Trastuzumab plus paclitaxel or docetaxel in HER-2-negative/HER-2 ECD-positive anthracycline- and taxane-refractory advanced breast cancer

Alexandros Ardavanis, Panteleimon Kountourakis, Flora Kyriakou, Savoula Malliou, Ioannis Mantzaris, Anastasia Garoufali, Ioulia Yiotis, Andreas Scorilas, Nikolaos Baziotis, Gerasimos Rigatos

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Trastuzumab is considered effective against human epidermal growth factor receptor (HER)-2-positive breast cancer as assessed by immunohistochemistry (IHC) and fluorescence or chromogenic in situ hybridization (FISH/CISH) on biopsy material. Trastuzumab is now approved in both the adjuvant and metastatic settings for this patient population. Because HER-2 extracellular domain (ECD) levels have been correlated with disease progression in the metastatic setting, we considered trastuzumab salvage therapy plus a taxane in heavily pretreated trastuzumab-naive relapsed breast cancer patients with high serum levels of HER-2 ECD (≥15 ng/ml). All patients had previously failed at least two lines of anthracycline- and taxane-based regimens and were HER-2 negative by IHC and FISH/CISH prior to a centralized reanalysis, and were serum positive for HER-2 ECD (≥15 ng/ml) at baseline. Regular serum accounts of HER-2 ECD were recorded and compared with response and survival outcomes. Twenty-two patients were finally eligible for salvage therapy. Minor responses were observed in five (23%) and stable disease (SD) was observed in 11 patients, leading to a clinical benefit rate of 73% (16 of 22 patients). The median time to progression and overall survival time were 5 (6.5 months in minor responders and SD) and 12 months, respectively; 11 and eight patients remained progression free for >6 and >12 months, respectively. Eleven and seven patients were alive at 12 and 15 months, respectively, after treatment start. Furthermore, in total, 13 (59.1%) patients obtained a biochemical response. In our study, patients with conventionally HER-2-negative disease but with expression of HER-2 ECD above the normal limit (≥15 ng/ml) displayed a rapid response, both biochemically and clinically, to the trastuzumab-taxane combination. This is the first study assessing anti-HER-2- based treatment in HER-2-negative advanced breast cancer according to HER-2 ECD positivity; if our results are confirmed, additional patients with "hidden" HER-2-positive breast cancer might benefit from anti-HER-2 treatment.

Original languageEnglish (US)
Pages (from-to)361-369
Number of pages9
JournalOncologist
Volume13
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

Fingerprint

docetaxel
Anthracyclines
Paclitaxel
Breast Neoplasms
Salvage Therapy
taxane
Trastuzumab
Serum
Immunohistochemistry

Keywords

  • Anthracycline/taxane resistant
  • HER-2 ECD
  • HER-2/neu
  • Metastatic breast cancer
  • Salvage

ASJC Scopus subject areas

  • Cancer Research
  • Hematology

Cite this

Trastuzumab plus paclitaxel or docetaxel in HER-2-negative/HER-2 ECD-positive anthracycline- and taxane-refractory advanced breast cancer. / Ardavanis, Alexandros; Kountourakis, Panteleimon; Kyriakou, Flora; Malliou, Savoula; Mantzaris, Ioannis; Garoufali, Anastasia; Yiotis, Ioulia; Scorilas, Andreas; Baziotis, Nikolaos; Rigatos, Gerasimos.

In: Oncologist, Vol. 13, No. 4, 04.2008, p. 361-369.

Research output: Contribution to journalArticle

Ardavanis, A, Kountourakis, P, Kyriakou, F, Malliou, S, Mantzaris, I, Garoufali, A, Yiotis, I, Scorilas, A, Baziotis, N & Rigatos, G 2008, 'Trastuzumab plus paclitaxel or docetaxel in HER-2-negative/HER-2 ECD-positive anthracycline- and taxane-refractory advanced breast cancer', Oncologist, vol. 13, no. 4, pp. 361-369. https://doi.org/10.1634/theoncologist.2007-0207
Ardavanis, Alexandros ; Kountourakis, Panteleimon ; Kyriakou, Flora ; Malliou, Savoula ; Mantzaris, Ioannis ; Garoufali, Anastasia ; Yiotis, Ioulia ; Scorilas, Andreas ; Baziotis, Nikolaos ; Rigatos, Gerasimos. / Trastuzumab plus paclitaxel or docetaxel in HER-2-negative/HER-2 ECD-positive anthracycline- and taxane-refractory advanced breast cancer. In: Oncologist. 2008 ; Vol. 13, No. 4. pp. 361-369.
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