Peter Dall1, Gertrud Lenzen2, Thomas Göhler3, Christian Lerchenmüller4, Gabriele Feisel-Schwickardi5, Thorsten Koch6, Jochen Eggert7, Volker Heilmann8, Christof Schindler9, Jochen Wilke10, Hans Tesch11, Johannes Selbach12, Tim Wohlfarth13, Heidi Eustermann14, Axel Hinke14. 1. Department of Obstetrics and Gynaecology and Breast Cancer Center, Klinikum Lüneburg, Lüneburg, Germany. Electronic address: peter.dall@klinikum-lueneburg.de. 2. Oncology Practice, Osnabrück, Germany. 3. Onkozentrum Dresden/Freiberg, Dresden, Germany. 4. Oncology Practice, Münster, Germany. 5. Department of Obstetrics and Gynaecology and Breast Cancer Center, Klinikum Kassel, Kassel, Germany. 6. Breast Center, Klinikum Nürnberg, Nürnberg, Germany. 7. Oncology Practice, Moers, Germany. 8. Oncology Practice, Günzburg, Germany. 9. Gynecology Practice, Leipzig, Germany. 10. Oncology Practice, Fürth, Germany. 11. Onkologie Bethanien, Frankfurt, Germany. 12. Oncology Practice, Duisburg, Germany. 13. Roche Pharma AG, Grenzach-Wyhlen, Germany. 14. WiSP Research Institute, Langenfeld, Germany.
Abstract
BACKGROUND: In elderly patients with HER2-positive breast cancer, few data on efficacy and toxicity of adjuvant trastuzumab treatment exists since older patients were in general excluded from large randomized studies. This prospective observational study aimed to confirm the beneficial findings from pivotal trials in age cohorts ≥65 years. MATERIALS AND METHODS: There were no restrictions for recruitment with respect to age or concomitant/sequential adjuvant medication. Long-term relapse/survival status of the patients was assessed once a year. RESULTS: Among the 3940 evaluable patients enrolled between 2006 and 2012 at 339 institutions, 507 were aged between 65 and 69 years, with another 507 patients ≥70 years. Elderly patients suffered from significantly more advanced primary tumors. Preceding or concomitant chemotherapy showed decreasing aggressiveness with patient's age. Trastuzumab treatment was stopped prematurely in only 11% of the elderly, but more often than in younger patients (p=0.0008). With 453 events hitherto reported, elderly patients did not exhibit an inferior relapse-free survival when adjusted for other relevant prognostic factors (hazard ratio: 1.01 per year; p=0.24). Three-year overall survival was significantly lower in the population older than 64 years than in younger patients (94.2% vs. 96.8%, p=0.0011). CONCLUSIONS: To our knowledge, our population of elderly patients treated with adjuvant trastuzumab is the largest analyzed so far. The beneficial long-term results were comparable to those in the younger cohorts. Although the risk of cardiotoxicity increased significantly with age, it also remained manageable in older patients. Thus, chronological age alone should not preclude HER2 antibody treatment.
BACKGROUND: In elderly patients with HER2-positive breast cancer, few data on efficacy and toxicity of adjuvant trastuzumab treatment exists since older patients were in general excluded from large randomized studies. This prospective observational study aimed to confirm the beneficial findings from pivotal trials in age cohorts ≥65 years. MATERIALS AND METHODS: There were no restrictions for recruitment with respect to age or concomitant/sequential adjuvant medication. Long-term relapse/survival status of the patients was assessed once a year. RESULTS: Among the 3940 evaluable patients enrolled between 2006 and 2012 at 339 institutions, 507 were aged between 65 and 69 years, with another 507 patients ≥70 years. Elderly patients suffered from significantly more advanced primary tumors. Preceding or concomitant chemotherapy showed decreasing aggressiveness with patient's age. Trastuzumab treatment was stopped prematurely in only 11% of the elderly, but more often than in younger patients (p=0.0008). With 453 events hitherto reported, elderly patients did not exhibit an inferior relapse-free survival when adjusted for other relevant prognostic factors (hazard ratio: 1.01 per year; p=0.24). Three-year overall survival was significantly lower in the population older than 64 years than in younger patients (94.2% vs. 96.8%, p=0.0011). CONCLUSIONS: To our knowledge, our population of elderly patients treated with adjuvant trastuzumab is the largest analyzed so far. The beneficial long-term results were comparable to those in the younger cohorts. Although the risk of cardiotoxicity increased significantly with age, it also remained manageable in older patients. Thus, chronological age alone should not preclude HER2 antibody treatment.
Authors: Thomas Fietz; Mark-Oliver Zahn; Andreas Köhler; Erik Engel; Melanie Frank; Lisa Kruggel; Martina Jänicke; Norbert Marschner Journal: Breast Cancer Res Treat Date: 2017-10-13 Impact factor: 4.872
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: Noam Pondé; Dominique Agbor-Tarh; Lissandra Dal Lago; Larissa A Korde; Florentine Hilbers; Christian Jackisch; Olena Werner; Richard D Gelber; Aminah Jatoi; Amylou C Dueck; Alvaro Moreno-Aspitia; Christos Sotiriou; Evandro de Azambuja; Martine Piccart Journal: Breast Cancer Res Treat Date: 2020-09-19 Impact factor: 4.872