Dissecting the effect of hormone receptor status in patients with HER2-positive early breast cancer: exploratory analysis from the ALTTO (BIG 2-06) randomized clinical trial.
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Breast Neoplasms
/ diagnosis
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Humans
Molecular Targeted Therapy
Proportional Hazards Models
Receptor, ErbB-2
/ antagonists & inhibitors
Receptors, Progesterone
/ metabolism
Treatment Outcome
Breast cancer
Estrogen receptor
HER2
Progesterone receptor
Journal
Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104
Informations de publication
Date de publication:
Aug 2019
Aug 2019
Historique:
received:
13
04
2019
accepted:
16
05
2019
pubmed:
28
5
2019
medline:
21
12
2019
entrez:
29
5
2019
Statut:
ppublish
Résumé
Limited evidence exists on the impact of hormone receptor (HR) status to counsel HER2-positive early breast cancer patients receiving adjuvant anti-HER2 therapy. ALTTO (BIG 2-06) was an international, intergroup, open-label, randomized phase III trial in HER2-positive early breast cancer patients randomized to receive 1 year of trastuzumab and/or lapatinib. HER2, estrogen and progesterone receptors were centrally tested for all patients. We investigated the impact of HR status on prognosis, risk of disease-free survival (DFS) events over time, patterns of first DFS events, and factors associated with risk of DFS events overall, in years 0-5 and 6-8. Out of 6273 patients included in this analysis, 3603 (57.4%) had HR-positive tumors. Median follow-up was 6.93 years. Five-year and 8-year DFS were 86% and 80% in patients with HR-positive disease, and 83% and 79% in those with HR-negative tumors, respectively. Mean annual hazards of recurrence in years 0-5 were 3% in patients with HR-positive disease and 4% in those with HR-negative tumors, while in years 6-8 they were 3% and 2%, respectively. Distribution of first DFS event in years 6-8 (P = 0.005) and type of first distant recurrence (P < 0.001) were significantly different between the two groups. Risk factors for DFS events overall, in years 0-5, and 6-8 were different in patients with HR-positive and HR-negative tumors. HER2-positive early breast cancer is characterized by the presence of two diseases with distinct natural history based on HR status requiring the development of different follow-up strategies and future de-escalation and escalation clinical trials.
Identifiants
pubmed: 31134488
doi: 10.1007/s10549-019-05284-y
pii: 10.1007/s10549-019-05284-y
doi:
Substances chimiques
Receptors, Progesterone
0
Receptor, ErbB-2
EC 2.7.10.1
Types de publication
Clinical Trial
Clinical Trial, Phase III
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
103-114Références
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