Long-term hazard of recurrence in HER2+ breast cancer patients untreated with anti-HER2 therapy
Worldwide, many patients with HER2+ (human epidermal growth factor receptor 2-positive) early breast cancer (BC) do not receive adjuvant trastuzumab. Hazards of recurrence of these patients with respect to hormone receptor status of the primary tumor have not been described. Using data from 1,260 pa...
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| Veröffentlicht in: | Breast cancer research : BCR 2015-04, Vol.17 (1), p.56-56, Article 56 |
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| creator | Strasser-Weippl, Kathrin Horick, Nora Smith, Ian E O'Shaughnessy, Joyce Ejlertsen, Bent Boyle, Frances Buzdar, Aman U Fumoleau, Pierre Gradishar, William Martin, Miguel Moy, Beverly Piccart-Gebhart, Martine Pritchard, Kathleen I Lindquist, Deborah Rappold, Erica Finkelstein, Dianne M Goss, Paul E |
| description | Worldwide, many patients with HER2+ (human epidermal growth factor receptor 2-positive) early breast cancer (BC) do not receive adjuvant trastuzumab. Hazards of recurrence of these patients with respect to hormone receptor status of the primary tumor have not been described.
Using data from 1,260 patients randomized to placebo in the adjuvant TEACH trial, we report 10-year annual hazards of recurrence in HER2+ patients not treated with anti-HER2 therapy.
Disease-free survival (DFS) was 75% after 5 and 61% after 10 years, respectively. Patients with HER2+ hormone receptor-positive (HR+ (hormone receptor-positive); ER+ (estrogen receptor-positive) or PR+ (progesterone receptor-positive)) disease had a significantly better DFS than patients with HER2+ HR- (ER-/PR-) disease (hazard ratio 0.72, P=0.02). This difference was explainable by a significantly higher hazard of recurrence in years 1 to 5 in HER2+ HR- compared to HER2+ HR+ patients, with a mean risk of recurrence of 9%/year for HR- versus 5%/year in HR+ patients (hazard ratio 0.59, P=0.002 for years 1 to 5). The high early risk of recurrence of HER2+ HR- patients declined sharply over time, so that it was similar to that seen in HER2+ HR+ patients in years 6 to 10 (hazard ratio 0.97, P=0.92 for years 6 to 10).
Our results show that outcomes in HER2+ patients with early BC not receiving anti-HER2 therapy strongly depend on HR expression. The very high early risk of relapse seen in HER2+ HR- patients is particularly relevant in health care settings with limited access to adjuvant anti-HER2 treatment. The event rates shown for subpopulations of HER2+ BC patients suggest that in resource-constrained environments patients with HER2+ HR- early BC should be prioritized for consideration of adjuvant anti-HER2 therapy. |
| doi_str_mv | 10.1186/s13058-015-0568-1 |
| format | Article |
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Using data from 1,260 patients randomized to placebo in the adjuvant TEACH trial, we report 10-year annual hazards of recurrence in HER2+ patients not treated with anti-HER2 therapy.
Disease-free survival (DFS) was 75% after 5 and 61% after 10 years, respectively. Patients with HER2+ hormone receptor-positive (HR+ (hormone receptor-positive); ER+ (estrogen receptor-positive) or PR+ (progesterone receptor-positive)) disease had a significantly better DFS than patients with HER2+ HR- (ER-/PR-) disease (hazard ratio 0.72, P=0.02). This difference was explainable by a significantly higher hazard of recurrence in years 1 to 5 in HER2+ HR- compared to HER2+ HR+ patients, with a mean risk of recurrence of 9%/year for HR- versus 5%/year in HR+ patients (hazard ratio 0.59, P=0.002 for years 1 to 5). The high early risk of recurrence of HER2+ HR- patients declined sharply over time, so that it was similar to that seen in HER2+ HR+ patients in years 6 to 10 (hazard ratio 0.97, P=0.92 for years 6 to 10).
Our results show that outcomes in HER2+ patients with early BC not receiving anti-HER2 therapy strongly depend on HR expression. The very high early risk of relapse seen in HER2+ HR- patients is particularly relevant in health care settings with limited access to adjuvant anti-HER2 treatment. The event rates shown for subpopulations of HER2+ BC patients suggest that in resource-constrained environments patients with HER2+ HR- early BC should be prioritized for consideration of adjuvant anti-HER2 therapy.</description><identifier>ISSN: 1465-542X</identifier><identifier>ISSN: 1465-5411</identifier><identifier>EISSN: 1465-542X</identifier><identifier>DOI: 10.1186/s13058-015-0568-1</identifier><identifier>PMID: 25888246</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Analysis ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Breast cancer ; Breast Neoplasms - drug therapy ; Breast Neoplasms - metabolism ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Cancer patients ; Care and treatment ; Chemotherapy, Adjuvant ; Diagnosis ; Diseases ; Epidermal growth factor ; Estrogen ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Molecular Targeted Therapy ; Neoplasm Recurrence, Local ; Progesterone ; Prognosis ; Proportional Hazards Models ; Receptor, ErbB-2 - antagonists & inhibitors ; Receptor, ErbB-2 - genetics ; Receptor, ErbB-2 - metabolism ; Receptors, Estrogen - metabolism ; Receptors, Progesterone - metabolism ; Relapse ; Treatment Outcome ; Young Adult</subject><ispartof>Breast cancer research : BCR, 2015-04, Vol.17 (1), p.56-56, Article 56</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>Strasser-Weippl et al.; licensee BioMed Central. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-ad6a99123a0557df200ade3c9952aec4ce81e76054830369a9f8e874acb95ef3</citedby><cites>FETCH-LOGICAL-c466t-ad6a99123a0557df200ade3c9952aec4ce81e76054830369a9f8e874acb95ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423419/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4423419/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25888246$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Strasser-Weippl, Kathrin</creatorcontrib><creatorcontrib>Horick, Nora</creatorcontrib><creatorcontrib>Smith, Ian E</creatorcontrib><creatorcontrib>O'Shaughnessy, Joyce</creatorcontrib><creatorcontrib>Ejlertsen, Bent</creatorcontrib><creatorcontrib>Boyle, Frances</creatorcontrib><creatorcontrib>Buzdar, Aman U</creatorcontrib><creatorcontrib>Fumoleau, Pierre</creatorcontrib><creatorcontrib>Gradishar, William</creatorcontrib><creatorcontrib>Martin, Miguel</creatorcontrib><creatorcontrib>Moy, Beverly</creatorcontrib><creatorcontrib>Piccart-Gebhart, Martine</creatorcontrib><creatorcontrib>Pritchard, Kathleen I</creatorcontrib><creatorcontrib>Lindquist, Deborah</creatorcontrib><creatorcontrib>Rappold, Erica</creatorcontrib><creatorcontrib>Finkelstein, Dianne M</creatorcontrib><creatorcontrib>Goss, Paul E</creatorcontrib><title>Long-term hazard of recurrence in HER2+ breast cancer patients untreated with anti-HER2 therapy</title><title>Breast cancer research : BCR</title><addtitle>Breast Cancer Res</addtitle><description>Worldwide, many patients with HER2+ (human epidermal growth factor receptor 2-positive) early breast cancer (BC) do not receive adjuvant trastuzumab. Hazards of recurrence of these patients with respect to hormone receptor status of the primary tumor have not been described.
Using data from 1,260 patients randomized to placebo in the adjuvant TEACH trial, we report 10-year annual hazards of recurrence in HER2+ patients not treated with anti-HER2 therapy.
Disease-free survival (DFS) was 75% after 5 and 61% after 10 years, respectively. Patients with HER2+ hormone receptor-positive (HR+ (hormone receptor-positive); ER+ (estrogen receptor-positive) or PR+ (progesterone receptor-positive)) disease had a significantly better DFS than patients with HER2+ HR- (ER-/PR-) disease (hazard ratio 0.72, P=0.02). This difference was explainable by a significantly higher hazard of recurrence in years 1 to 5 in HER2+ HR- compared to HER2+ HR+ patients, with a mean risk of recurrence of 9%/year for HR- versus 5%/year in HR+ patients (hazard ratio 0.59, P=0.002 for years 1 to 5). The high early risk of recurrence of HER2+ HR- patients declined sharply over time, so that it was similar to that seen in HER2+ HR+ patients in years 6 to 10 (hazard ratio 0.97, P=0.92 for years 6 to 10).
Our results show that outcomes in HER2+ patients with early BC not receiving anti-HER2 therapy strongly depend on HR expression. The very high early risk of relapse seen in HER2+ HR- patients is particularly relevant in health care settings with limited access to adjuvant anti-HER2 treatment. The event rates shown for subpopulations of HER2+ BC patients suggest that in resource-constrained environments patients with HER2+ HR- early BC should be prioritized for consideration of adjuvant anti-HER2 therapy.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - metabolism</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Chemotherapy, Adjuvant</subject><subject>Diagnosis</subject><subject>Diseases</subject><subject>Epidermal growth factor</subject><subject>Estrogen</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Molecular Targeted Therapy</subject><subject>Neoplasm Recurrence, Local</subject><subject>Progesterone</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Receptor, ErbB-2 - antagonists & inhibitors</subject><subject>Receptor, ErbB-2 - genetics</subject><subject>Receptor, ErbB-2 - metabolism</subject><subject>Receptors, Estrogen - metabolism</subject><subject>Receptors, Progesterone - metabolism</subject><subject>Relapse</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>1465-542X</issn><issn>1465-5411</issn><issn>1465-542X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkVFrFDEUhYMotlZ_gC8S8KUg0yYzSSZ5EUqpVlgQSh98C3czd3YjM8maZJT215tla2lB8pBw73cO9-YQ8p6zM861Os-8Y1I3jMuGSaUb_oIcc6FkI0X74-WT9xF5k_NPxnivpX5NjlqptW6FOiZ2FcOmKZhmuoV7SAONI03olpQwOKQ-0Ourm_YTXSeEXKiDWk10B8VjKJkuodRGwYH-8WVLIRTf7AW0bDHB7u4teTXClPHdw31Cbr9c3V5eN6vvX79dXqwaJ5QqDQwKjOFtB0zKfhhbxmDAzhkjW0AnHGqOvWJS6I51yoAZNepegFsbiWN3Qj4fbHfLesbB1dkSTHaX_Azpzkbw9nkn-K3dxN9WiLYT3FSD0weDFH8tmIudfXY4TRAwLtlypevv9dyoin48oBuY0Powxuro9ri9kIJL0xouKnX2H6qeAWfvYsDR1_ozAT8IXIo5Jxwfp-fM7uO2h7htjdvu47a8aj48XftR8S_f7i_b4aVr</recordid><startdate>20150416</startdate><enddate>20150416</enddate><creator>Strasser-Weippl, Kathrin</creator><creator>Horick, Nora</creator><creator>Smith, Ian E</creator><creator>O'Shaughnessy, Joyce</creator><creator>Ejlertsen, Bent</creator><creator>Boyle, Frances</creator><creator>Buzdar, Aman U</creator><creator>Fumoleau, Pierre</creator><creator>Gradishar, William</creator><creator>Martin, Miguel</creator><creator>Moy, Beverly</creator><creator>Piccart-Gebhart, Martine</creator><creator>Pritchard, Kathleen I</creator><creator>Lindquist, Deborah</creator><creator>Rappold, Erica</creator><creator>Finkelstein, Dianne M</creator><creator>Goss, Paul E</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150416</creationdate><title>Long-term hazard of recurrence in HER2+ breast cancer patients untreated with anti-HER2 therapy</title><author>Strasser-Weippl, Kathrin ; Horick, Nora ; Smith, Ian E ; O'Shaughnessy, Joyce ; Ejlertsen, Bent ; Boyle, Frances ; Buzdar, Aman U ; Fumoleau, Pierre ; Gradishar, William ; Martin, Miguel ; Moy, Beverly ; Piccart-Gebhart, Martine ; Pritchard, Kathleen I ; Lindquist, Deborah ; Rappold, Erica ; Finkelstein, Dianne M ; Goss, Paul E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-ad6a99123a0557df200ade3c9952aec4ce81e76054830369a9f8e874acb95ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - metabolism</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Chemotherapy, Adjuvant</topic><topic>Diagnosis</topic><topic>Diseases</topic><topic>Epidermal growth factor</topic><topic>Estrogen</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Molecular Targeted Therapy</topic><topic>Neoplasm Recurrence, Local</topic><topic>Progesterone</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Receptor, ErbB-2 - antagonists & inhibitors</topic><topic>Receptor, ErbB-2 - genetics</topic><topic>Receptor, ErbB-2 - metabolism</topic><topic>Receptors, Estrogen - metabolism</topic><topic>Receptors, Progesterone - metabolism</topic><topic>Relapse</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Strasser-Weippl, Kathrin</creatorcontrib><creatorcontrib>Horick, Nora</creatorcontrib><creatorcontrib>Smith, Ian E</creatorcontrib><creatorcontrib>O'Shaughnessy, Joyce</creatorcontrib><creatorcontrib>Ejlertsen, Bent</creatorcontrib><creatorcontrib>Boyle, Frances</creatorcontrib><creatorcontrib>Buzdar, Aman U</creatorcontrib><creatorcontrib>Fumoleau, Pierre</creatorcontrib><creatorcontrib>Gradishar, William</creatorcontrib><creatorcontrib>Martin, Miguel</creatorcontrib><creatorcontrib>Moy, Beverly</creatorcontrib><creatorcontrib>Piccart-Gebhart, Martine</creatorcontrib><creatorcontrib>Pritchard, Kathleen I</creatorcontrib><creatorcontrib>Lindquist, Deborah</creatorcontrib><creatorcontrib>Rappold, Erica</creatorcontrib><creatorcontrib>Finkelstein, Dianne M</creatorcontrib><creatorcontrib>Goss, Paul E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Breast cancer research : BCR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Strasser-Weippl, Kathrin</au><au>Horick, Nora</au><au>Smith, Ian E</au><au>O'Shaughnessy, Joyce</au><au>Ejlertsen, Bent</au><au>Boyle, Frances</au><au>Buzdar, Aman U</au><au>Fumoleau, Pierre</au><au>Gradishar, William</au><au>Martin, Miguel</au><au>Moy, Beverly</au><au>Piccart-Gebhart, Martine</au><au>Pritchard, Kathleen I</au><au>Lindquist, Deborah</au><au>Rappold, Erica</au><au>Finkelstein, Dianne M</au><au>Goss, Paul E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term hazard of recurrence in HER2+ breast cancer patients untreated with anti-HER2 therapy</atitle><jtitle>Breast cancer research : BCR</jtitle><addtitle>Breast Cancer Res</addtitle><date>2015-04-16</date><risdate>2015</risdate><volume>17</volume><issue>1</issue><spage>56</spage><epage>56</epage><pages>56-56</pages><artnum>56</artnum><issn>1465-542X</issn><issn>1465-5411</issn><eissn>1465-542X</eissn><abstract>Worldwide, many patients with HER2+ (human epidermal growth factor receptor 2-positive) early breast cancer (BC) do not receive adjuvant trastuzumab. Hazards of recurrence of these patients with respect to hormone receptor status of the primary tumor have not been described.
Using data from 1,260 patients randomized to placebo in the adjuvant TEACH trial, we report 10-year annual hazards of recurrence in HER2+ patients not treated with anti-HER2 therapy.
Disease-free survival (DFS) was 75% after 5 and 61% after 10 years, respectively. Patients with HER2+ hormone receptor-positive (HR+ (hormone receptor-positive); ER+ (estrogen receptor-positive) or PR+ (progesterone receptor-positive)) disease had a significantly better DFS than patients with HER2+ HR- (ER-/PR-) disease (hazard ratio 0.72, P=0.02). This difference was explainable by a significantly higher hazard of recurrence in years 1 to 5 in HER2+ HR- compared to HER2+ HR+ patients, with a mean risk of recurrence of 9%/year for HR- versus 5%/year in HR+ patients (hazard ratio 0.59, P=0.002 for years 1 to 5). The high early risk of recurrence of HER2+ HR- patients declined sharply over time, so that it was similar to that seen in HER2+ HR+ patients in years 6 to 10 (hazard ratio 0.97, P=0.92 for years 6 to 10).
Our results show that outcomes in HER2+ patients with early BC not receiving anti-HER2 therapy strongly depend on HR expression. The very high early risk of relapse seen in HER2+ HR- patients is particularly relevant in health care settings with limited access to adjuvant anti-HER2 treatment. The event rates shown for subpopulations of HER2+ BC patients suggest that in resource-constrained environments patients with HER2+ HR- early BC should be prioritized for consideration of adjuvant anti-HER2 therapy.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25888246</pmid><doi>10.1186/s13058-015-0568-1</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Analysis Antineoplastic Combined Chemotherapy Protocols - therapeutic use Breast cancer Breast Neoplasms - drug therapy Breast Neoplasms - metabolism Breast Neoplasms - mortality Breast Neoplasms - pathology Cancer patients Care and treatment Chemotherapy, Adjuvant Diagnosis Diseases Epidermal growth factor Estrogen Female Follow-Up Studies Humans Middle Aged Molecular Targeted Therapy Neoplasm Recurrence, Local Progesterone Prognosis Proportional Hazards Models Receptor, ErbB-2 - antagonists & inhibitors Receptor, ErbB-2 - genetics Receptor, ErbB-2 - metabolism Receptors, Estrogen - metabolism Receptors, Progesterone - metabolism Relapse Treatment Outcome Young Adult |
| title | Long-term hazard of recurrence in HER2+ breast cancer patients untreated with anti-HER2 therapy |
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