TY - JOUR
T1 - Outcomes of patients with small and node-negative HER2-positive early breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy—a sub-analysis of the ALTTO study
AU - Nader-Marta, Guilherme
AU - Debien, Véronique
AU - Eiger, Daniel
AU - Tsourti, Zoi
AU - Caparica, Rafael
AU - Kassapian, Marie
AU - Napoleone, Sylvia
AU - Hultsch, Susanne
AU - Korde, Larissa
AU - Wang, Yingbo
AU - Chumsri, Saranya
AU - Pritchard, Kathleen I.
AU - Untch, Michael
AU - Bellet-Ezquerra, Meritxell
AU - Dornelles Rosa, Daniela
AU - Moreno-Aspitia, Alvaro
AU - Piccart, Martine
AU - Dafni, Urania
AU - de Azambuja, Evandro
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/11/9
Y1 - 2022/11/9
N2 - Background: Patients with small node-negative HER2-positive breast cancer are commonly treated with paclitaxel and 1 year of adjuvant trastuzumab. We performed a sub-analysis of the ALTTO trial to explore the long-term outcomes of patients with small node-negative tumours. Methods: The ALTTO trial randomised 8381 patients with early HER2-positive BC treated with adjuvant chemotherapy (anthracycline/taxane- or taxane/carboplatin-based), to trastuzumab (T), lapatinib (L), their sequence (T → L) or their combination (L + T). Patients with tumours ≤3 cm and node-negative were included in this sub-analysis. Results: A total of 2821 patients were analysed (median follow-up of 7 years). The median age was 52 years, and most patients had tumours ≤2 cm (64.3%). The 7-year disease-free survival (DFS) was 88.1% (95% CI: 86.7–89.3%). DFS was similar for arms T, T + L and T⟶L and significantly lower for arm L (stratified log-rank P = 0.031). The 7-year overall survival rate was 95.9% (95% CI: [95.0–96.6%) and the 7-year time-to-distant recurrence was 93.4% (95% CI: 92.3–94.4%). Conclusion: With most patients treated with anthracycline-based regimens, ALTTO shows that patients with small tumours treated with trastuzumab and concomitant chemotherapy have excellent long-term outcomes, similar to those of the APT trial. Trial registration: Clinicaltrials.gov identifier NCT00490139.
AB - Background: Patients with small node-negative HER2-positive breast cancer are commonly treated with paclitaxel and 1 year of adjuvant trastuzumab. We performed a sub-analysis of the ALTTO trial to explore the long-term outcomes of patients with small node-negative tumours. Methods: The ALTTO trial randomised 8381 patients with early HER2-positive BC treated with adjuvant chemotherapy (anthracycline/taxane- or taxane/carboplatin-based), to trastuzumab (T), lapatinib (L), their sequence (T → L) or their combination (L + T). Patients with tumours ≤3 cm and node-negative were included in this sub-analysis. Results: A total of 2821 patients were analysed (median follow-up of 7 years). The median age was 52 years, and most patients had tumours ≤2 cm (64.3%). The 7-year disease-free survival (DFS) was 88.1% (95% CI: 86.7–89.3%). DFS was similar for arms T, T + L and T⟶L and significantly lower for arm L (stratified log-rank P = 0.031). The 7-year overall survival rate was 95.9% (95% CI: [95.0–96.6%) and the 7-year time-to-distant recurrence was 93.4% (95% CI: 92.3–94.4%). Conclusion: With most patients treated with anthracycline-based regimens, ALTTO shows that patients with small tumours treated with trastuzumab and concomitant chemotherapy have excellent long-term outcomes, similar to those of the APT trial. Trial registration: Clinicaltrials.gov identifier NCT00490139.
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U2 - 10.1038/s41416-022-01963-8
DO - 10.1038/s41416-022-01963-8
M3 - Article
C2 - 36050448
AN - SCOPUS:85137187508
SN - 0007-0920
VL - 127
SP - 1799
EP - 1807
JO - British journal of cancer
JF - British journal of cancer
IS - 10
ER -