PURPOSE: Recent trials have shown potential benefit of extended adjuvant endocrine therapy and relatively high risk of recurrence (RoR) after 5 years in hormone receptor-positive (HR+) human epidermal growth factor receptor 2-negative (HER2-) breast cancer. Although risk of late relapse in HR+ HER2- breast cancer is fairly well defined, the risk in HER2-positive (HER2+) breast cancer treated with adjuvant trastuzumab-based chemotherapy remains largely unknown. METHODS: We included 3,177 patients with HER2+ breast cancer treated withadjuvant chemotherapy alone or with trastuzumab from the North Central Cancer Treatment Group N9831 (ClinicalTrials.gov identifier: NCT00005970) and National Surgical Adjuvant Breast and Bowel Project B-31 (ClinicalTrials.gov identifier: NCT00004067) trials. RESULTS: Overall, HR+ breast cancer was significantly associated with improved recurrence-free survival (RFS) during the first 5 years (hazard ratio, 0.65; 95% CI, 0.56 to 0.77; P < .001). Among patients treated with trastuzumab, cumulative hazard for RFS was lower in patients with HR+ HER2+ breast cancer during the first 5 years (10.96% v 17.48%; hazard ratio, 0.60; 95% CI, 0.45 to 0.79; P < .001). However, there was no significant difference in RFS based on HR status during years 5 to 10 (hazard ratio, 1.32; 95% CI, 0.93 to 1.88; P = .12). A comparable degree of trastuzumab benefit was observed in HR+ and HR- breast cancers ( P for interaction = .87). Furthermore, we observed low RoR in years 5 to 10 among patients with HR+ HER2+ breast cancer: 3.23% in patients without lymph node involvement (N0) and 6.39% in patients with involvement of one to three lymph nodes (N1). CONCLUSION: The benefit of adjuvant trastuzumab persists for a long time. A distinct pattern of recurrence was observed between HR+ and HR- HER2+ disease but with similar degree of benefit from adjuvant trastuzumab. RoR in years 5 to 10 in HR+ HER2+ breast cancer is low, particularly in patients with N0 or N1 disease.
RCT Entities:
PURPOSE: Recent trials have shown potential benefit of extended adjuvant endocrine therapy and relatively high risk of recurrence (RoR) after 5 years in hormone receptor-positive (HR+) humanepidermal growth factor receptor 2-negative (HER2-) breast cancer. Although risk of late relapse in HR+ HER2- breast cancer is fairly well defined, the risk in HER2-positive (HER2+) breast cancer treated with adjuvant trastuzumab-based chemotherapy remains largely unknown. METHODS: We included 3,177 patients with HER2+ breast cancer treated with adjuvant chemotherapy alone or with trastuzumab from the North Central Cancer Treatment Group N9831 (ClinicalTrials.gov identifier: NCT00005970) and National Surgical Adjuvant Breast and Bowel Project B-31 (ClinicalTrials.gov identifier: NCT00004067) trials. RESULTS: Overall, HR+ breast cancer was significantly associated with improved recurrence-free survival (RFS) during the first 5 years (hazard ratio, 0.65; 95% CI, 0.56 to 0.77; P < .001). Among patients treated with trastuzumab, cumulative hazard for RFS was lower in patients with HR+ HER2+ breast cancer during the first 5 years (10.96% v 17.48%; hazard ratio, 0.60; 95% CI, 0.45 to 0.79; P < .001). However, there was no significant difference in RFS based on HR status during years 5 to 10 (hazard ratio, 1.32; 95% CI, 0.93 to 1.88; P = .12). A comparable degree of trastuzumab benefit was observed in HR+ and HR- breast cancers ( P for interaction = .87). Furthermore, we observed low RoR in years 5 to 10 among patients with HR+ HER2+ breast cancer: 3.23% in patients without lymph node involvement (N0) and 6.39% in patients with involvement of one to three lymph nodes (N1). CONCLUSION: The benefit of adjuvant trastuzumab persists for a long time. A distinct pattern of recurrence was observed between HR+ and HR- HER2+ disease but with similar degree of benefit from adjuvant trastuzumab. RoR in years 5 to 10 in HR+ HER2+ breast cancer is low, particularly in patients with N0 or N1 disease.
Authors: Harold J Burstein; Sarah Temin; Holly Anderson; Thomas A Buchholz; Nancy E Davidson; Karen E Gelmon; Sharon H Giordano; Clifford A Hudis; Diana Rowden; Alexander J Solky; Vered Stearns; Eric P Winer; Jennifer J Griggs Journal: J Clin Oncol Date: 2014-05-27 Impact factor: 44.544
Authors: Edith A Perez; Karla V Ballman; Afshin Mashadi-Hossein; Kathleen S Tenner; Jennifer M Kachergus; Nadine Norton; Brian M Necela; Jennifer M Carr; Sean Ferree; Charles M Perou; Frederick Baehner; Maggie Chon U Cheang; E Aubrey Thompson Journal: J Natl Cancer Inst Date: 2016-10-28 Impact factor: 13.506
Authors: Edith A Perez; Edward H Romond; Vera J Suman; Jong-Hyeon Jeong; Nancy E Davidson; Charles E Geyer; Silvana Martino; Eleftherios P Mamounas; Peter A Kaufman; Norman Wolmark Journal: J Clin Oncol Date: 2011-07-18 Impact factor: 44.544
Authors: Edith A Perez; Edward H Romond; Vera J Suman; Jong-Hyeon Jeong; George Sledge; Charles E Geyer; Silvana Martino; Priya Rastogi; Julie Gralow; Sandra M Swain; Eric P Winer; Gerardo Colon-Otero; Nancy E Davidson; Eleftherios Mamounas; Jo Anne Zujewski; Norman Wolmark Journal: J Clin Oncol Date: 2014-10-20 Impact factor: 44.544
Authors: Martin Filipits; Torsten O Nielsen; Margaretha Rudas; Richard Greil; Herbert Stöger; Raimund Jakesz; Zsuzsanna Bago-Horvath; Otto Dietze; Peter Regitnig; Christine Gruber-Rossipal; Elisabeth Müller-Holzner; Christian F Singer; Brigitte Mlineritsch; Peter Dubsky; Thomas Bauernhofer; Michael Hubalek; Michael Knauer; Harald Trapl; Christian Fesl; Carl Schaper; Sean Ferree; Shuzhen Liu; J Wayne Cowens; Michael Gnant Journal: Clin Cancer Res Date: 2014-02-11 Impact factor: 12.531
Authors: Hongchao Pan; Richard Gray; Jeremy Braybrooke; Christina Davies; Carolyn Taylor; Paul McGale; Richard Peto; Kathleen I Pritchard; Jonas Bergh; Mitch Dowsett; Daniel F Hayes Journal: N Engl J Med Date: 2017-11-09 Impact factor: 91.245
Authors: Paul E Goss; James N Ingle; Kathleen I Pritchard; Nicholas J Robert; Hyman Muss; Julie Gralow; Karen Gelmon; Tim Whelan; Kathrin Strasser-Weippl; Sheldon Rubin; Keren Sturtz; Antonio C Wolff; Eric Winer; Clifford Hudis; Alison Stopeck; J Thaddeus Beck; Judith S Kaur; Kate Whelan; Dongsheng Tu; Wendy R Parulekar Journal: N Engl J Med Date: 2016-06-05 Impact factor: 91.245
Authors: Giulia Petroni; Lewis C Cantley; Laura Santambrogio; Silvia C Formenti; Lorenzo Galluzzi Journal: Nat Rev Clin Oncol Date: 2021-11-24 Impact factor: 66.675
Authors: Mariana Brandão; Rafael Caparica; Luca Malorni; Aleix Prat; Lisa A Carey; Martine Piccart Journal: Clin Cancer Res Date: 2020-02-11 Impact factor: 12.531