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Trastuzumab re-treatment following adjuvant trastuzumab and the importance of distant disease-free interval: the HERA trial experience

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Abstract

This retrospective analysis conducted using data from patients enrolled onto the Herceptin Adjuvant has two objectives: The first is to evaluate the impact of the time interval between the end of adjuvant trastuzumab and distant recurrence (TDRI) upon overall survival (OS). The second is to describe the duration of trastuzumab-based regimens in the metastatic setting for patients previously treated with adjuvant trastuzumab. The first objective included 187 patients treated with adjuvant trastuzumab and diagnosed with distant recurrence at 4-year median follow-up. The second objective included data from questionnaires sent to investigators retreating patients with trastuzumab upon distant recurrence: 144 of 156 questionnaires were returned (93 %), and 90 patients were selected based on available clinical information and consent for subsequent studies. There was no statistically significant relationship between TDRI following 1 year of adjuvant trastuzumab and OS from distant recurrence: hazard ratio 0.991, p = 0.46. The median OS from distant recurrence was numerically longer among patients with a TDRI of ≥12 months (n = 103) than <12 months (n = 84) but not statistically significant (23.7 vs. 17.8 months, p = 0.47). The median duration of first-line trastuzumab-based regimens for patients previously treated with adjuvant trastuzumab and diagnosed with distant disease recurrence was 8.8 months (n = 88). This retrospective, exploratory study suggests that TDRI did not impact on OS measured from distant recurrence. We argue that prospective collection of treatment information beyond disease progression should be included in future clinical studies.

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Acknowledgments

We thank the women who participated in this study; the Breast European Adjuvant Study Team Data Centre; the Frontier Science Team; the Breast International Group Secretariat; the HERA steering committee; the Independent Data Monitoring Committee; F Hoff mann-La Roche; and the doctors who participated in HERA.

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Authors and Affiliations

  1. Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue Yawkey, Boston, 1238, USA

    Otto Metzger-Filho

  2. Department of Medical Oncology and Breast European Adjuvant Study Team (BrEAST) Data Centre, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium

    Evandro de Azambuja

  3. Frontier Science (Scotland) Ltd, Kincraig, Kingussie, UK

    Marion Procter

  4. Breast European Adjuvant Study Team (BrEAST) Data Centre, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium

    Magalie Krieguer

  5. Breast Unit, Royal Marsden Hospital, and Institute of Cancer Research, London, UK

    Ian Smith

  6. Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Jose Baselga

  7. Edinburgh Cancer Research Centre, Western general Hospital, University of Edinburgh, Crewe Road South, Edinburgh, UK

    David Cameron

  8. Department of Gynecology and Obstetrics and Multidisciplinary Breast Cancer Center, Helios Klinikum, Berlin-Buch, Germany

    Michael Untch

  9. Department of Gynecology and Obstetrics, Klinikum Off enbach, Off Enbach, Germany

    Christian Jackisch

  10. Department of Medical Oncology, The Andrew Love Cancer Centre, Deakin University, Geelong, Australia

    Richard Bell

  11. Department of Medical Oncology, San Raffaele Institute, Milan, Italy

    Luca Gianni

  12. European Institute of Oncology, Milan, Italy

    Aron Goldhirsch

  13. Swiss Center for Breast Health, Sant’Anna Clinic, Lugano-Sorengo, Switzerland

    Aron Goldhirsch

  14. Department of Medicine, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium

    Martine Piccart

  15. Department of Biostatistics and Computational Biology, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, USA

    Richard D. Gelber

Authors
  1. Otto Metzger-Filho
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  2. Evandro de Azambuja
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  3. Marion Procter
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  4. Magalie Krieguer
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  5. Ian Smith
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  6. Jose Baselga
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  7. David Cameron
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  8. Michael Untch
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  9. Christian Jackisch
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  10. Richard Bell
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  11. Luca Gianni
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  12. Aron Goldhirsch
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  13. Martine Piccart
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  14. Richard D. Gelber
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HREA Study Team

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Correspondence to Otto Metzger-Filho.

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Metzger-Filho, O., de Azambuja, E., Procter, M. et al. Trastuzumab re-treatment following adjuvant trastuzumab and the importance of distant disease-free interval: the HERA trial experience. Breast Cancer Res Treat 155, 127–132 (2016). https://doi.org/10.1007/s10549-015-3656-0

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  • DOI: https://doi.org/10.1007/s10549-015-3656-0

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