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Outcomes of trastuzumab therapy in HER2-positive early breast cancer patients: extended follow-up of JBCRG-cohort study 01.
- Source :
-
Breast cancer (Tokyo, Japan) [Breast Cancer] 2020 Jul; Vol. 27 (4), pp. 631-641. Date of Electronic Publication: 2020 Feb 14. - Publication Year :
- 2020
-
Abstract
- Background: Previous large trials of trastuzumab (TZM) demonstrated improved outcomes in patients with HER2-positive early breast cancer. However, its effectiveness and safety in Japanese patients is not yet clear. Recently, new anti-HER2 agents were developed to improve treatment outcomes, but the patient selection criteria remain controversial.<br />Purpose: The aim of this study was to evaluate the long-term effectiveness of TZM therapy as perioperative therapy for HER2-positive operable breast cancer in daily clinical practice and to create a recurrence prediction model for therapeutic selection.<br />Methods: An observational study was conducted in Japan (UMIN000002737) to observe the prognosis of women (n = 2024) with HER2-positive invasive breast cancer who received TZM for stage I-III C disease between July 2009 and June 2011. Moreover, a recurrence-predicting model was designed to evaluate the risk factors for recurrence.<br />Results: The 5- and 10-year disease-free survival (DFS) rates were 88.9 (95% CI 87.5-90.3%) and 82.4% (95% CI 79.2-85.6%), respectively. The 5- and 10-year overall survival (OS) rates were 96% (95% CI 95.1-96.9%) and 92.7% (95% CI 91.1-94.3%), respectively. Multivariate analysis revealed that the risk factors for recurrence were an age of ≥ 70 years, T2 or larger tumors, clinically detected lymph node metastasis, histological tumor diameter of > 1 cm, histologically detected lymph node metastasis (≥ n2), and the implementation of preoperative treatment. The 5-year recurrence rate under the standard treatment was estimated to be > 10% in patients with a score of 3 or greater on the recurrence-predicting model.<br />Conclusion: The recurrence-predicting model designed in this study may improve treatment selection of patients with stage I-III C disease. However, further studies are needed to validate the scores generated by this model.
- Subjects :
- Adult
Age Factors
Aged
Antineoplastic Agents, Immunological adverse effects
Antineoplastic Combined Chemotherapy Protocols
Breast Neoplasms mortality
Breast Neoplasms pathology
Chemotherapy, Adjuvant adverse effects
Chemotherapy, Adjuvant methods
Disease-Free Survival
Female
Follow-Up Studies
Humans
Japan epidemiology
Kaplan-Meier Estimate
Lymphatic Metastasis pathology
Mastectomy
Middle Aged
Models, Statistical
Multivariate Analysis
Neoplasm Recurrence, Local pathology
Neoplasm Recurrence, Local prevention & control
Neoplasm Staging
Receptor, ErbB-2 metabolism
Risk Assessment methods
Risk Factors
Trastuzumab adverse effects
Antineoplastic Agents, Immunological administration & dosage
Breast Neoplasms therapy
Neoplasm Recurrence, Local epidemiology
Receptor, ErbB-2 antagonists & inhibitors
Trastuzumab administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1880-4233
- Volume :
- 27
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Breast cancer (Tokyo, Japan)
- Publication Type :
- Academic Journal
- Accession number :
- 32060785
- Full Text :
- https://doi.org/10.1007/s12282-020-01057-4