Survival of HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy plus trastuzumab

A multicenter retrospective observational study (JBCRG-C03 study)

M. Takada, H. Ishiguro, S. Nagai, S. Ohtani, H. Kawabata, Y. Yanagita, Y. Hozumi, C. Shimizu, S. Takao, N. Sato, Y. Kosaka, Y. Sagara, H. Iwata, S. Ohno, K. Kuroi, N. Masuda, H. Yamashiro, M. Sugimoto, M. Kondo, Yasuhiro Naito & 4 others H. Sasano, T. Inamoto, S. Morita, M. Toi

Research output: Contribution to journalArticle

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Abstract

We investigated the disease-free survival (DFS) of HER2-positive primary breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab, as well as predictive factors for DFS and pathologic response. Data from 829 female patients treated between 2001 and 2010 were collected from 38 institutions in Japan. Predictive factors were evaluated using multivariate analyses. The 3-year DFS rate was 87 % [95 % confidence interval (CI) 85-90]. The pathologic complete response (pCR: ypT0/is + ypN0) rate was 51 %. The pCR rate was higher in the ER/PgR-negative patients than in the ER/PgR-positive patients (64 vs. 36 %, P < 0.001). Patients with pCR showed a higher DFS rate than patients without pCR (93 vs. 82 %, P < 0.001). Multivariate analysis revealed three independent predictors for poorer DFS: advanced nodal stage [hazard ratio (HR) 2.63, 95 % CI 1.36-5.21, P = 0.004 for cN2-3 vs. cN0], histological/nuclear grade 3 (HR 1.81, 95 % CI 1.15-2.91, P = 0.011), and non-pCR (HR 1.98, 95 % CI 1.22-3.24, P = 0.005). In the ER/PgR-negative dataset, non-pCR (HR 2.63, 95 % CI 1.43-4.90, P = 0.002) and clinical tumor stage (HR 2.20, 95 % CI 1.16-4.20, P = 0.017 for cT3-4 vs. cT1-2) were independent predictors for DFS, and in the ER/PgR-positive dataset, histological grade of 3 (HR 3.09, 95 % CI 1.48-6.62, P = 0.003), clinical nodal stage (HR 4.26, 95 % CI 1.53-13.14, P = 0.005 for cN2-3 vs. cN0), and young age (HR 2.40, 95 % CI 1.12-4.94, P = 0.026 for ≤40 vs. ;gt40) were negative predictors for DFS. Strict pCR (ypT0 + ypN0) was an independent predictor for DFS in both the ER/PgR-negative and -positive datasets (HR 2.66, 95 % CI 1.31-5.97, P = 0.006 and HR 3.86, 95 % CI 1.13-24.21, P = 0.029, respectively). These results may help assure a more accurate prognosis and personalized treatment for HER2-positive breast cancer patients.

Original languageEnglish
Pages (from-to)143-153
Number of pages11
JournalBreast Cancer Research and Treatment
Volume145
Issue number1
DOIs
Publication statusPublished - 2014

Fingerprint

Observational Studies
Retrospective Studies
Confidence Intervals
Breast Neoplasms
Disease-Free Survival
Drug Therapy
Survival
Trastuzumab
Multivariate Analysis
Survival Rate
Japan

Keywords

  • Breast cancer
  • HER2
  • Neoadjuvant chemotherapy
  • Pathologic complete response
  • Prognostic factors
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Medicine(all)

Cite this

Survival of HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy plus trastuzumab : A multicenter retrospective observational study (JBCRG-C03 study). / Takada, M.; Ishiguro, H.; Nagai, S.; Ohtani, S.; Kawabata, H.; Yanagita, Y.; Hozumi, Y.; Shimizu, C.; Takao, S.; Sato, N.; Kosaka, Y.; Sagara, Y.; Iwata, H.; Ohno, S.; Kuroi, K.; Masuda, N.; Yamashiro, H.; Sugimoto, M.; Kondo, M.; Naito, Yasuhiro; Sasano, H.; Inamoto, T.; Morita, S.; Toi, M.

In: Breast Cancer Research and Treatment, Vol. 145, No. 1, 2014, p. 143-153.

Research output: Contribution to journalArticle

Takada, M, Ishiguro, H, Nagai, S, Ohtani, S, Kawabata, H, Yanagita, Y, Hozumi, Y, Shimizu, C, Takao, S, Sato, N, Kosaka, Y, Sagara, Y, Iwata, H, Ohno, S, Kuroi, K, Masuda, N, Yamashiro, H, Sugimoto, M, Kondo, M, Naito, Y, Sasano, H, Inamoto, T, Morita, S & Toi, M 2014, 'Survival of HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy plus trastuzumab: A multicenter retrospective observational study (JBCRG-C03 study)', Breast Cancer Research and Treatment, vol. 145, no. 1, pp. 143-153. https://doi.org/10.1007/s10549-014-2907-9
Takada, M. ; Ishiguro, H. ; Nagai, S. ; Ohtani, S. ; Kawabata, H. ; Yanagita, Y. ; Hozumi, Y. ; Shimizu, C. ; Takao, S. ; Sato, N. ; Kosaka, Y. ; Sagara, Y. ; Iwata, H. ; Ohno, S. ; Kuroi, K. ; Masuda, N. ; Yamashiro, H. ; Sugimoto, M. ; Kondo, M. ; Naito, Yasuhiro ; Sasano, H. ; Inamoto, T. ; Morita, S. ; Toi, M. / Survival of HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy plus trastuzumab : A multicenter retrospective observational study (JBCRG-C03 study). In: Breast Cancer Research and Treatment. 2014 ; Vol. 145, No. 1. pp. 143-153.
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abstract = "We investigated the disease-free survival (DFS) of HER2-positive primary breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab, as well as predictive factors for DFS and pathologic response. Data from 829 female patients treated between 2001 and 2010 were collected from 38 institutions in Japan. Predictive factors were evaluated using multivariate analyses. The 3-year DFS rate was 87 {\%} [95 {\%} confidence interval (CI) 85-90]. The pathologic complete response (pCR: ypT0/is + ypN0) rate was 51 {\%}. The pCR rate was higher in the ER/PgR-negative patients than in the ER/PgR-positive patients (64 vs. 36 {\%}, P < 0.001). Patients with pCR showed a higher DFS rate than patients without pCR (93 vs. 82 {\%}, P < 0.001). Multivariate analysis revealed three independent predictors for poorer DFS: advanced nodal stage [hazard ratio (HR) 2.63, 95 {\%} CI 1.36-5.21, P = 0.004 for cN2-3 vs. cN0], histological/nuclear grade 3 (HR 1.81, 95 {\%} CI 1.15-2.91, P = 0.011), and non-pCR (HR 1.98, 95 {\%} CI 1.22-3.24, P = 0.005). In the ER/PgR-negative dataset, non-pCR (HR 2.63, 95 {\%} CI 1.43-4.90, P = 0.002) and clinical tumor stage (HR 2.20, 95 {\%} CI 1.16-4.20, P = 0.017 for cT3-4 vs. cT1-2) were independent predictors for DFS, and in the ER/PgR-positive dataset, histological grade of 3 (HR 3.09, 95 {\%} CI 1.48-6.62, P = 0.003), clinical nodal stage (HR 4.26, 95 {\%} CI 1.53-13.14, P = 0.005 for cN2-3 vs. cN0), and young age (HR 2.40, 95 {\%} CI 1.12-4.94, P = 0.026 for ≤40 vs. ;gt40) were negative predictors for DFS. Strict pCR (ypT0 + ypN0) was an independent predictor for DFS in both the ER/PgR-negative and -positive datasets (HR 2.66, 95 {\%} CI 1.31-5.97, P = 0.006 and HR 3.86, 95 {\%} CI 1.13-24.21, P = 0.029, respectively). These results may help assure a more accurate prognosis and personalized treatment for HER2-positive breast cancer patients.",
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TY - JOUR

T1 - Survival of HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy plus trastuzumab

T2 - A multicenter retrospective observational study (JBCRG-C03 study)

AU - Takada, M.

AU - Ishiguro, H.

AU - Nagai, S.

AU - Ohtani, S.

AU - Kawabata, H.

AU - Yanagita, Y.

AU - Hozumi, Y.

AU - Shimizu, C.

AU - Takao, S.

AU - Sato, N.

AU - Kosaka, Y.

AU - Sagara, Y.

AU - Iwata, H.

AU - Ohno, S.

AU - Kuroi, K.

AU - Masuda, N.

AU - Yamashiro, H.

AU - Sugimoto, M.

AU - Kondo, M.

AU - Naito, Yasuhiro

AU - Sasano, H.

AU - Inamoto, T.

AU - Morita, S.

AU - Toi, M.

PY - 2014

Y1 - 2014

N2 - We investigated the disease-free survival (DFS) of HER2-positive primary breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab, as well as predictive factors for DFS and pathologic response. Data from 829 female patients treated between 2001 and 2010 were collected from 38 institutions in Japan. Predictive factors were evaluated using multivariate analyses. The 3-year DFS rate was 87 % [95 % confidence interval (CI) 85-90]. The pathologic complete response (pCR: ypT0/is + ypN0) rate was 51 %. The pCR rate was higher in the ER/PgR-negative patients than in the ER/PgR-positive patients (64 vs. 36 %, P < 0.001). Patients with pCR showed a higher DFS rate than patients without pCR (93 vs. 82 %, P < 0.001). Multivariate analysis revealed three independent predictors for poorer DFS: advanced nodal stage [hazard ratio (HR) 2.63, 95 % CI 1.36-5.21, P = 0.004 for cN2-3 vs. cN0], histological/nuclear grade 3 (HR 1.81, 95 % CI 1.15-2.91, P = 0.011), and non-pCR (HR 1.98, 95 % CI 1.22-3.24, P = 0.005). In the ER/PgR-negative dataset, non-pCR (HR 2.63, 95 % CI 1.43-4.90, P = 0.002) and clinical tumor stage (HR 2.20, 95 % CI 1.16-4.20, P = 0.017 for cT3-4 vs. cT1-2) were independent predictors for DFS, and in the ER/PgR-positive dataset, histological grade of 3 (HR 3.09, 95 % CI 1.48-6.62, P = 0.003), clinical nodal stage (HR 4.26, 95 % CI 1.53-13.14, P = 0.005 for cN2-3 vs. cN0), and young age (HR 2.40, 95 % CI 1.12-4.94, P = 0.026 for ≤40 vs. ;gt40) were negative predictors for DFS. Strict pCR (ypT0 + ypN0) was an independent predictor for DFS in both the ER/PgR-negative and -positive datasets (HR 2.66, 95 % CI 1.31-5.97, P = 0.006 and HR 3.86, 95 % CI 1.13-24.21, P = 0.029, respectively). These results may help assure a more accurate prognosis and personalized treatment for HER2-positive breast cancer patients.

AB - We investigated the disease-free survival (DFS) of HER2-positive primary breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab, as well as predictive factors for DFS and pathologic response. Data from 829 female patients treated between 2001 and 2010 were collected from 38 institutions in Japan. Predictive factors were evaluated using multivariate analyses. The 3-year DFS rate was 87 % [95 % confidence interval (CI) 85-90]. The pathologic complete response (pCR: ypT0/is + ypN0) rate was 51 %. The pCR rate was higher in the ER/PgR-negative patients than in the ER/PgR-positive patients (64 vs. 36 %, P < 0.001). Patients with pCR showed a higher DFS rate than patients without pCR (93 vs. 82 %, P < 0.001). Multivariate analysis revealed three independent predictors for poorer DFS: advanced nodal stage [hazard ratio (HR) 2.63, 95 % CI 1.36-5.21, P = 0.004 for cN2-3 vs. cN0], histological/nuclear grade 3 (HR 1.81, 95 % CI 1.15-2.91, P = 0.011), and non-pCR (HR 1.98, 95 % CI 1.22-3.24, P = 0.005). In the ER/PgR-negative dataset, non-pCR (HR 2.63, 95 % CI 1.43-4.90, P = 0.002) and clinical tumor stage (HR 2.20, 95 % CI 1.16-4.20, P = 0.017 for cT3-4 vs. cT1-2) were independent predictors for DFS, and in the ER/PgR-positive dataset, histological grade of 3 (HR 3.09, 95 % CI 1.48-6.62, P = 0.003), clinical nodal stage (HR 4.26, 95 % CI 1.53-13.14, P = 0.005 for cN2-3 vs. cN0), and young age (HR 2.40, 95 % CI 1.12-4.94, P = 0.026 for ≤40 vs. ;gt40) were negative predictors for DFS. Strict pCR (ypT0 + ypN0) was an independent predictor for DFS in both the ER/PgR-negative and -positive datasets (HR 2.66, 95 % CI 1.31-5.97, P = 0.006 and HR 3.86, 95 % CI 1.13-24.21, P = 0.029, respectively). These results may help assure a more accurate prognosis and personalized treatment for HER2-positive breast cancer patients.

KW - Breast cancer

KW - HER2

KW - Neoadjuvant chemotherapy

KW - Pathologic complete response

KW - Prognostic factors

KW - Trastuzumab

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