Weekly Paclitaxel and Trastuzumab as a First-Line Therapy in Patients with HER2-Overexpressing Metastatic Breast Cancer: Magnitude of HER2/neu Amplification as a Predictive Factor for Efficacy.
10.3346/jkms.2009.24.5.910
- Author:
Hye Suk HAN
1
;
Jin Soo KIM
;
Jin Hyun PARK
;
Yoon Kyung JEON
;
Keun Wook LEE
;
Do Youn OH
;
Jee Hyun KIM
;
So Yeon PARK
;
Seock Ah IM
;
Tae You KIM
;
In Ae PARK
;
Yung Jue BANG
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. moisa@snu.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Breast Neoplasms;
In Situ Hybridization, Fluorescence;
HER2;
Paclitaxel;
Trastuzumab
- MeSH:
Adult;
Aged;
Antibodies, Monoclonal/*administration & dosage/therapeutic use;
Antineoplastic Combined Chemotherapy Protocols/*administration & dosage/therapeutic use;
Breast Neoplasms/*drug therapy/mortality/pathology;
Disease Progression;
Drug Administration Schedule;
Female;
Gene Amplification;
Humans;
In Situ Hybridization, Fluorescence;
Middle Aged;
Paclitaxel/*administration & dosage/therapeutic use;
Predictive Value of Tests;
Receptor, erbB-2/*genetics/metabolism;
Survival Analysis
- From:Journal of Korean Medical Science
2009;24(5):910-917
- CountryRepublic of Korea
- Language:English
-
Abstract:
We evaluated the efficacy and safety of weekly paclitaxel plus trastuzumab as firs-tline chemotherapy in women with HER2-overexpressing metastatic breast cancer (MBC), and we investigated the prognostic factors including magnitude of HER2/neu amplification in this population. We analyzed 54 patients with HER2-overexpressing MBC that were treated with weekly paclitaxel plus trastuzumab as first-line chemotherapy from February 2004 to December 2006. At a median follow-up of 28 months, median time to progression (TTP) was 16.6 months (95% CI, 9.4 to 23.7 months) and median overall survival was 25.6 months (95% CI, 21.8 to 27.3 months). Therapy was generally well tolerated, although three patients (5.5%) experienced reversible, symptomatic heart failure. Of the 27 patients evaluable for the HER2 FISH, patients with a HER2/CEP17 ratio of < or =4.0 had significantly shorter TTP than those with a HER2/CEP17 ratio of >4.0 (10.8 vs. 23.2 months, P=0.034). A HER2/CEP17 ratio of >4.0 was identified as significant predictive factor of TTP by multivariate analysis (P=0.032). The combination of weekly paclitaxel plus trastuzumab as first-line chemotherapy is an effective regimen in patients with HER2-FISH-positive MBC. Furthermore, the magnitude of HER2 amplification is an independent predictive factor of TTP.
