</title><author>Watanuki, Rurina ; Hayashida, Tetsu ; Kawai, Yuko ; Kikuchi, Masayuki ; Nakashoji, Ayako ; Yokoe, Takamichi ; Toyota, Tomoka ; Seki, Tomoko ; Takahashi, Maiko ; Kitagawa, Yuko</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c571t-ae4887b62821a001eb3bdac9ec88e788df2705d1bd7c7d5cec9e26877dea10d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Anthracycline</topic><topic>Breast cancer</topic><topic>Cancer Research</topic><topic>Chemotherapy</topic><topic>Epidermal growth factor</topic><topic>ErbB-2 protein</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Monoclonal antibodies</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Targeted cancer therapy</topic><topic>Trastuzumab</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Watanuki, Rurina</creatorcontrib><creatorcontrib>Hayashida, Tetsu</creatorcontrib><creatorcontrib>Kawai, Yuko</creatorcontrib><creatorcontrib>Kikuchi, Masayuki</creatorcontrib><creatorcontrib>Nakashoji, Ayako</creatorcontrib><creatorcontrib>Yokoe, Takamichi</creatorcontrib><creatorcontrib>Toyota, Tomoka</creatorcontrib><creatorcontrib>Seki, Tomoko</creatorcontrib><creatorcontrib>Takahashi, Maiko</creatorcontrib><creatorcontrib>Kitagawa, Yuko</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database (Proquest)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest_Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of clinical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watanuki, Rurina</au><au>Hayashida, Tetsu</au><au>Kawai, Yuko</au><au>Kikuchi, Masayuki</au><au>Nakashoji, Ayako</au><au>Yokoe, Takamichi</au><au>Toyota, Tomoka</au><au>Seki, Tomoko</au><au>Takahashi, Maiko</au><au>Kitagawa, Yuko</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal use of anthracycline-free perioperative chemotherapy in HER2-positive breast cancer patients</atitle><jtitle>International journal of clinical oncology</jtitle><stitle>Int J Clin Oncol</stitle><addtitle>Int J Clin Oncol</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>24</volume><issue>7</issue><spage>807</spage><epage>814</epage><pages>807-814</pages><issn>1341-9625</issn><eissn>1437-7772</eissn><abstract>Purpose
In adjuvant settings of human epidermal growth factor receptor 2 (HER2)-positive breast cancer, anthracycline-based chemotherapy followed by taxane and trastuzumab is a standard regimen. Recent studies have reported the use of anthracycline-free adjuvant chemotherapy in selected HER2-positive breast cancer patients. We conducted a single-center retrospective study to identify the characteristics of HER2-positive breast cancer patients for whom anthracyclines can be safely omitted.
Methods
A total of 238 women were diagnosed with HER2-positive breast cancer and treated with neoadjuvant and/or adjuvant chemotherapy between January 1, 2008 and December 31, 2015 at Keio University Hospital. They were divided in two cohorts: an “anthracycline” cohort of 112 anthracycline-treated women and a “no anthracycline” cohort of 126 anthracycline-untreated women. Survival outcomes were estimated by Kaplan–Meier method.
Results
The 3-year disease-free survival rates in the no-anthracycline and anthracycline cohorts were 91.3% and 93.1%, respectively (
P
= 0.692). After using a statistical method with inverse probability of treatment weighting to minimize the selection bias, no significant differences were observed between the two cohorts (adjusted hazard ratio for disease-free survival: 1.042;
P
= 0.909). Stratified by tumor size, no significant differences were observed between the two cohorts in the cT1N0 and cT2N0 subsets (
P
= 0.516 and
P
= 0.579, respectively). The recurrence rate was low among patients who achieved pathological complete response after receiving neoadjuvant chemotherapy with or without anthracyclines.
Conclusion
Our study suggests that anthracyclines can be safely omitted in selected patients with HER2-positive breast cancer, who have cT1N0 or cT2N0 and achieved pathological complete response after receiving neoadjuvant chemotherapy.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>30810890</pmid><doi>10.1007/s10147-019-01420-2</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Anthracycline Breast cancer Cancer Research Chemotherapy Epidermal growth factor ErbB-2 protein Medicine Medicine & Public Health Monoclonal antibodies Oncology Original Article Patients Surgical Oncology Survival Targeted cancer therapy Trastuzumab Womens health |
title | Optimal use of anthracycline-free perioperative chemotherapy in HER2-positive breast cancer patients |
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