We recently found that trastuzumab benefit may be lower in a small subset of early breast cancer (BC) patients (pts) with tumors expressing high levels of both hormonal receptors (HRs), i.e. triple positive (TP). To better investigate the role of HRs in HER2 positive BC, we retrospectively identified 872 TP BC pts treated with adjuvant chemotherapy alone (cohort A-366 pts), or plus trastuzumab (cohort B-506 pts). Relapse-free-survival (RFS) and breast-cancer-specific-survival (BCSS) were evaluated. Trastuzumab improved RFS and BCSS in all the subsets analyzed, but the effect on BCSS in tumors expressing both HRs in >30% of cells (TP30), and even on RFS in tumors with both HRs expressed in >50% of cells (TP50) was not significant. Distinct patterns of relapse were observed in TP50 and no-TP50 tumors, the former showing low and constant risk in the first 5 years, a late increase beyond 5 years and modest trastuzumab effect. Trastuzumab effect tended to disappear in pts whose tumors expressed ER in >50% of cells. Multivariate analysis of RFS confirmed a significant interaction between trastuzumab and ER expression, with benefit confined to pts whose tumors expressed ER in ≤50% of cells. Our data suggest that the pattern of relapse of TP tumors with high HRs is similar to that of "luminal", HER2 negative tumors, without clear benefit from adjuvant trastuzumab, which remains the standard treatment even in TP tumors. Confirmatory findings on the extent to which quantitative expression of HRs may impact clinical behavior of HER2 positive BC are warranted.

"Triple positive" early breast cancer: an observational multicenter retrospective analysis of outcome / Vici, Patrizia; Pizzuti, Laura; Sperduti, Isabella; Frassoldati, Antonio; Natoli, Clara; Gamucci, Teresa; Tomao, Silverio; Michelotti, Andrea; Moscetti, Luca; Gori, Stefania; Baldini, Editta; Giotta, Francesco; Cassano, Alessandra; Santini, Daniele; Giannarelli, Diana; Di Lauro, Luigi; Corsi, Domenico Cristiano; Marchetti, Paolo; Sini, Valentina; Sergi, Domenico; Barba, Maddalena; Maugeri-Saccà, Marcello; Russillo, Michelangelo; Mentuccia, Lucia; D'Onofrio, Loretta; Iezzi, Laura; Scinto, Angelo Fedele; Da Ros, Lucia; Bertolini, Ilaria; Basile, Maria Luisa; Rossi, Valentina; De Maria, Ruggero; Montemurro, Filippo. - In: ONCOTARGET. - ISSN 1949-2553. - 7:14(2016), pp. 17932-17944. [10.18632/oncotarget.7480]

"Triple positive" early breast cancer: an observational multicenter retrospective analysis of outcome

Pizzuti, Laura;Sperduti, Isabella;Tomao, Silverio;Santini, Daniele;Marchetti, Paolo;Sini, Valentina;Sergi, Domenico;Barba, Maddalena;Russillo, Michelangelo;Mentuccia, Lucia;Basile, Maria Luisa;De Maria, Ruggero;
2016

Abstract

We recently found that trastuzumab benefit may be lower in a small subset of early breast cancer (BC) patients (pts) with tumors expressing high levels of both hormonal receptors (HRs), i.e. triple positive (TP). To better investigate the role of HRs in HER2 positive BC, we retrospectively identified 872 TP BC pts treated with adjuvant chemotherapy alone (cohort A-366 pts), or plus trastuzumab (cohort B-506 pts). Relapse-free-survival (RFS) and breast-cancer-specific-survival (BCSS) were evaluated. Trastuzumab improved RFS and BCSS in all the subsets analyzed, but the effect on BCSS in tumors expressing both HRs in >30% of cells (TP30), and even on RFS in tumors with both HRs expressed in >50% of cells (TP50) was not significant. Distinct patterns of relapse were observed in TP50 and no-TP50 tumors, the former showing low and constant risk in the first 5 years, a late increase beyond 5 years and modest trastuzumab effect. Trastuzumab effect tended to disappear in pts whose tumors expressed ER in >50% of cells. Multivariate analysis of RFS confirmed a significant interaction between trastuzumab and ER expression, with benefit confined to pts whose tumors expressed ER in ≤50% of cells. Our data suggest that the pattern of relapse of TP tumors with high HRs is similar to that of "luminal", HER2 negative tumors, without clear benefit from adjuvant trastuzumab, which remains the standard treatment even in TP tumors. Confirmatory findings on the extent to which quantitative expression of HRs may impact clinical behavior of HER2 positive BC are warranted.
adjuvant breast cancer; chemotherapy; hormonal receptors; trastuzumab; triple positive; adult; aged; aged, 80 and over; antineoplastic combined Chemotherapy Protocols; Breast Neoplasms; Chemotherapy, adjuvant; cohort studies; disease-free survival; female; humans; middle aged; retrospective studies; survival rate; trastuzumab; treatctment Ouome
01 Pubblicazione su rivista::01a Articolo in rivista
"Triple positive" early breast cancer: an observational multicenter retrospective analysis of outcome / Vici, Patrizia; Pizzuti, Laura; Sperduti, Isabella; Frassoldati, Antonio; Natoli, Clara; Gamucci, Teresa; Tomao, Silverio; Michelotti, Andrea; Moscetti, Luca; Gori, Stefania; Baldini, Editta; Giotta, Francesco; Cassano, Alessandra; Santini, Daniele; Giannarelli, Diana; Di Lauro, Luigi; Corsi, Domenico Cristiano; Marchetti, Paolo; Sini, Valentina; Sergi, Domenico; Barba, Maddalena; Maugeri-Saccà, Marcello; Russillo, Michelangelo; Mentuccia, Lucia; D'Onofrio, Loretta; Iezzi, Laura; Scinto, Angelo Fedele; Da Ros, Lucia; Bertolini, Ilaria; Basile, Maria Luisa; Rossi, Valentina; De Maria, Ruggero; Montemurro, Filippo. - In: ONCOTARGET. - ISSN 1949-2553. - 7:14(2016), pp. 17932-17944. [10.18632/oncotarget.7480]
File allegati a questo prodotto
File Dimensione Formato  
Vici_Triple-positive_2016.pdf

accesso aperto

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 3.6 MB
Formato Adobe PDF
3.6 MB Adobe PDF Visualizza/Apri PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1280379
Citazioni
  • ???jsp.display-item.citation.pmc??? 12
  • Scopus 34
  • ???jsp.display-item.citation.isi??? 28
social impact