Stemmler Hans-Joachim, Kahlert Steffen, Siekiera Wolfgang, Untch Michael, Heinrich Bernhard, Heinemann Volker
Medical Department III, University Hospital of Munich, Grosshadern, Germany.
Onkologie. 2005 Nov;28(11):582-6. doi: 10.1159/000088296.
The aim of this retrospective analysis was to evaluate the impact of trastuzumab-based regimens on the survival of patients with HER2-overexpressing metastatic breast cancer (MBC). The study specifically focussed on the influence of the continuation of trastuzumab-based treatment despite tumor progression on survival.
Patients with HER2 overexpressing MBC were included in this retrospective analysis. HER2 overexpression was determined by the immunohistochemical staining score (DAKO Hercep Test). Trastuzumab was applied at a loading dose of 4 mg/kg and a maintenance dose of 2 mg/kg.
Among 136 HER2 overexpressing patients (DAKO score 3+), 66 patients received first-line trastuzumab, 47 patients received trastuzumab as second-line therapy and 23 patients received trastuzumab beyond disease progression. There was no significant difference regarding the duration of trastuzumab-based treatment (first-line: 29.5 weeks vs. second-line: 25 weeks). Moreover, there was no difference in the response rate (first-line: 37.9% vs. second-line: 35.7%) or the median survival (p = 0.47 log rank). Patients who received = 2 trastuzumab-based regimens for MBC survived significantly longer compared to those who had received only 1 regimen (= 2 regimens: 62.4 months vs. 1 regimen: 38.5 months; p = 0.01 log rank).
Trastuzumab is highly effective in the treatment of HER2 overexpressing MBC. Compared to historical controls, overall survival appears to be markedly prolonged, particularly in patients who received sequential trastuzumab-based treatment beyond disease progression.
本回顾性分析的目的是评估基于曲妥珠单抗的治疗方案对HER2过表达转移性乳腺癌（MBC）患者生存的影响。该研究特别关注尽管肿瘤进展但继续基于曲妥珠单抗的治疗对生存的影响。
HER2过表达的MBC患者纳入本回顾性分析。HER2过表达通过免疫组织化学染色评分（DAKO Hercep检测）确定。曲妥珠单抗的负荷剂量为4mg/kg，维持剂量为2mg/kg。
在136例HER2过表达患者（DAKO评分为3+）中，66例患者接受一线曲妥珠单抗治疗，47例患者接受曲妥珠单抗二线治疗，23例患者在疾病进展后接受曲妥珠单抗治疗。基于曲妥珠单抗的治疗持续时间无显著差异（一线：29.5周 vs. 二线：25周）。此外，缓解率（一线：37.9% vs. 二线：35.7%）或中位生存期（p = 0.47，对数秩检验）也无差异。接受≥2种基于曲妥珠单抗的MBC治疗方案的患者比仅接受1种方案的患者生存时间显著更长（≥2种方案：62.4个月 vs. 1种方案：38.5个月；p = 0.01，对数秩检验）。
曲妥珠单抗在治疗HER2过表达的MBC方面非常有效。与历史对照相比，总体生存期似乎显著延长，特别是在疾病进展后接受序贯基于曲妥珠单抗治疗的患者中。
