Incidence of late relapses in patients with HER2-positive breast cancer receiving adjuvant trastuzumab: Combined analysis of NCCTG N9831 (Alliance) and NRG oncology/NSABP B-31

Saranya Chumsri, Zhuo Li, Daniel J. Serie, Afshin Mashadi-Hossein, Gerardo Colon-Otero, Nan Song, Katherine L. Pogue-Geile, Patrick G. Gavin, Soonmyung Paik, Alvaro Moreno-Aspitia, Edith A. Perez, E. Aubrey Thompson

Research output: Contribution to journalArticle

Abstract

PURPOSE Recent trials have shown potential benefit of extended adjuvant endocrine therapy and relatively high risk of recurrence (RoR) after 5 years in hormone receptor-positive (HR+) human epidermal growth factor receptor 2–negative (HER22) breast cancer. Although risk of late relapse in HR+ HER22 breast cancer is fairly well defined, the risk in HER2-positive (HER2+) breast cancer treated with adjuvant trastuzumab-based chemotherapy remains largely unknown. METHODS We included 3,177 patients with HER2+ breast cancer treated with adjuvant chemotherapy alone or with trastuzumab from the North Central Cancer Treatment Group N9831 (ClinicalTrials.gov identifier: NCT00005970) and National Surgical Adjuvant Breast and Bowel Project B-31 (ClinicalTrials.gov identifier: NCT00004067) trials. RESULTS Overall, HR+ breast cancer was significantly associated with improved recurrence-free survival (RFS) during the first 5 years (hazard ratio, 0.65; 95% CI, 0.56 to 0.77; P, .001). Among patients treated with trastuzumab, cumulative hazard for RFS was lower in patients with HR+ HER2+ breast cancer during the first 5 years (10.96% v 17.48%; hazard ratio, 0.60; 95% CI, 0.45 to 0.79; P, .001). However, there was no significant difference in RFS based on HR status during years 5 to 10 (hazard ratio, 1.32; 95% CI, 0.93 to 1.88; P = .12). A comparable degree of trastuzumab benefit was observed in HR+ and HR2 breast cancers (P for interaction = .87). Furthermore, we observed low RoR in years 5 to 10 among patients with HR+ HER2+ breast cancer: 3.23% in patients without lymph node involvement (N0) and 6.39% in patients with involvement of one to three lymph nodes (N1). CONCLUSION The benefit of adjuvant trastuzumab persists for a long time. A distinct pattern of recurrence was observed between HR+ and HR2 HER2+ disease but with similar degree of benefit from adjuvant trastuzumab. RoR in years 5 to 10 in HR+ HER2+ breast cancer is low, particularly in patients with N0 or N1 disease.

Original languageEnglish (US)
Pages (from-to)3425-3435
Number of pages11
JournalJournal of Clinical Oncology
Volume37
Issue number35
DOIs
StatePublished - Jan 1 2019

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Breast Neoplasms
Recurrence
Incidence
Survival
Lymph Nodes
Trastuzumab
B 31
Adjuvant Chemotherapy
Epidermal Growth Factor Receptor
Breast
Hormones
Drug Therapy
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Incidence of late relapses in patients with HER2-positive breast cancer receiving adjuvant trastuzumab : Combined analysis of NCCTG N9831 (Alliance) and NRG oncology/NSABP B-31. / Chumsri, Saranya; Li, Zhuo; Serie, Daniel J.; Mashadi-Hossein, Afshin; Colon-Otero, Gerardo; Song, Nan; Pogue-Geile, Katherine L.; Gavin, Patrick G.; Paik, Soonmyung; Moreno-Aspitia, Alvaro; Perez, Edith A.; Aubrey Thompson, E.

In: Journal of Clinical Oncology, Vol. 37, No. 35, 01.01.2019, p. 3425-3435.

Research output: Contribution to journalArticle

Chumsri, S, Li, Z, Serie, DJ, Mashadi-Hossein, A, Colon-Otero, G, Song, N, Pogue-Geile, KL, Gavin, PG, Paik, S, Moreno-Aspitia, A, Perez, EA & Aubrey Thompson, E 2019, 'Incidence of late relapses in patients with HER2-positive breast cancer receiving adjuvant trastuzumab: Combined analysis of NCCTG N9831 (Alliance) and NRG oncology/NSABP B-31', Journal of Clinical Oncology, vol. 37, no. 35, pp. 3425-3435. https://doi.org/10.1200/JCO.19.00443
Chumsri, Saranya ; Li, Zhuo ; Serie, Daniel J. ; Mashadi-Hossein, Afshin ; Colon-Otero, Gerardo ; Song, Nan ; Pogue-Geile, Katherine L. ; Gavin, Patrick G. ; Paik, Soonmyung ; Moreno-Aspitia, Alvaro ; Perez, Edith A. ; Aubrey Thompson, E. / Incidence of late relapses in patients with HER2-positive breast cancer receiving adjuvant trastuzumab : Combined analysis of NCCTG N9831 (Alliance) and NRG oncology/NSABP B-31. In: Journal of Clinical Oncology. 2019 ; Vol. 37, No. 35. pp. 3425-3435.
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title = "Incidence of late relapses in patients with HER2-positive breast cancer receiving adjuvant trastuzumab: Combined analysis of NCCTG N9831 (Alliance) and NRG oncology/NSABP B-31",
abstract = "PURPOSE Recent trials have shown potential benefit of extended adjuvant endocrine therapy and relatively high risk of recurrence (RoR) after 5 years in hormone receptor-positive (HR+) human epidermal growth factor receptor 2–negative (HER22) breast cancer. Although risk of late relapse in HR+ HER22 breast cancer is fairly well defined, the risk in HER2-positive (HER2+) breast cancer treated with adjuvant trastuzumab-based chemotherapy remains largely unknown. METHODS We included 3,177 patients with HER2+ breast cancer treated with adjuvant chemotherapy alone or with trastuzumab from the North Central Cancer Treatment Group N9831 (ClinicalTrials.gov identifier: NCT00005970) and National Surgical Adjuvant Breast and Bowel Project B-31 (ClinicalTrials.gov identifier: NCT00004067) trials. RESULTS Overall, HR+ breast cancer was significantly associated with improved recurrence-free survival (RFS) during the first 5 years (hazard ratio, 0.65; 95{\%} CI, 0.56 to 0.77; P, .001). Among patients treated with trastuzumab, cumulative hazard for RFS was lower in patients with HR+ HER2+ breast cancer during the first 5 years (10.96{\%} v 17.48{\%}; hazard ratio, 0.60; 95{\%} CI, 0.45 to 0.79; P, .001). However, there was no significant difference in RFS based on HR status during years 5 to 10 (hazard ratio, 1.32; 95{\%} CI, 0.93 to 1.88; P = .12). A comparable degree of trastuzumab benefit was observed in HR+ and HR2 breast cancers (P for interaction = .87). Furthermore, we observed low RoR in years 5 to 10 among patients with HR+ HER2+ breast cancer: 3.23{\%} in patients without lymph node involvement (N0) and 6.39{\%} in patients with involvement of one to three lymph nodes (N1). CONCLUSION The benefit of adjuvant trastuzumab persists for a long time. A distinct pattern of recurrence was observed between HR+ and HR2 HER2+ disease but with similar degree of benefit from adjuvant trastuzumab. RoR in years 5 to 10 in HR+ HER2+ breast cancer is low, particularly in patients with N0 or N1 disease.",
author = "Saranya Chumsri and Zhuo Li and Serie, {Daniel J.} and Afshin Mashadi-Hossein and Gerardo Colon-Otero and Nan Song and Pogue-Geile, {Katherine L.} and Gavin, {Patrick G.} and Soonmyung Paik and Alvaro Moreno-Aspitia and Perez, {Edith A.} and {Aubrey Thompson}, E.",
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language = "English (US)",
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TY - JOUR

T1 - Incidence of late relapses in patients with HER2-positive breast cancer receiving adjuvant trastuzumab

T2 - Combined analysis of NCCTG N9831 (Alliance) and NRG oncology/NSABP B-31

AU - Chumsri, Saranya

AU - Li, Zhuo

AU - Serie, Daniel J.

AU - Mashadi-Hossein, Afshin

AU - Colon-Otero, Gerardo

AU - Song, Nan

AU - Pogue-Geile, Katherine L.

AU - Gavin, Patrick G.

AU - Paik, Soonmyung

AU - Moreno-Aspitia, Alvaro

AU - Perez, Edith A.

AU - Aubrey Thompson, E.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - PURPOSE Recent trials have shown potential benefit of extended adjuvant endocrine therapy and relatively high risk of recurrence (RoR) after 5 years in hormone receptor-positive (HR+) human epidermal growth factor receptor 2–negative (HER22) breast cancer. Although risk of late relapse in HR+ HER22 breast cancer is fairly well defined, the risk in HER2-positive (HER2+) breast cancer treated with adjuvant trastuzumab-based chemotherapy remains largely unknown. METHODS We included 3,177 patients with HER2+ breast cancer treated with adjuvant chemotherapy alone or with trastuzumab from the North Central Cancer Treatment Group N9831 (ClinicalTrials.gov identifier: NCT00005970) and National Surgical Adjuvant Breast and Bowel Project B-31 (ClinicalTrials.gov identifier: NCT00004067) trials. RESULTS Overall, HR+ breast cancer was significantly associated with improved recurrence-free survival (RFS) during the first 5 years (hazard ratio, 0.65; 95% CI, 0.56 to 0.77; P, .001). Among patients treated with trastuzumab, cumulative hazard for RFS was lower in patients with HR+ HER2+ breast cancer during the first 5 years (10.96% v 17.48%; hazard ratio, 0.60; 95% CI, 0.45 to 0.79; P, .001). However, there was no significant difference in RFS based on HR status during years 5 to 10 (hazard ratio, 1.32; 95% CI, 0.93 to 1.88; P = .12). A comparable degree of trastuzumab benefit was observed in HR+ and HR2 breast cancers (P for interaction = .87). Furthermore, we observed low RoR in years 5 to 10 among patients with HR+ HER2+ breast cancer: 3.23% in patients without lymph node involvement (N0) and 6.39% in patients with involvement of one to three lymph nodes (N1). CONCLUSION The benefit of adjuvant trastuzumab persists for a long time. A distinct pattern of recurrence was observed between HR+ and HR2 HER2+ disease but with similar degree of benefit from adjuvant trastuzumab. RoR in years 5 to 10 in HR+ HER2+ breast cancer is low, particularly in patients with N0 or N1 disease.

AB - PURPOSE Recent trials have shown potential benefit of extended adjuvant endocrine therapy and relatively high risk of recurrence (RoR) after 5 years in hormone receptor-positive (HR+) human epidermal growth factor receptor 2–negative (HER22) breast cancer. Although risk of late relapse in HR+ HER22 breast cancer is fairly well defined, the risk in HER2-positive (HER2+) breast cancer treated with adjuvant trastuzumab-based chemotherapy remains largely unknown. METHODS We included 3,177 patients with HER2+ breast cancer treated with adjuvant chemotherapy alone or with trastuzumab from the North Central Cancer Treatment Group N9831 (ClinicalTrials.gov identifier: NCT00005970) and National Surgical Adjuvant Breast and Bowel Project B-31 (ClinicalTrials.gov identifier: NCT00004067) trials. RESULTS Overall, HR+ breast cancer was significantly associated with improved recurrence-free survival (RFS) during the first 5 years (hazard ratio, 0.65; 95% CI, 0.56 to 0.77; P, .001). Among patients treated with trastuzumab, cumulative hazard for RFS was lower in patients with HR+ HER2+ breast cancer during the first 5 years (10.96% v 17.48%; hazard ratio, 0.60; 95% CI, 0.45 to 0.79; P, .001). However, there was no significant difference in RFS based on HR status during years 5 to 10 (hazard ratio, 1.32; 95% CI, 0.93 to 1.88; P = .12). A comparable degree of trastuzumab benefit was observed in HR+ and HR2 breast cancers (P for interaction = .87). Furthermore, we observed low RoR in years 5 to 10 among patients with HR+ HER2+ breast cancer: 3.23% in patients without lymph node involvement (N0) and 6.39% in patients with involvement of one to three lymph nodes (N1). CONCLUSION The benefit of adjuvant trastuzumab persists for a long time. A distinct pattern of recurrence was observed between HR+ and HR2 HER2+ disease but with similar degree of benefit from adjuvant trastuzumab. RoR in years 5 to 10 in HR+ HER2+ breast cancer is low, particularly in patients with N0 or N1 disease.

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