Guideline concordant therapy prolongs survival in HER2-positive breast cancer patients: results from a large population-based cohort of a cancer registry.
Even though randomized controlled clinical trials demonstrated improved survival by adjuvant trastuzumab treatment of HER2-positive breast cancer patients, data on its effect in clinical routine are scarce. This study evaluated the use and efficacy of trastuzumab in routine treatment of HER2-positive breast cancer patients. Data from the clinical cancer registry Regensburg (Germany) were analyzed. The present study investigated 6,991 female patients with primary invasive breast cancer. In premenopausal HER2-positive patients a considerable increase of trastuzumab therapy was observed from 58.1% in 2006 to 90.9% in 2011, whereas in postmenopausal patients trastuzumab was rather used on a constant rate of 49.1%. Best overall survival (OS) was found in HER2/steroid hormone receptor-positive patients receiving guideline concordant treatment with trastuzumab plus chemotherapy (CHT) plus antihormone therapy (AHT) with a 7-year OS rate of 96% compared to the non-trastuzumab group with a 7-year OS rate of 92%. In multivariable analysis, HER2-positive patients treated with CHT or AHT who did not get trastuzumab, had a worse 7-year OS (65%, P = 0.006 versus 79%, P = 0.017) than the control groups. This population-based study demonstrated that guideline concordant use of adjuvant trastuzumab improves OS for HER2-positive breast cancer patients treated in routine clinical care.
Department of Gynecology and Obstetrics, University Medical Center Regensburg, Landshuter Straße 65, 93053 Regensburg, Germany.
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Inwald
Department of Gynecology and Obstetrics, University Medical Center Regensburg, Landshuter Straße 65, 93053 Regensburg, Germany.
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Ortmann
Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany.
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Zeman
Center for Clinical Studies, University Hospital Regensburg, 93053 Regensburg, Germany.
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Koller
Institute of Pathology, University of Regensburg, 93053 Regensburg, Germany.
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Hofstädter
Tumor Center Regensburg e.V., University of Regensburg, 93053 Regensburg, Germany.
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Gerstenhauer
Tumor Center Regensburg e.V., University of Regensburg, 93053 Regensburg, Germany.
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Klinkhammer-Schalke
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* / Q000235:genetics / Q000401:mortality*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D005858:Germany; D006801:Humans; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics*; D012042:Registries; D015996:Survival Rate; D000068878:Trastuzumab; D055815:Young Adult
D061067:Antibodies, Monoclonal, Humanized; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human