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Hormone-receptor expression and activity of trastuzumab with chemotherapy in HER2-positive advanced breast cancer patients
Version of Record online: 19 MAY 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 1, pages 17–26, 1 January 2012
How to Cite
Montemurro, F., Rossi, V., Cossu Rocca, M., Martinello, R., Verri, E., Redana, S., Adamoli, L., Valabrega, G., Sapino, A., Aglietta, M., Viale, G., Goldhirsch, A. and Nolè, F. (2012), Hormone-receptor expression and activity of trastuzumab with chemotherapy in HER2-positive advanced breast cancer patients. Cancer, 118: 17–26. doi: 10.1002/cncr.26162
- Issue online: 16 DEC 2011
- Version of Record online: 19 MAY 2011
- Manuscript Accepted: 7 MAR 2011
- Manuscript Revised: 9 FEB 2011
- Manuscript Received: 30 DEC 2010
- breast neoplasms;
- estrogen receptor;
- endocrine therapy
The relationship between quantitative immunohistochemical hormone receptor expression and response to the combination of trastuzumab with chemotherapy in HER2-positive advanced breast cancer is currently unknown.
Estrogen receptor (ER) and progesterone receptor expression was studied both as a dichotomous variable (positivity set at ≥1% of positive cells) and as a continuous variable. The effect of hormone receptor expression on overall response rate and progression-free survival in patients receiving trastuzumab-based treatment was studied by univariate and multivariate analysis.
One hundred eleven of 227 consecutive advanced breast cancer patients treated at 2 Institutions had hormone receptor-positive tumors (49%). High expression of ER (≥30% of tumor cells) predicted reduced probability of tumor response to trastuzumab plus chemotherapy (multivariate odds ratio, 0.422; 95% confidence interval [CI], 0.222-0.803; P = .009). In patients with hormone receptor-positive tumors (≥1% of tumor cells), maintenance endocrine therapy added to trastuzumab upon the completion of chemotherapy was associated with a significant progression-free survival benefit (hazard ratio, 0.521; 95% CI, 0.3325-0.836; P = .007).
Our results suggest a predictive role of hormone receptor expression in HER2-positive tumors. Further investigation in this patient subset is warranted to optimize the use of HER2-targeting agents, chemotherapy, and endocrine therapy. Cancer 2012;. © 2011 American Cancer Society.