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    Continuing trastuzumab beyond disease progression: Outcomes analysis in patients with metastatic breast cancer

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    Name:
    Continuing trastuzumab beyond ...
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    Genre
    Journal Article
    Date
    2008-07-16
    Author
    Cancello, G
    Montagna, E
    D'Agostino, D
    Giuliano, M
    Giordano, A
    Di Lorenzo, G
    Plaitano, M
    De Placido, S
    De Laurentiis, M
    Subject
    Adult
    Aged
    Antibodies, Monoclonal
    Antibodies, Monoclonal, Humanized
    Antineoplastic Agents
    Breast Neoplasms
    Disease Progression
    Disease-Free Survival
    Female
    Humans
    In Situ Hybridization, Fluorescence
    Middle Aged
    Neoplasm Metastasis
    Retrospective Studies
    Trastuzumab
    Treatment Outcome
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    Permanent link to this record
    http://hdl.handle.net/20.500.12613/5604
    
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    DOI
    10.1186/bcr2119
    Abstract
    Introduction: We performed a retrospective analysis of HER2-overexpressing metastatic breast cancer patients to describe clinical outcomes of those who, despite progression of the disease (PD), maintained trastuzumab for multiple chemotherapy lines. We also compared survival of these patients with that of those who halted trastuzumab at first PD.Methods: We identified 101 patients treated between July 2000 and January 2007. Nineteen were still receiving the first-line trastuzumab-based treatment without evidence of PD and were not included in this analysis. Of the remaining 82 patients, 59 retained trastuzumab for one or more additional lines of chemotherapy after PD, according to our institution policy. Twenty-three patients who changed treating institution and stopped trastuzumab at first progression were used as a control group.Results: For patients retaining trastuzumab, the median follow-up was 39.6 months. Clinical outcomes showed the typical degradation between first and second lines of therapy which we would expect by halting trastuzumab at first progression. Response rates were 35% and 16% and median times to progression were 7.25 and 5.25 months for the first and second lines of trastuzumab therapy, respectively. The median overall survival (OS) rates were 70 months for patients who retained trastuzumab and 56 months for patients who halted the drug (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.51 to 1.18; P = 0.52). If we consider OS from the start of trastuzumab therapy, the figures are 53.9 and 34.8 months, respectively (HR 0.78, 95% CI 0.58 to 1.32; P = 0.2).Conclusion: A nonstatistically significant trend of improved survival for patients retaining trastuzumab is observed. This is in line with most retrospective analyses and recent randomized data. Retaining trastuzumab after progression is a reasonable option, but further randomized data are warranted to better define its role in comparison with other available options. © 2008 Cancello et al.; licensee BioMed Central Ltd.
    Citation to related work
    Springer Science and Business Media LLC
    Has part
    Breast Cancer Research
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    ae974a485f413a2113503eed53cd6c53
    http://dx.doi.org/10.34944/dspace/5586
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