Long term HER2+ metastatic breast cancer survivors treated by trastuzumab: Results from the French cohort study LHORA

Spano, J. P.; Beuzeboc, Philippe; Coeffic, D.; Arnould́, Laurent; Lortholary, Alain; Varga, Andrea; Ferrero, Jean Marc

doi:10.1016/j.breast.2015.02.035

Cited by 16 publications

(11 citation statements)

References 31 publications

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“…3 On the other hand, trastuzumab, as part of adjuvant therapy was the only negative predictor identified in the LongHER patients. 5 As positive prognostic factors, other studies identified the ductal histotype, 4 younger age, stage I-II, HR positive status, one organ involvement at the diagnosis, 10 as well as the surgical management with resection of both the primary tumor and the metastasis. 11 Regarding molecular analysis, only the LongHer study demonstrated that mutations in PI3K pathway were associated with poor response to trastuzumab-based therapy.…”

Section: Discussionmentioning

confidence: 99%

“…To date, no clinical and/or molecular factors have been univocally correlated with long-term response to anti-HER2 agents. [3][4][5][6] In the recent years, several multigene tests have changed the understanding of breast cancer (BC), providing an opportunity to perform more detailed and individualized treatments. Gene expression analysis with its ability to simultaneously analyse hundreds of genes, has become a powerful tool in understanding all the aspects of cancer biology.…”

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confidence: 99%

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Clinical and molecular predictors of long-term response in HER2 positive metastatic breast cancer patients

Omarini

Bettelli²,

Caprera³

et al. 2018

Cancer Biology & Therapy

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Clinical and molecular predictors of long-term response in HER2 positive metastatic breast cancer patients

Omarini

Bettelli²,

Caprera³

et al. 2018

Cancer Biology & Therapy

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“…Therefore, the low level of cardiac SAEs observed in the ROP Study is due to enrollment of patients who have each demonstrated cardiac tolerability to H therapy in their prior lead-in studies, respectively. Other publications studying long-term H treatment in metastatic, locally advanced, or relapsed HER2-positive breast cancer also reported low risk of cardiac AEs and continued response [ 3 , 14 – 16 ]; nevertheless, there remains a need for more information about patients with long-term H treatment, as reported by the ROP Study.…”

Section: Discussionmentioning

confidence: 99%

Long-term trastuzumab (Herceptin®) treatment in a continuation study of patients with HER2-positive breast cancer or HER2-positive gastric cancer

et al. 2018

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BackgroundTrastuzumab (Herceptin® [H]) is the standard of care for HER2-positive locally advanced/metastatic breast cancer and gastric/gastroesophageal junction (GEJ) cancer. However, there is a paucity of data available on long-term H treatment of patients. The Rollover Protocol (ROP) Study was conducted to report safety data for patients with HER2-positive locally advanced/metastatic breast and gastric/GEJ cancer who have received long-term H therapy (≥ 5 years and ≥ 3 years for breast and gastric/GEJ cancer, respectively).MethodsThe ROP Study was a single-arm, multicenter, international continuation trial of H in patients who had previously completed a global Roche-sponsored trial with H therapy, had stable disease, and were receiving H at the end of the lead-in trial. Patients with chronic heart failure during the lead-in trial could be included following a risk–benefit analysis. The primary objectives were to provide H therapy to patients with HER2-overexpressing locally advanced/metastatic breast or gastric/GEJ cancer at the end of the lead-in study, and to follow the long-term outcomes and long-term overall safety in these patients.ResultsTwenty-five of 69 patients enrolled in the ROP Study received long-term H therapy (19 breast cancer and 6 gastric/GEJ cancer). The median duration of H treatment for patients with breast cancer was 8 years 7 months, and 5 years 2 months for patients with gastric/GEJ cancer. The cardiac status of the patients remained stable over time, with no serious cardiac adverse events or marked changes in left ventricular ejection fraction (LVEF). The median overall worst LVEF measurement was 57.0%, and no patients experienced an LVEF of < 45% (range 47–63%). There were no serious adverse events related to study treatment.ConclusionsThese results suggest that H has an acceptable safety profile and was well tolerated in patients who received long-term H therapy (≥ 5 years and ≥ 3 years for breast and gastric/GEJ cancer, respectively). Further investigation and reporting of long-term H therapy would be valuable.Trial registrationThis study was retrospectively registered on March 24, 2016 with Clinicaltrials.gov, number NCT02721641.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4183-2) contains supplementary material, which is available to authorized users.

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“…A prolonged phase of single-agent maintenance trastuzumab, together with hormonal manipulation in patients with hormone-sensitive disease, appears to play a meaningful role in preventing disease relapse and possibly conferring a long-term cure. Therefore, it is the practice within our institution to continue trastuzumab indefinitely after discontinuation of cytotoxic chemotherapy for patients who have achieved a CR [ 5 , 9 - 10 ].…”

Section: Discussionmentioning

confidence: 99%

Metastatic HER2+ Breast Cancer: A Potentially Curable Disease?

Prior¹,

Lim²,

Ward³

et al. 2017

Cureus

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The advent of trastuzumab and other human epidermal growth factor receptor 2 (HER2)-directed therapies has revolutionized the treatment of metastatic HER2-positive breast cancer, leading to prolonged survival and appreciable clinical benefit for a substantial subset of patients. Previously, in a retrospective study at our institution, we observed that nearly 10% of patients achieved a durable complete remission (DCR) following a combination of HER2-directed therapy and cytotoxic chemotherapy. We are currently expanding this study to include patients who were treated since the initial introduction of trastuzumab. From our ongoing study, we present a selected case series of three patients with metastatic HER2-positive breast cancer who achieved a DCR. It is theorized that metastatic HER2-positive breast cancer may be potentially curable in certain patients with favorable clinicopathological and molecular factors, which the patients within our case series mostly demonstrate. These include de novo presentation, estrogen receptor (ER)-negative status, limited disease burden, and absence of deleterious gene or pathway mutations. More research is needed in order to incorporate these findings into clinical practice.

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Long term HER2+ metastatic breast cancer survivors treated by trastuzumab: Results from the French cohort study LHORA

Cited by 16 publications

References 31 publications

Clinical and molecular predictors of long-term response in HER2 positive metastatic breast cancer patients

Clinical and molecular predictors of long-term response in HER2 positive metastatic breast cancer patients

Long-term trastuzumab (Herceptin®) treatment in a continuation study of patients with HER2-positive breast cancer or HER2-positive gastric cancer

Metastatic HER2+ Breast Cancer: A Potentially Curable Disease?

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