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Prognosis

HER-2 expression is a prognostic factor in patients with metastatic breast cancer treated with a combination of high-dose cyclophosphamide, mitoxantrone, paclitaxel and autologous blood stem cell support

Bone Marrow Transplantation volume 27, pages 847–853 (2001)Cite this article

Abstract

The expression levels of a circulating extracellular domain of HER-2 can be detected in the plasma and serum of patients with metastatic breast cancer using an enzyme immunoassay (ELISA) method. In this study, we evaluated the clinical significance of high and low levels of HER-2 in the plasma of 46 patients with metastatic breast cancer enrolled in a clinical trial of high-dose chemotherapy (HDCT) using cyclophosphamide, mitoxantrone, and paclitaxel with autologous stem cell transplantation (ASCT). Using 2500 U/ml as the cut-point, 20 patients (46%) had elevated HER-2 levels (HER-2 positive). Our results suggest that patients with metastatic breast cancer and high soluble plasma HER-2 have a significantly poorer overall (OS) and progression-free survival (PFS) following high-dose chemotherapy with paclitaxel and ASCT. The median OS of patients with low levels of HER-2 was significantly longer (P < 0.01) than the median OS of patients with high levels of HER-2 (29.8 months vs 15.9 months). PFS was also significantly longer (P < 0.01) for patients who were HER-2-negative, than for patients who were HER-2-positive (13.0 vs 8.6 months). Univariate analysis showed that patients with liver or lung metastases had significantly reduced OS and PFS. Patients with metastases to two or more sites also had a significantly reduced time to disease progression, but not OS. In multivariable analysis, lung metastases contributed along with HER-2-positive status to determine a group of patients with significantly poorer OS. However, HER-2-positive status remained the only independent predictor of PFS. Bone Marrow Transplantation (2001) 27, 847–853.

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Acknowledgements

This research was supported by grants from the Northern Cancer Research Foundation, Sudbury, Ontario; Northern Ontario Heritage Fund, Sault Ste. Marie, Ontario, Canada. The authors would like to thank the Medical Oncology Department, the Nursing staff, and the Clinical Trials staff of the Northeastern Ontario Regional Cancer Centre for their contribution and dedication to their clinical work.

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  1. Northeastern Ontario Regional Cancer Center, Sudbury, Ontario, Canada

    M Bewick, M Conlon, S Gerard, H Lee, AM Parissenti, L Zhang & RM Lafrenie

  2. Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada

    S Glück

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  1. M Bewick
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Bewick, M., Conlon, M., Gerard, S. et al. HER-2 expression is a prognostic factor in patients with metastatic breast cancer treated with a combination of high-dose cyclophosphamide, mitoxantrone, paclitaxel and autologous blood stem cell support. Bone Marrow Transplant 27, 847–853 (2001). https://doi.org/10.1038/sj.bmt.1703005

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