TY - JOUR
T1 - Durable complete response in HER2-positive breast cancer
T2 - a multicenter retrospective analysis
AU - Niikura, Naoki
AU - Shimomura, Akihiko
AU - Fukatsu, Yumi
AU - Sawaki, Masataka
AU - Ogiya, Rin
AU - Yasojima, Hiroyuki
AU - Fujisawa, Tomomi
AU - Yamamoto, Mitsugu
AU - Tsuneizumi, Michiko
AU - Kitani, Akira
AU - Watanabe, Junichiro
AU - Matsui, Akira
AU - Takahashi, Yuko
AU - Takashima, Seiki
AU - Shien, Tadatoshi
AU - Tamura, Kenji
AU - Saji, Shigehira
AU - Masuda, Norikazu
AU - Tokuda, Yutaka
AU - Iwata, Hhiroji
N1 - Funding Information:
Disclosure Shigehira Saji received a research grant from Chugai Pharmaceutical Co. Ltd. Yutaka Tokuda received a research grant from Chugai Pharmaceutical Co., Ltd, Eisai Co. Ltd, and Novartis Pharma L.K. Hiroji Iwata holds honorarium in Chugai Pharmaceutical Co. Ltd. Norikazu Masuda holds honoraria in Chugai Pharmaceutical Co. Ltd and AstraZeneca. The other authors have declared no conflicts of interest.
Funding Information:
Funding This research is partially supported by the Practical Research for Innovative Cancer Control (15ck0106049h0002, 17ck0106307h0001) from the Japan Agency for Medical Research and Development, AMED, National Cancer Center Research and Development Fund (26-A-4).
Funding Information:
We would like to thank the following individuals for providing us with data on patients: Nobusuke Sasada; Hiroshima University Hospital, Mayumi Ishida; National Kyushu Cancer Center, Fukuoka, Japan, Keisei Anan; Kitakyushu Municipal Medical Center; Yasuyuki Kojima, St Marianna University School of Medicine, Hideaki Shigematsu; National Hospital Organization Kure Medical Center; and Hideaki Komatsu, Iwate Medical University School of Medicine. We would also like to thank Editage for providing editorial assistance. This research is partially supported by the Practical Research for Innovative Cancer Control (15ck0106049h0002, 17ck0106307h0001) from the Japan Agency for Medical Research and Development, AMED, National Cancer Center Research and Development Fund (26-A-4). Shigehira Saji received a research grant from Chugai Pharmaceutical Co. Ltd. Yutaka Tokuda received a research grant from Chugai Pharmaceutical Co., Ltd, Eisai Co. Ltd, and Novartis Pharma L.K. Hiroji Iwata holds honorarium in Chugai Pharmaceutical Co. Ltd. Norikazu Masuda holds honoraria in Chugai Pharmaceutical Co. Ltd and AstraZeneca. The other authors have declared no conflicts of interest.
Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Purpose: Though advanced and metastatic epidermal growth factor receptor 2 (HER2)-positive disease is not curable, a small proportion of patients with HER2-positive metastatic breast cancer remain in prolonged complete remission with anti-HER2 treatment. We hypothesized that some cases of HER2-positive metastatic breast cancer may be curable. In this large, multicenter retrospective study, we aimed to assess the long-term outcomes for patients with a durable response to trastuzumab. Methods: We retrospectively evaluated the data of patients diagnosed with HER2-positive metastatic breast cancer who received trastuzumab for more than 2 years as the first-line treatment. Patients diagnosed between April 1, 2001 and December 31, 2014 at 19 institutions in Japan were included in the analysis. From 124 potential subjects, 16 were excluded and 108 were evaluated. Results: The median follow-up length was 7.7 years. Disease progression occurred in 44/108 (40.7%) patients and 13/108 (12%) patients died. The median progression-free survival was 11.2 years, and as more than 80% of patients were alive 10 years after metastatic breast cancer diagnosis. Of the 108 patients, 57 achieved a clinical complete response. Trastuzumab therapy was interrupted for 27 (47.4%) of these patients (based on the doctor’s recommendation for 19 patients, owing to adverse events for 4 patients, owing to unknown reasons for 3 patients, and at the request of 1 patient). Disease progression occurred in 4 of the 27 patients after the interruption of trastuzumab treatment. The median duration of trastuzumab therapy for all 27 patients was 5.1 years (0.9–9.3 years). Conclusion: We found that some patients showed no evidence of disease after the interruption of trastuzumab therapy. Discontinuation of maintenance trastuzumab in this patient population after a limited time should be explored cautiously while awaiting a global collaborative effort for a randomized trial.
AB - Purpose: Though advanced and metastatic epidermal growth factor receptor 2 (HER2)-positive disease is not curable, a small proportion of patients with HER2-positive metastatic breast cancer remain in prolonged complete remission with anti-HER2 treatment. We hypothesized that some cases of HER2-positive metastatic breast cancer may be curable. In this large, multicenter retrospective study, we aimed to assess the long-term outcomes for patients with a durable response to trastuzumab. Methods: We retrospectively evaluated the data of patients diagnosed with HER2-positive metastatic breast cancer who received trastuzumab for more than 2 years as the first-line treatment. Patients diagnosed between April 1, 2001 and December 31, 2014 at 19 institutions in Japan were included in the analysis. From 124 potential subjects, 16 were excluded and 108 were evaluated. Results: The median follow-up length was 7.7 years. Disease progression occurred in 44/108 (40.7%) patients and 13/108 (12%) patients died. The median progression-free survival was 11.2 years, and as more than 80% of patients were alive 10 years after metastatic breast cancer diagnosis. Of the 108 patients, 57 achieved a clinical complete response. Trastuzumab therapy was interrupted for 27 (47.4%) of these patients (based on the doctor’s recommendation for 19 patients, owing to adverse events for 4 patients, owing to unknown reasons for 3 patients, and at the request of 1 patient). Disease progression occurred in 4 of the 27 patients after the interruption of trastuzumab treatment. The median duration of trastuzumab therapy for all 27 patients was 5.1 years (0.9–9.3 years). Conclusion: We found that some patients showed no evidence of disease after the interruption of trastuzumab therapy. Discontinuation of maintenance trastuzumab in this patient population after a limited time should be explored cautiously while awaiting a global collaborative effort for a randomized trial.
KW - Breast cancer
KW - Durable complete response
KW - HER2 positive
KW - Trastuzumab
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UR - http://www.scopus.com/inward/citedby.url?scp=85029051213&partnerID=8YFLogxK
U2 - 10.1007/s10549-017-4489-9
DO - 10.1007/s10549-017-4489-9
M3 - Article
C2 - 28895005
AN - SCOPUS:85029051213
SN - 0167-6806
VL - 167
SP - 81
EP - 87
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 1
ER -
