C Jackisch1, M Welslau2, W Schoenegg3, J Selbach4, H-D Harich5, J Schröder6, M Schmidt7, T Göhler8, H Eustermann9, R Ringel10, A Hinke9. 1. Klinikum Offenbach GmbH, Germany. Electronic address: christian.jackisch@klinikum-offenbach.de. 2. Aschaffenburg, Germany. 3. Berlin, Germany. 4. Duisburg, Germany. 5. Hof, Germany. 6. Mülheim, Germany. 7. Johannes Gutenberg University, Mainz, Germany. 8. Onkozentrum Dresden/Freiberg, Germany. 9. WiSP Research Institute, Langenfeld, Germany. 10. Friedberg, Germany.
Abstract
OBJECTIVES: Evidence suggests that continued trastuzumab therapy beyond progression (TBP) may provide additional survival benefit. Within the framework of an observational prospective study of patients with advanced/metastatic breast cancer receiving trastuzumab in routine clinical practice, we had the opportunity to examine the effect of TBP in a large population. PATIENTS AND METHODS: Among a total of 1843 trastuzumab-treated patients, a sub-cohort of 418 fulfilled the selection criteria for the TBP analysis: 261 continued trastuzumab and 157 discontinued. Logrank tests and Cox models were used to compare survival and identify prognostic factors. RESULTS: Survival from progression was significantly longer in those patients continuing trastuzumab treatment beyond disease progression (TBP: median 22.1 months; no TBP: median 14.9 months; HR = 0.64; P = 0.00021). In addition to TBP, a positive endocrine receptor status, a longer relapse-free interval, no visceral metastasis, no concomitant chemotherapy during first-line treatment, and first-line response were independently significant prognostic variables for longer survival on multivariate analysis. CONCLUSION: The hitherto limited evidence for TBP benefit from randomized studies was confirmed. While a number of strong disease-related predictors for survival after first progression could be identified, the positive effect of trastuzumab continuation retained statistical significance in a multivariate model.
OBJECTIVES: Evidence suggests that continued trastuzumab therapy beyond progression (TBP) may provide additional survival benefit. Within the framework of an observational prospective study of patients with advanced/metastatic breast cancer receiving trastuzumab in routine clinical practice, we had the opportunity to examine the effect of TBP in a large population. PATIENTS AND METHODS: Among a total of 1843 trastuzumab-treated patients, a sub-cohort of 418 fulfilled the selection criteria for the TBP analysis: 261 continued trastuzumab and 157 discontinued. Logrank tests and Cox models were used to compare survival and identify prognostic factors. RESULTS: Survival from progression was significantly longer in those patients continuing trastuzumab treatment beyond disease progression (TBP: median 22.1 months; no TBP: median 14.9 months; HR = 0.64; P = 0.00021). In addition to TBP, a positive endocrine receptor status, a longer relapse-free interval, no visceral metastasis, no concomitant chemotherapy during first-line treatment, and first-line response were independently significant prognostic variables for longer survival on multivariate analysis. CONCLUSION: The hitherto limited evidence for TBP benefit from randomized studies was confirmed. While a number of strong disease-related predictors for survival after first progression could be identified, the positive effect of trastuzumab continuation retained statistical significance in a multivariate model.
Authors: Benjamin Daniels; Sarah J Lord; Belinda E Kiely; Nehmat Houssami; Philip Haywood; Christine Y Lu; Robyn L Ward; Sallie-Anne Pearson Journal: BMJ Open Date: 2017-01-24 Impact factor: 2.692
Authors: Christian Jackisch; Winfried Schoenegg; Dietmar Reichert; Manfred Welslau; Johannes Selbach; Hanns-Detlev Harich; Hans Tesch; Tim Wohlfarth; Heidi Eustermann; Axel Hinke Journal: BMC Cancer Date: 2014-12-08 Impact factor: 4.430