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Hormone-receptor expression and activity of trastuzumab with chemotherapy in HER2-positive advanced breast cancer patients

  1. Filippo Montemurro MD1,†,*,
  2. Valentina Rossi MD1,
  3. Maria Cossu Rocca MD2,
  4. Rossella Martinello MD1,
  5. Elena Verri MD2,
  6. Stefania Redana MD1,
  7. Laura Adamoli PhD2,
  8. Giorgio Valabrega MD1,
  9. Anna Sapino MD3,
  10. Massimo Aglietta MD1,
  11. Giuseppe Viale MD4,
  12. Aron Goldhirsch MD2,
  13. Franco Nolè MD2

Article first published online: 19 MAY 2011

DOI: 10.1002/cncr.26162

Issue

Cancer

Cancer

Volume 118, Issue 1, pages 17–26, 1 January 2012

Additional Information

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

Author Information

  1. 1

    Division of Medical Oncology 1, Piedmont Foundation for Oncology, Institute for Cancer Research and Treatment, Candiolo, Italy

  2. 2

    Division of Medical Oncology, European Institute of Oncology, Milan, Italy

  3. 3

    University of Turin, Department of Biomedical Sciences and Human Oncology, Turin, Italy

  4. 4

    Division of Surgical Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy

  1. †

    Fax: (011) 0039 011 9933299

*Filippo Montemurro, MD, Division of Medical Oncology 1, Fondazione del Piemonte per l”Oncologia, Institute for Cancer Research and Treatment, 10060 Candiolo (Torino), Italy

  1. †

    Fax: (011) 0039 011 9933299

Publication History

  1. Issue published online: 16 DEC 2011
  2. Article first published online: 19 MAY 2011
  3. Manuscript Accepted: 7 MAR 2011
  4. Manuscript Revised: 9 FEB 2011
  5. Manuscript Received: 30 DEC 2010

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Keywords:

  • breast neoplasms;
  • HER2;
  • estrogen receptor;
  • trastuzumab;
  • chemotherapy;
  • endocrine therapy

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

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