Guarneri V, Bengala C, Orlandini C, Gennari A, Donati S, Campani D, Collecchi P, Maur M, Conte P F
Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy.
Bone Marrow Transplant. 2004 Sep;34(5):413-7. doi: 10.1038/sj.bmt.1704619.
We retrospectively evaluated the predictive and prognostic role of HER2 expression in 44 metastatic breast cancer (MBC) patients treated with high-dose consolidation chemotherapy (HDCT) and autologous stem cell support after induction chemotherapy (IC) with six courses of epirubicin+paclitaxel (22 patients) or gemcitabine+epirubicin+paclitaxel (22 patients). HER2 expression was evaluated by an immunohistochemical method (Herceptest, Dako). A total of 13 patients (29.5%) showed a HER2 overexpression (score 3+). After IC, nine patients were in complete response (CR), 30 in partial response (PR), and five in stable disease (SD); after HDCT, 20 (45.5%) obtained a CR, and 23 were in PR, for a conversion rate of 48.5%. Conversion rate for HER2-positive patients was 87.5 vs 37% for HER2-negative patients (P=0.018). The median progression-free (PFS) and overall survivals (OS) were 17.6 (95% CI 13.2-22.0) and 44 (95% CI 25.9-62.3) months, respectively. Patients with HER2 overexpression experienced a significantly (P=0.0042) shorter median PFS (15.3 months, 95% CI 11.1-19.5) compared to HER2-negative patients (21.3 months, 95% CI 14.3-28.4). The median OS was 27.6 months (95% CI 4.5-50.7) in HER2-positive patients and 50.3 months (95% CI 38.7-62.0) in HER2-negative patients (P=0.345). These results indicate that HER2 overexpression predicts a worse outcome for patients with MBC treated with HDCT, despite the high CR rate obtained in this subset of patients.
我们回顾性评估了44例转移性乳腺癌(MBC)患者中HER2表达的预测和预后作用,这些患者在接受表柔比星+紫杉醇(22例患者)或吉西他滨+表柔比星+紫杉醇(22例患者)六个疗程的诱导化疗(IC)后接受了大剂量巩固化疗(HDCT)和自体干细胞支持。HER2表达通过免疫组织化学方法(Herceptest,Dako)进行评估。共有13例患者(29.5%)显示HER2过表达(评分3+)。IC后,9例患者完全缓解(CR),30例部分缓解(PR),5例疾病稳定(SD);HDCT后,20例(45.5%)获得CR,23例PR,转化率为48.5%。HER2阳性患者的转化率为87.5%,HER2阴性患者为37%(P=0.018)。中位无进展生存期(PFS)和总生存期(OS)分别为17.6个月(95%CI 13.2 - 22.0)和44个月(95%CI 25.9 - 62.3)。与HER2阴性患者(21.3个月,95%CI 14.3 - 28.4)相比,HER2过表达患者的中位PFS显著缩短(P=0.0042,15.3个月,95%CI 11.1 - 19.5)。HER2阳性患者的中位OS为27.6个月(95%CI 4.5 - 50.7),HER2阴性患者为50.3个月(95%CI 38.7 - 62.0)(P=0.345)。这些结果表明,尽管该亚组患者获得了较高的CR率,但HER2过表达预示着接受HDCT治疗的MBC患者预后更差。