| HER2 overexpression and doxorubicin in adjuvant chemotherapy for resectable breast cancer. | |
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MedLine Citation:
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PMID: 12560435 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Human epidermal growth factor receptor 2 (HER2) overexpression was found to predict a good response in breast carcinoma patients treated with doxorubicin (Adriamycin [ADM]). Evidence from our recent study indicates that node-positive patients respond to cyclophosphamide, methotrexate, and fluorouracil (CMF) regardless of HER2 status. We address the issue of whether therapy regimens including CMF and ADM versus CMF alone have the same therapeutic effect in patients with HER2+ and HER2- tumors in terms of relapse-free survival (RFS) and overall survival (OS). METHODS: Archival specimens of the primary tumors from 506 patients in a prospective clinical trial were stained with the anti-HER2 monoclonal antibody CB11. Originally, patients were randomly allocated to receive either 12 courses of intravenous CMF or eight courses of the same regimen followed by four cycles of ADM. RFS and OS were analyzed by a Cox model taking into account treatment, HER2 status, and the interaction between treatment and HER2 status, adjusting for the effect of other known clinical and biopathologic factors. RESULTS: Analysis of survival rates indicates a possible differential effect of treatment in the patients grouped according to HER2 status. Improved RFS and OS were observed in the HER2+ subgroup after treatment with CMF plus ADM versus CMF alone. With a median follow-up of 15 years, the hazard ratio (HR) for RFS was 0.83 in HER2+ tumors and 1.22 in HER2- tumors. The effect of treatment was more evident on OS in HER2+ patients (HR = 0.61; CI, 0.32 to 1.16) than in HER2- patients (HR = 1.26). CONCLUSION: Our data indicate that adding ADM to CMF might be beneficial for patients with HER2+ tumors. |
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Authors:
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Angela Moliterni; Sylvie Ménard; Pinuccia Valagussa; Elia Biganzoli; Patrizia Boracchi; Andrea Balsari; Patrizia Casalini; Gorana Tomasic; Ettore Marubini; Silvana Pilotti; Gianni Bonadonna |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of clinical oncology : official journal of the American Society of Clinical Oncology Volume: 21 ISSN: 0732-183X ISO Abbreviation: J. Clin. Oncol. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-01-31 Completed Date: 2003-02-25 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 8309333 Medline TA: J Clin Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 458-62 Citation Subset: IM |
Affiliation:
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Medical Oncology Unit, Department of Experimental Oncology, Scientific Direction, Istituto Nazionale Tumori, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antineoplastic Agents / therapeutic use* Antineoplastic Combined Chemotherapy Protocols / administration & dosage, therapeutic use* Breast Neoplasms / drug therapy*, genetics*, pathology Chemotherapy, Adjuvant Cyclophosphamide / administration & dosage Doxorubicin / therapeutic use* Female Fluorouracil / administration & dosage Gene Expression Regulation, Neoplastic* Humans Immunohistochemistry Methotrexate / administration & dosage Middle Aged Predictive Value of Tests Prognosis Receptor, erbB-2 / analysis, biosynthesis* Survival |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/CMF regimen; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 51-21-8/Fluorouracil; 59-05-2/Methotrexate; EC 2.7.10.1/Receptor, erbB-2 |
| Comments/Corrections | |
Comment In:
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J Clin Oncol. 2003 Aug 15;21(16):3179-80; author reply 3180
[PMID:
12915616
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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