Real-world outcomes of different treatments in the management of patients with HER-2 positive breast cancer: a retrospective study.
OBJECTIVE
To investigate the treatment outcome in terms of relapse free survival and overall survival, and explore the determinants of the clinical outcome in HER-2/neu positive breast cancer patients who received or not received adjuvant trastuzumab.


METHODS
The authors reviewed retrospectively of newly diagnosed non-metastatic breast cancer patients at the Faculty of Medicine, Chiang Mai University between January 2004 and December 2007. Comparisons were made between the two cohorts, women who did not receive adjuvant trastuzumab (100 patients) and women who received adjuvant trastuzumab (14 patients).


RESULTS
The median follow-up time was 4.7 years. Four-year relapse-free survival (RFS) and overall survival (OS) in patients receiving trastuzumab was 92.3% and 100%, respectively. In the cohort of HER-2 positive patients who did not receive trastuzumab, the 4-year RFS in this group was 68.2% and 4-year OS was 87.8%. The difference was not statistically significant between the 4-year RFS rates (p = 0.103) and the 4-year OS rates (p = 0.214). By multivariate Cox regression analyses, only nodal status was identified as the independent predictors for superior RFS (hazard ratio 2.93; 95% CI, 1.07 to 5.88; p = 0.034) and none of the clinical parameters were significant predictors for 4-year overall survival.


CONCLUSIONS
A hospital-based analysis of adjuvant Trastuzumab use in our center does not demonstrate the different treatment outcome. However there is a trend of favorable outcome in the group receiving adjuvant trastuzumab.
Division of Therapeutic Radiology and Oncology, Chiang Mai University, Chiang Mai, Thailand. imjai@hotmail.com
Imjai
I
Chitapanarux
Hongsin
H
Trakultivakorn
Songpol
S
Srisukho
Areewan
A
Somwangprasert
Kirati
K
Watcharachan
Jirawattana
J
Srikawin
Benjaporn
B
Chaiwun
Patrinee
P
Traisathit
D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D012189:Retrospective Studies; D015996:Survival Rate; D000068878:Trastuzumab; D016896:Treatment Outcome
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human