BACKGROUND: Adjuvant chemotherapy with anthracyclines improves disease-free and overall survival compared with non-anthracycline-based adjuvant chemotherapy regimens in the treatment of early breast cancer. The role of HER2 status as a marker of anthracycline responsiveness has been explored by subset analyses within randomized clinical trials, with inconsistent results. We performed a pooled analysis of the interaction between HER2 status and the efficacy of adjuvant anthracyclines based on the published subset data. METHODS: We searched literature databases to identify randomized trials that compared anthracycline-based with non-anthracycline-based adjuvant chemotherapy regimens in the treatment of early breast cancer and reported efficacy data according to HER2 status. Log hazard ratios (HRs) for disease-free and overall survival were pooled across the studies according to HER2 status by inverse variance weighting. A pooled test for treatment by HER2 status interaction was performed by weighted linear meta-regression. All statistical tests were two-sided. RESULTS: Eight studies (with 6564 randomly assigned patients, of whom 5354 had HER2 status information available) were eligible for this analysis. In HER2-positive disease (n = 1536 patients), anthracyclines were superior to non-anthracycline-based regimens in terms of disease-free (pooled HR of relapse = 0.71; 95% confidence interval [CI] = 0.61 to 0.83; P < .001) and overall (pooled HR of death from any cause = 0.73; 95% CI = 0.62 to 0.85; P < .001) survival. In HER2-negative disease (n = 3818 patients), anthracyclines did not improve disease-free (HR = 1.00; 95% CI = 0.90 to 1.11; P = .75) or overall (HR = 1.03; 95% CI = 0.92 to 1.16; P = .60) survival. The test for treatment by HER2 status interaction yielded statistically significant results: for disease-free survival, the chi-square statistic for interaction was 13.7 (P < .001), and for overall survival, it was 12.6 (P < .001). CONCLUSIONS: The added benefits of adjuvant chemotherapy with anthracyclines appear to be confined to women who have HER2 overexpressed or amplified breast tumors.
BACKGROUND: Adjuvant chemotherapy with anthracyclines improves disease-free and overall survival compared with non-anthracycline-based adjuvant chemotherapy regimens in the treatment of early breast cancer. The role of HER2 status as a marker of anthracycline responsiveness has been explored by subset analyses within randomized clinical trials, with inconsistent results. We performed a pooled analysis of the interaction between HER2 status and the efficacy of adjuvant anthracyclines based on the published subset data. METHODS: We searched literature databases to identify randomized trials that compared anthracycline-based with non-anthracycline-based adjuvant chemotherapy regimens in the treatment of early breast cancer and reported efficacy data according to HER2 status. Log hazard ratios (HRs) for disease-free and overall survival were pooled across the studies according to HER2 status by inverse variance weighting. A pooled test for treatment by HER2 status interaction was performed by weighted linear meta-regression. All statistical tests were two-sided. RESULTS: Eight studies (with 6564 randomly assigned patients, of whom 5354 had HER2 status information available) were eligible for this analysis. In HER2-positive disease (n = 1536 patients), anthracyclines were superior to non-anthracycline-based regimens in terms of disease-free (pooled HR of relapse = 0.71; 95% confidence interval [CI] = 0.61 to 0.83; P < .001) and overall (pooled HR of death from any cause = 0.73; 95% CI = 0.62 to 0.85; P < .001) survival. In HER2-negative disease (n = 3818 patients), anthracyclines did not improve disease-free (HR = 1.00; 95% CI = 0.90 to 1.11; P = .75) or overall (HR = 1.03; 95% CI = 0.92 to 1.16; P = .60) survival. The test for treatment by HER2 status interaction yielded statistically significant results: for disease-free survival, the chi-square statistic for interaction was 13.7 (P < .001), and for overall survival, it was 12.6 (P < .001). CONCLUSIONS: The added benefits of adjuvant chemotherapy with anthracyclines appear to be confined to women who have HER2 overexpressed or amplified breast tumors.
Authors: Marco Colleoni; Bernard F Cole; Giuseppe Viale; Meredith M Regan; Karen N Price; Eugenio Maiorano; Mauro G Mastropasqua; Diana Crivellari; Richard D Gelber; Aron Goldhirsch; Alan S Coates; Barry A Gusterson Journal: J Clin Oncol Date: 2010-05-10 Impact factor: 44.544
Authors: Wolfgang Janni; Brigitte Rack; Nadja Harbeck; Ingo Bauerfeind; Harald Sommer; Klaus Friese Journal: Breast Care (Basel) Date: 2008-08-22 Impact factor: 2.860
Authors: Michael F Press; Guido Sauter; Marc Buyse; Leslie Bernstein; Roberta Guzman; Angela Santiago; Ivonne E Villalobos; Wolfgang Eiermann; Tadeusz Pienkowski; Miguel Martin; Nicholas Robert; John Crown; Valerie Bee; Henry Taupin; Kerry J Flom; Isabelle Tabah-Fisch; Giovanni Pauletti; Mary-Ann Lindsay; Alessandro Riva; Dennis J Slamon Journal: J Clin Oncol Date: 2010-12-28 Impact factor: 44.544
Authors: Brigitte Rack; Ulrich Andergassen; Julia Neugebauer; Jessica Salmen; Philip Hepp; Harald Sommer; Werner Lichtenegger; Klaus Friese; Matthias W Beckmann; Dagmar Hauner; Hans Hauner; Wolfgang Janni Journal: Breast Care (Basel) Date: 2010-12-08 Impact factor: 2.860
Authors: Harold J Burstein; Martine J Piccart-Gebhart; Edith A Perez; Gabriel N Hortobagyi; Norman Wolmark; Kathy S Albain; Larry Norton; Eric P Winer; Clifford A Hudis Journal: J Clin Oncol Date: 2012-05-21 Impact factor: 44.544
Authors: Christian Schindlbeck; D Mayr; C Olivier; B Rack; V Engelstaedter; J Jueckstock; C Jenderek; U Andergassen; U Jeschke; K Friese Journal: J Cancer Res Clin Oncol Date: 2010-01-06 Impact factor: 4.553