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Breast Cancer

HER2 overexpression as a prognostic factor in metastatic breast cancer patients treated with high-dose chemotherapy and autologous stem cell support

Summary:

We retrospectively evaluated the predictive and prognostic role of HER2 expression in 44 metastatic breast cancer (MBC) patients treated with high-dose consolidation chemotherapy (HDCT) and autologous stem cell support after induction chemotherapy (IC) with six courses of epirubicin+paclitaxel (22 patients) or gemcitabine+epirubicin+paclitaxel (22 patients). HER2 expression was evaluated by an immunohistochemical method (Herceptest, Dako). A total of 13 patients (29.5%) showed a HER2 overexpression (score 3+). After IC, nine patients were in complete response (CR), 30 in partial response (PR), and five in stable disease (SD); after HDCT, 20 (45.5%) obtained a CR, and 23 were in PR, for a conversion rate of 48.5%. Conversion rate for HER2-positive patients was 87.5 vs 37% for HER2-negative patients (P=0.018). The median progression-free (PFS) and overall survivals (OS) were 17.6 (95% CI 13.2–22.0) and 44 (95% CI 25.9–62.3) months, respectively. Patients with HER2 overexpression experienced a significantly (P=0.0042) shorter median PFS (15.3 months, 95% CI 11.1–19.5) compared to HER2-negative patients (21.3 months, 95% CI 14.3–28.4). The median OS was 27.6 months (95% CI 4.5–50.7) in HER2-positive patients and 50.3 months (95% CI 38.7–62.0) in HER2-negative patients (P=0.345). These results indicate that HER2 overexpression predicts a worse outcome for patients with MBC treated with HDCT, despite the high CR rate obtained in this subset of patients.

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Guarneri, V., Bengala, C., Orlandini, C. et al. HER2 overexpression as a prognostic factor in metastatic breast cancer patients treated with high-dose chemotherapy and autologous stem cell support. Bone Marrow Transplant 34, 413–417 (2004). https://doi.org/10.1038/sj.bmt.1704619

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  • DOI: https://doi.org/10.1038/sj.bmt.1704619

Keywords

  • high-dose chemotherapy
  • HER2 status
  • metastatic breast cancer

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