Efficacy of adjuvant trastuzumab in women with HER2-positive T1a or bN0M0 breast cancer: a population-based cohort study.
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal, Humanized
/ therapeutic use
Breast Neoplasms
/ drug therapy
Canada
/ epidemiology
Chemotherapy, Adjuvant
/ methods
Cohort Studies
Disease-Free Survival
Female
Humans
Middle Aged
Neoplasm Recurrence, Local
/ drug therapy
Proportional Hazards Models
Receptor, ErbB-2
/ genetics
Trastuzumab
/ therapeutic use
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
20 01 2022
20 01 2022
Historique:
received:
04
06
2021
accepted:
03
01
2022
entrez:
21
1
2022
pubmed:
22
1
2022
medline:
3
3
2022
Statut:
epublish
Résumé
Adjuvant trastuzumab has been associated with superior survival in women with ≥ T1c or node-positive HER2-positive early-stage breast cancer; however, there is a lack of phase III trials in women with T1a/bN0 disease. Our study aimed to assess the outcomes of women with HER2-positive T1a/bN0 breast cancer who received adjuvant trastuzumab in Saskatchewan, Canada. We evaluated all women diagnosed with HER2-positive T1a/bN0 breast cancer in Saskatchewan between 2008 and 2017. We performed Cox proportional multivariable analysis to determine factors correlated with survival. In addition, inverse probability treatment weighting (IPTW) using propensity score was performed to assess benefit of adjuvant trastuzumab. Ninety-one eligible women with a median age of 61 years (range 30-89) were identified. Thirty-nine (43%) women received adjuvant trastuzumab. Women who received trastuzumab were younger and had a higher rate of T1b disease. Overall, 3% of women who received trastuzumab compared to 12% of women who did not receive trastuzumab developed breast cancer recurrence (p = 0.23). Five-year disease-free survival (DFS) of women who received adjuvant trastuzumab was 94.8% compared to 82.7% of women who did not receive trastuzumab (p = 0.22). Five-year overall survival was 100% of women who received trastuzumab compared to 90.4% of women who did not receive adjuvant trastuzumab (p = 0.038). In the multivariable analysis, grade III tumors were correlated with inferior DFS (hazard ratio [HR] 5.5, 95% CI [1.7-17.7]). The propensity score using the inverse probability of treatment weighting showed that lack of adjuvant trastuzumab was correlated inferior DFS, with an HR of 4 (95% CI 1.05-15.5). Women with HER2-positive T1a/bN0 breast cancer had overall low recurrence of breast cancer. However, the results of this exploratory analysis indicate that women who received adjuvant trastuzumab had better survival.
Identifiants
pubmed: 35058536
doi: 10.1038/s41598-022-05209-8
pii: 10.1038/s41598-022-05209-8
pmc: PMC8776836
doi:
Substances chimiques
Antibodies, Monoclonal, Humanized
0
ERBB2 protein, human
EC 2.7.10.1
Receptor, ErbB-2
EC 2.7.10.1
Trastuzumab
P188ANX8CK
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1068Informations de copyright
© 2022. The Author(s).
Références
J Clin Oncol. 2021 Jul 20;39(21):2375-2385
pubmed: 34077270
Ann Oncol. 2011 Nov;22(11):2387-2393
pubmed: 21406473
Lancet Oncol. 2011 Mar;12(3):236-44
pubmed: 21354370
Cochrane Database Syst Rev. 2012 Apr 18;(4):CD006243
pubmed: 22513938
Lancet. 2019 Jun 29;393(10191):2599-2612
pubmed: 31178152
Lancet Oncol. 2017 Apr;18(4):545-554
pubmed: 28238593
Breast Cancer Res Treat. 2010 Feb;119(3):653-61
pubmed: 19957028
J Breast Cancer. 2020 Dec 07;23(6):672-673
pubmed: 33408893
Breast Cancer. 2015 Mar;22(2):101-16
pubmed: 25634227
Multivariate Behav Res. 2011 May;46(3):399-424
pubmed: 21818162
JAMA. 2019 Jan 22;321(3):288-300
pubmed: 30667505
J Clin Oncol. 2009 Dec 1;27(34):5693-9
pubmed: 19884553
BMC Cancer. 2019 May 30;19(1):520
pubmed: 31146706
Ann Transl Med. 2020 Mar;8(5):187
pubmed: 32309334
N Engl J Med. 2011 Oct 6;365(14):1273-83
pubmed: 21991949
JAMA Netw Open. 2020 Aug 3;3(8):e2011777
pubmed: 32833018
N Engl J Med. 2015 Jan 8;372(2):134-41
pubmed: 25564897
BMC Cancer. 2018 Jan 8;18(1):51
pubmed: 29310623
J Clin Oncol. 2009 Dec 1;27(34):5700-6
pubmed: 19884543
N Engl J Med. 2001 Mar 15;344(11):783-92
pubmed: 11248153
J Clin Oncol. 2011 Sep 1;29(25):3366-73
pubmed: 21768458
Breast Cancer Res Treat. 2016 Jul;158(2):361-71
pubmed: 27357813