title: Trastuzumab treatment beyond progression in advanced breast cancer: patterns of care in six Swiss breast cancer centers.
abstract: BACKGROUND
  Trastuzumab is an established treatment for HER2-positive breast cancer (BC). We analyzed Swiss patterns of care in patients with HER2-positive BC after disease progression on trastuzumab-containing therapy for metastatic BC (MBC).
  
  
  METHODS
  A retrospective analysis was performed in six Swiss BC centers. Patients with HER2-positive MBC treated with at least one infusion of trastuzumab for advanced disease between January 2006 and December 2007 were identified. Treatment patterns in first and further lines were analyzed.
  
  
  RESULTS
  All of the 72 identified patients received trastuzumab as their first palliative anti-HER2 therapy, either as monotherapy (n = 23) or in combination with chemotherapy (typically taxane or vinorelbine; n = 49). Median time to progression was 8.1, 8.0 and 7.9 months in the monotherapy, trastuzumab-taxane and trastuzumab-vinorelbine cohorts, respectively. After progression on first-line anti-HER2 therapy, trastuzumab was continued in 67 of 68 patients who received further therapy. One patient received second-line lapatinib plus capecitabine. The median duration of anti-HER2 therapy was 20 months. Patients received a median of 4 lines of anti-HER2 therapy.
  
  
  CONCLUSIONS
  Durable responses were achieved with repeated exposure to anti-HER2 therapy. In a selected patient population, trastuzumab monotherapy appears to be a reasonable first-line treatment option.
authors: Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland. jens.huober@kssg.ch
authors: Jens
authors: J
authors: Huober
authors: Michael
authors: M
authors: Baumann
authors: Christoph
authors: C
authors: Rochlitz
authors: Stefan
authors: S
authors: Aebi
authors: Uwe
authors: U
authors: Güth
authors: Roger
authors: R
authors: von Moos
authors: Andreas
authors: A
authors: Müller
authors: Lukas
authors: L
authors: von Rohr
authors: Isabelle
authors: I
authors: Widmer
authors: Beat
authors: B
authors: Thürlimann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000378:metabolism; D012189:Retrospective Studies; D013557:Switzerland; D043823:Taxoids / Q000008:administration & dosage; D000068878:Trastuzumab; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D001952:Bridged-Ring Compounds; D018719:Erb-b2 Receptor Tyrosine Kinases; D043823:Taxoids; D000068878:Trastuzumab; D014747:Vinblastine; D000077235:Vinorelbine; C080625:taxane