title: Efficacy of trastuzumab in unselected patients with HER2-positive metastatic breast cancer: a retrospective analysis.
abstract: OBJECTIVE
  The addition of trastuzumab to chemotherapy for HER2-positive metastatic breast cancer has significantly improved progression-free survival and overall survival, although most patients develop resistance or have a primarily resistant disease. The aim of the study was to describe the efficacy and safety of a first-line treatment in unselected metastatic HER2-positive breast cancer patients, treated according to clinical practice.
  
  
  METHODS
  From 2000 to 2009, we conducted a retrospective multi-institutional analysis of 182 consecutive patients with HER2-positive metastatic breast cancer who underwent first-line treatment with trastuzumab. The primary end points were progression-free survival and overall survival; the secondary end points were survival after progression in patients treated with second-line chemotherapy with or without trastuzumab and safety. A total of 172 patients were analyzed.
  
  
  RESULTS
  Median progression-free survival and overall survival were 1.2 (95% CI, 1.1-1.4) and 4.4 years (95% CI, 3.6-5.4), respectively. For 100 patients who received second-line chemotherapy, median survival after progression was significantly longer in those who also received trastuzumab: 2.8 (95% CI, 2.1-4.0) versus 1.2 years (95% CI, 0.6-1.9).
  
  
  CONCLUSIONS
  Although based on retrospective data, the study confirms the role of trastuzumab as first-line treatment in metastatic breast cancer outside of a controlled trial. Moreover, information obtained on the use of trastuzumab beyond disease progression supports its use in this setting.
authors.forename: Elena
authors.initials: E
authors.lastname: Collovà
authors.forename: Antonella
authors.initials: A
authors.lastname: Ferzi
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Scandurra
authors.forename: Gaetano
authors.initials: G
authors.lastname: Aurilio
authors.forename: Valter
authors.initials: V
authors.lastname: Torri
authors.forename: Luca
authors.initials: L
authors.lastname: Porcu
authors.forename: Maria Vita
authors.initials: MV
authors.lastname: Sanò
authors.forename: Eleonora
authors.initials: E
authors.lastname: Taibi
authors.forename: Jennifer
authors.initials: J
authors.lastname: Foglietta
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreis
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Dazzani
authors.forename: Annalisa
authors.initials: A
authors.lastname: Bramati
authors.forename: Ilaria
authors.initials: I
authors.lastname: Marcon
authors.forename: Francesco
authors.initials: F
authors.lastname: Atzori
authors.forename: Saverio
authors.initials: S
authors.lastname: Cinieri
authors.forename: Luca
authors.initials: L
authors.lastname: Tondulli
authors.forename: Donatella
authors.initials: D
authors.lastname: Grasso
authors.forename: Franco
authors.initials: F
authors.lastname: Nolè
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Petrella
authors.forename: Stefania
authors.initials: S
authors.lastname: Gori
authors.forename: Nicla
authors.initials: N
authors.lastname: La Verde
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000737:chemistry* / Q000188:drug therapy* / Q000473:pathology; D066126:Cardiotoxicity / Q000209:etiology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D012189:Retrospective Studies; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human