Trastuzumab Provides a Comparable Prognosis in Patients With HER2-Positive Breast Cancer to Those With HER2-Negative Breast Cancer: Analyses of a Randomized Controlled Trial of Post-Mastectomy Hypofractionated Radiotherapy.

BACKGROUND AND PURPOSE

We investigated the locoregional effect of trastuzumab, and determined whether patients with human epidermal growth factor receptor (HER)2-positive breast cancer (BC) treated with trastuzumab could achieve comparable efficacy to that of patients with HER2-negative BC.

MATERIALS AND METHODS

This was analyses of data of 793 BC patients from a randomized controlled trial comparing post-mastectomy hypofractionated radiotherapy with conventional fractionated radiotherapy. Survival rates were analyzed by the Kaplan-Meier method and compared by the log-rank test.

RESULTS

Patients were classified into three groups: HER2-negative (HER2; n = 547), HER2-positve with trastuzumab (HER2 + T; n = 136), and HER2-positive without trastuzumab (HER2 - T; n = 110). The HER2 + T group had significantly lower locoregional recurrence (LRR, 6.0% 13.9%), distant metastasis (DM, 17.4% 33.8%) and higher disease-free survival (DFS, 81.2% 61.9%) at 5 years than that of the HER2 - T group ( <.05). The HER2 group had significantly lower LRR (6.8% 13.9%), DM (22.4% 33.8%) and higher DFS (76.1% 61.9%) at 5 years than that of the HER2 - T group ( <.05). The difference in LRR, DM and DFS at 5 years was not significant between the HER2 + T group and HER2 group ( >.05). Different annual LRR patterns was found among groups according to HR status.

CONCLUSION

Trastuzumab reduces LRR in patients with locally advanced HER2-positive BC who have received post-mastectomy radiotherapy. It provides comparable DFS to that with patients with HER2-negative BC.