Ignatov Tanja, Eggemann Holm, Burger Elke, Costa Serban Dan, Ignatov Atanas
Department of Obstetrics and GynecologyOtto-von-Guericke University, Magdeburg, Germany.
Institute of Biometry and Medical InformaticsOtto-von-Guericke University, Magdeburg, Germany.
Endocr Relat Cancer. 2016 May;23(5):349-55. doi: 10.1530/ERC-16-0084. Epub 2016 Mar 23.
Overexpression of human epidermal growth factor receptor 2 (HER2) predicts response to anti-HER2 therapy in breast cancer. We investigated whether hormone receptor (HR) status influences the treatment benefit of trastuzumab in patients with breast cancer. Data from 8338 patients with primary nonmetastatic breast cancer from the cancer registry of Saxony-Anhalt Germany were analyzed. A total of 5554 patients were eligible for analysis. The median follow-up of the study was 6 years. Of the 5554 patients investigated, 1128 (20.3%) showed HER2 overexpression and 656 (58.2%) of them received adjuvant trastuzumab. The 10-year overall survival (OS) in the study cohort according to HR, HER2 status, and trastuzumab treatment was as follows: 78.4% for HR-/HER2-, 85.0% for HR+/HER2-, 70.4% HR-/HER2+/TRA-, 71.4% for HR+/HER2+/TRA-, 80.9% for HR-/HER2+/TRA+, and 89.2% for HR+/HER2+/TRA+. Trastuzumab treatment improved OS in the HR- patients only in the first 3 years, whereas in the HR+ group the effect of trastuzumab was still apparent 5 years after diagnosis. Notably, the relative improvement in a patient outcome was higher for HR+ patients. Nevertheless, matching for age, histological type, tumor stage, tumor grade, and performance status between patients with HR- and HR+ tumors demonstrated that the survival effect of trastuzumab was not affected by HR status; P=0.890. Trastuzumab treatment improves patients' survival regardless of HR status and should be offered to all HER2+ patients.
人表皮生长因子受体2（HER2）的过表达可预测乳腺癌患者对抗HER2治疗的反应。我们研究了激素受体（HR）状态是否会影响曲妥珠单抗对乳腺癌患者的治疗效果。分析了来自德国萨克森-安哈尔特癌症登记处的8338例原发性非转移性乳腺癌患者的数据。共有5554例患者符合分析条件。该研究的中位随访时间为6年。在5554例接受调查的患者中，1128例（20.3%）表现出HER2过表达，其中656例（58.2%）接受了辅助曲妥珠单抗治疗。根据HR、HER2状态和曲妥珠单抗治疗情况，研究队列中的10年总生存率（OS）如下：HR-/HER2-为78.4%，HR+/HER2-为85.0%，HR-/HER2+/TRA-为70.4%，HR+/HER2+/TRA-为71.4%，HR-/HER2+/TRA+为80.9%，HR+/HER2+/TRA+为89.2%。曲妥珠单抗治疗仅在最初3年改善了HR-患者的OS，而在HR+组中，曲妥珠单抗的效果在诊断后5年仍很明显。值得注意的是，HR+患者的患者结局相对改善更高。然而，对HR-和HR+肿瘤患者的年龄、组织学类型、肿瘤分期、肿瘤分级和体能状态进行匹配后发现，曲妥珠单抗的生存效果不受HR状态的影响；P = 0.890。无论HR状态如何，曲妥珠单抗治疗均可提高患者的生存率，应提供给所有HER2+患者。
