Use of trastuzumab beyond disease progression

Observations from a retrospective review of case histories

Karen A. Gelmon, John Mackey, Shailendra Verma, Stan Z. Gertler, Nikola Bangemann, Paul Klimo, Andreas Schneeweiss, Karl Bremer, Denis Soulieres, Katia Tonkin, Richard Bell, Bernhard Heinrich, Debjani Grenier, Reg Dias

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

HER2 overexpression is associated with poor breast cancer prognosis and is the target for the humanized monoclonal antibody trastuzumab. This novel agent, when administered until disease progression in combination with chemotherapy, extends the survival of women with HER2-positive metastatic breast cancer (MBC). However, the optimal duration of trastuzumab therapy remains to be confirmed. We conducted a restropective case review study of women with HER2-positive MBC who continued to receive trastuzumab beyond disease progression. Objectives were to assess whether treatment beyond disease progression shows any evidence of efficacy and to evaluate the feasibility of this approach. One hundred five patients (median age, 47 years; range, 24-77 years) were identified in 13 centers. Women had received ≤, 6 chemotherapy regimens (median, 1) before trastuzumab therapy. Median survival from first trastuzumab dose was 29 months. The overall response rate to trastuzumab alone or with a taxane as the first regimen was 39%; a further 30% of patients had stable disease as the best response. These rates were 36% and 38% after a second regimen of trastuzumab alone or with paclitaxel or vinorelbine was administered. Some patients responded to both the first and second regimens; others responded to the second regimen after the first had failed. Twenty-two patients experienced cardiac events, of whom 18 received ≥ 1 more trastuzumab regimen. Trastuzumab treatment beyond progression appears to be a value, producing responses and clinical benefit, and is well tolerated without significant cardiac toxicity. The feasibility of this approach warrants examination in prospective trials.

Original languageEnglish (US)
Pages (from-to)52-58
Number of pages7
JournalClinical Breast Cancer
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2004
Externally publishedYes

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Disease Progression
Breast Neoplasms
Antibodies, Monoclonal, Humanized
Trastuzumab
Survival
Therapeutics
Paclitaxel
Combination Drug Therapy
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Use of trastuzumab beyond disease progression : Observations from a retrospective review of case histories. / Gelmon, Karen A.; Mackey, John; Verma, Shailendra; Gertler, Stan Z.; Bangemann, Nikola; Klimo, Paul; Schneeweiss, Andreas; Bremer, Karl; Soulieres, Denis; Tonkin, Katia; Bell, Richard; Heinrich, Bernhard; Grenier, Debjani; Dias, Reg.

In: Clinical Breast Cancer, Vol. 5, No. 1, 01.01.2004, p. 52-58.

Research output: Contribution to journalArticle

Gelmon, KA, Mackey, J, Verma, S, Gertler, SZ, Bangemann, N, Klimo, P, Schneeweiss, A, Bremer, K, Soulieres, D, Tonkin, K, Bell, R, Heinrich, B, Grenier, D & Dias, R 2004, 'Use of trastuzumab beyond disease progression: Observations from a retrospective review of case histories', Clinical Breast Cancer, vol. 5, no. 1, pp. 52-58. https://doi.org/10.3816/CBC.2004.n.010
Gelmon, Karen A. ; Mackey, John ; Verma, Shailendra ; Gertler, Stan Z. ; Bangemann, Nikola ; Klimo, Paul ; Schneeweiss, Andreas ; Bremer, Karl ; Soulieres, Denis ; Tonkin, Katia ; Bell, Richard ; Heinrich, Bernhard ; Grenier, Debjani ; Dias, Reg. / Use of trastuzumab beyond disease progression : Observations from a retrospective review of case histories. In: Clinical Breast Cancer. 2004 ; Vol. 5, No. 1. pp. 52-58.
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