Increased overall survival independent of RECIST response in metastatic breast cancer patients continuing trastuzumab treatment: evidence from a retrospective study

被引：18

作者：

Campiglio, Manuela ^{[1
]}

Bufalino, Rosaria ^{[1
]}

Sandri, Marco ^{[1
]}

Ferri, Elisa ^{[1
]}

Aiello, Rosa Anna ^{[2
]}

De Matteis, Andrea ^{[3
]}

Mottolese, Marcella ^{[4
]}

De Placido, Sabino ^{[5
]}

Querzoli, Patrizia ^{[6
]}

Jirillo, Antonio ^{[7
]}

Bottini, Alberto ^{[8
]}

Fantini, Manuela ^{[9
]}

Bonetti, Andrea ^{[10
]}

Pedani, Fulvia ^{[11
]}

Mauri, Maria ^{[12
]}

Molino, Annamaria ^{[13
]}

Ferro, Antonella ^{[14
]}

Pupa, Serenella M. ^{[1
]}

Sasso, Marianna ^{[1
]}

Menard, Sylvie ^{[1
]}

Balsari, Andrea ^{[15
]}

Tagliabue, Elda ^{[1
]}

机构：

[1] Fdn IRCCS, Ist Nazl Tumori, I-20133 Milan, Italy

[2] Humanitas Ctr Catanese Oncol, Catania, Italy

[3] Ist Nazl Tumori, Naples, Italy

[4] Ist Tumori Regina Elena, Rome, Italy

[5] Univ Federico II, Naples, Italy

[6] Univ Ferrara, I-44100 Ferrara, Italy

[7] Ist Oncol Veneto IRCCS, Padua, Italy

[8] Azienda Ist Osped Cremona, Cremona, Italy

[9] Osped Infermi, Azianda USL Rimini, Rimini, Italy

[10] Osped Mater Salutis, Legnago, Italy

[11] Osped San Giovanni Bellinzona, Turin, Italy

[12] Osped San Giovanni Addolorata, Rome, Italy

[13] Univ Verona, I-37100 Verona, Italy

[14] Osped Santa Chiara, Trento, Italy

[15] Univ Milan, Dipartimento Morfol Umana & Sci Biomed, Milan, Italy

来源：

BREAST CANCER RESEARCH AND TREATMENT | 2011年 / 128卷 / 01期

关键词：

HER2; Trastuzumab; Metastatic breast cancer; RECIST; Propensity score matching; DISEASE PROGRESSION; PROPENSITY SCORE; RECEPTOR; RESISTANCE; EFFICACY; LAPATINIB; OUTCOMES; THERAPY; MODELS; ERBB2;

D O I：

10.1007/s10549-011-1484-4

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Recent studies have reported the potential clinical utility for metastatic breast cancer (MBC) patients of continuing trastuzumab beyond progression. Based on those results, here the authors have examined the benefits of trastuzumab-continuation by specifically evaluating RECIST responses upon first line trastuzumab-treatment as a potential predictive marker for therapeutic effect of trastuzumab-continuation beyond metastatic disease progression. The authors carried out a retrospective analysis of 272 HER2 positive MBC patients under trastuzumab treatment at 22 different oncology Italian centers during the years of 2000 and 2001 who progressed under first line trastuzumab-treatment. The primary end point of the study was the survival from the date of first documented progression upon first line trastuzumab treatment of disease. Data analysis involved the use of matching on propensity score to balance variables between treated and untreated subjects and to reduce bias. Of the 272 HER2-positive MBC patients, 154 (56.6%) continued treatment. 79 (51.3%) of those 154 patients showed responses based on RECIST criteria during first-line trastuzumab-treatment. Of the 118 patients that suspended trastuzumab, RECIST responses had been observed in 44 (37.3%). Cox proportional hazards analysis of progressed patients, matched using propensity score, showed that discontinuation of trastuzumab at metastatic disease progression was a risk factor for significantly reduced overall survival in both responder (HR = 2.23; 95% CI = 1.03-4.82) and non-responder groups (HR = 3.53, 95% CI = 1.73-7.21), with no significant differences in the two estimated HRs (P-value of the likelihood-ratio test = 0.690). Continued trastuzumab treatment after disease progression has clinically and statistically significant effects in both RECIST responder and non-responder MBC patients.

引用

页码：147 / 154

页数：8

共 26 条

[1] A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study [J].