Prognosis of Women With Metastatic Breast Cancer by HER2 Status and Trastuzumab Treatment: An Institutional-Based Review
Prognosis of Women With Metastatic Breast Cancer by HER2 Status and Trastuzumab Treatment: An Institutional-Based Review
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DOI：
10.1200/jco.2008.19.9844
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发表时间：
2010-01-01
影响因子：
45.3
通讯作者：
Giordano, Sharon H.
中科院分区：
文献类型：
--
作者：
Dawood, Shaheenah;Broglio, Kristine;Giordano, Sharon H.
本研究的目的是确定曲妥珠单抗是否改善了转移性人表皮生长因子受体2（HER 2）/neu阳性乳腺癌妇女的预后，超过了HER 2/neu阴性疾病妇女的预后。确定了已知HER 2/neu状态且在辅助治疗中未接受曲妥珠单抗的患者。将疾病分为以下三组：HER 2/neu阴性、HER 2/neu阳性但未接受一线曲妥珠单抗治疗和HER 2/neu阳性但接受一线曲妥珠单抗治疗。使用Kaplan-Meier乘积限法估计总生存期（OS），并使用对数秩检验进行组间比较。考克斯比例风险模型被用来确定OS和HER 2/neu状态之间的关联后，控制患者的characteristics.Results118例（5.6%）有HER 2/neu阳性疾病没有曲妥珠单抗治疗，191（9.1%）有HER 2/neu阳性疾病，并接受曲妥珠单抗治疗，和1,782（85.3%）有HER 2/neu阴性疾病。中位随访时间为16.9个月。HER 2/neu阴性疾病、HER 2/neu阳性疾病和曲妥珠单抗治疗以及HER 2/neu阳性疾病和未接受曲妥珠单抗治疗的患者的1年生存率为75.1%。（95% CI，72.9%至77.2%）、86.6%（95% CI，80.8%至90.8%）和70.2%（95% CI，60.3%至78.1%）。在多变量模型中，与HER 2/neu阴性疾病女性相比，接受曲妥珠单抗治疗的HER 2/neu阳性疾病女性的死亡风险降低了44%（风险比[HR] = 0.56; 95%CI，0.45至0.69; P < .0001）。这HR随时间而变化，是显着的第一个24个月，不显着后24 months.ConclusionOur结果表明，女性与HER 2/neu阳性疾病谁接受曲妥珠单抗有改善的预后与HER 2/neu阴性疾病的女性相比。
PurposeThe purpose of this study was to determine whether trastuzumab improves prognosis of women with metastatic human epidermal growth factor receptor 2 (HER2)/neu -positive breast cancer beyond that of women with HER2/neu-negative disease.Patients and MethodsTwo thousand ninety-one women with metastatic breast cancer diagnosed from 1991 to 2007, with known HER2/neu status and who had not received trastuzumab in the adjuvant setting, were identified. Disease was classified into the following three groups: HER2/neu negative, HER2/neu positive without first-line trastuzumab treatment, and HER2/neu positive with first-line trastuzumab treatment. Overall survival (OS) was estimated using the Kaplan-Meier product-limit method and compared between groups with the log-rank test. Cox proportional hazards models were used to determine associations between OS and HER2/neu status after controlling for patient characteristics.ResultsOne hundred eighteen patients (5.6%) had HER2/neu-positive disease without trastuzumab treatment, 191 (9.1%) had HER2/neu-positive disease and received trastuzumab treatment, and 1,782 (85.3%) had HER2/neu-negative disease. Median-follow-up was 16.9 months. One-year survival rates among patients with HER2/neu-negative disease, HER2/neu-positive disease and trastuzumab treatment, and HER2/neu-positive disease and no trastuzumab treatment were 75.1% (95% CI, 72.9% to 77.2%), 86.6% (95% CI, 80.8% to 90.8%), and 70.2% (95% CI, 60.3% to 78.1%), respectively. In a multivariable model, women with HER2/neu-positive disease who received trastuzumab had a 44% reduction in the risk of death compared with women with HER2/neu-negative disease (hazard ratio [HR] = 0.56; 95% CI, 0.45 to 0.69; P < .0001). This HR varied with time and was significant for the first 24 months and not significant after 24 months.ConclusionOur results show that women with HER2/neu-positive disease who received trastuzumab had improved prognosis compared with women with HER2/neu-negative disease.