The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study

The treatment with adjuvant Trastuzumab in patients diagnosed with HER2+ small breast cancers is controversial: limited prospective data from randomized trials is available. This study aims to measure the effect of Trastuzumab in the early stages of breast cancer (pT1mic/a pN0/1mi) in terms of disea...

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Autores principales:	Andrea Villasco, Silvia Actis, Valentina Elisabetta Bounous, Fulvio Borella, Marta D’Alonzo, Riccardo Ponzone, Corrado De Sanctis, Chiara Benedetto, Nicoletta Biglia
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	trastuzumab HER2 positive pT1mic-pT1a breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/b766fe32009e4e0a8c4034660152f416
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spelling	oai:doaj.org-article:b766fe32009e4e0a8c4034660152f4162021-11-25T17:04:34ZThe Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study10.3390/cancers132258362072-6694https://doaj.org/article/b766fe32009e4e0a8c4034660152f4162021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5836https://doaj.org/toc/2072-6694The treatment with adjuvant Trastuzumab in patients diagnosed with HER2+ small breast cancers is controversial: limited prospective data from randomized trials is available. This study aims to measure the effect of Trastuzumab in the early stages of breast cancer (pT1mic/a pN0/1mi) in terms of disease recurrence and to identify which are the factors that most affect the prognosis of small HER2+ tumors. One hundred HER2+ pT1mic-pT1a breast cancer patients who were treated in three Turin Breast Units between January 1998 and December 2018 were retrospectively selected and reviewed. Trastuzumab was administered to 23 patients. Clinicopathological features and disease-free survival (DFS) were compared between different subgroups. The primary outcome was the disease recurrence rate. Median follow-up time was 86 months. Compared to pT1a tumors, pT1mic lesions had a higher tumor grade (84% of pT1mic vs. 55% of pT1a; <i>p</i> = 0.003), a higher Ki-67 index (81% vs. 46%; <i>p</i> = 0.007) and were more frequently hormone receptor (HR) negative (69% vs. 36%, <i>p</i> = 0.001). Disease recurrence rate was significantly lower among patients who received adjuvant Trastuzumab (<i>p</i> = 0.02), with this therapy conferring an 85% reduction in the risk of relapse (HR 0.15; <i>p</i> = 0.02). Among the patients who did not receive adjuvant Trastuzumab, the only factor significantly associated with an increased risk of developing a recurrence was the immunohistochemical (IHC) subtype: in fact, HR− HER2+ tumors showed a risk seven times higher of relapsing (HR 7.29; <i>p</i> = 0.003). Adjuvant Trastuzumab appears to reduce the risk of disease recurrence even in small HER2+ tumors. The adjuvant targeted therapy should be considered in patients with HR− HER2+ tumors since they have the highest risk of recurrence, independently from size and grade.Andrea VillascoSilvia ActisValentina Elisabetta BounousFulvio BorellaMarta D’AlonzoRiccardo PonzoneCorrado De SanctisChiara BenedettoNicoletta BigliaMDPI AGarticletrastuzumabHER2 positivepT1mic-pT1abreast cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5836, p 5836 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	trastuzumab HER2 positive pT1mic-pT1a breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	trastuzumab HER2 positive pT1mic-pT1a breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Andrea Villasco Silvia Actis Valentina Elisabetta Bounous Fulvio Borella Marta D’Alonzo Riccardo Ponzone Corrado De Sanctis Chiara Benedetto Nicoletta Biglia The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study
description	The treatment with adjuvant Trastuzumab in patients diagnosed with HER2+ small breast cancers is controversial: limited prospective data from randomized trials is available. This study aims to measure the effect of Trastuzumab in the early stages of breast cancer (pT1mic/a pN0/1mi) in terms of disease recurrence and to identify which are the factors that most affect the prognosis of small HER2+ tumors. One hundred HER2+ pT1mic-pT1a breast cancer patients who were treated in three Turin Breast Units between January 1998 and December 2018 were retrospectively selected and reviewed. Trastuzumab was administered to 23 patients. Clinicopathological features and disease-free survival (DFS) were compared between different subgroups. The primary outcome was the disease recurrence rate. Median follow-up time was 86 months. Compared to pT1a tumors, pT1mic lesions had a higher tumor grade (84% of pT1mic vs. 55% of pT1a; <i>p</i> = 0.003), a higher Ki-67 index (81% vs. 46%; <i>p</i> = 0.007) and were more frequently hormone receptor (HR) negative (69% vs. 36%, <i>p</i> = 0.001). Disease recurrence rate was significantly lower among patients who received adjuvant Trastuzumab (<i>p</i> = 0.02), with this therapy conferring an 85% reduction in the risk of relapse (HR 0.15; <i>p</i> = 0.02). Among the patients who did not receive adjuvant Trastuzumab, the only factor significantly associated with an increased risk of developing a recurrence was the immunohistochemical (IHC) subtype: in fact, HR− HER2+ tumors showed a risk seven times higher of relapsing (HR 7.29; <i>p</i> = 0.003). Adjuvant Trastuzumab appears to reduce the risk of disease recurrence even in small HER2+ tumors. The adjuvant targeted therapy should be considered in patients with HR− HER2+ tumors since they have the highest risk of recurrence, independently from size and grade.
format	article
author	Andrea Villasco Silvia Actis Valentina Elisabetta Bounous Fulvio Borella Marta D’Alonzo Riccardo Ponzone Corrado De Sanctis Chiara Benedetto Nicoletta Biglia
author_facet	Andrea Villasco Silvia Actis Valentina Elisabetta Bounous Fulvio Borella Marta D’Alonzo Riccardo Ponzone Corrado De Sanctis Chiara Benedetto Nicoletta Biglia
author_sort	Andrea Villasco
title	The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study
title_short	The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study
title_full	The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study
title_fullStr	The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study
title_full_unstemmed	The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study
title_sort	role of trastuzumab in patients with her2 positive small (pt1mi/a) breast cancers, a multicenter retrospective study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b766fe32009e4e0a8c4034660152f416
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The Role of Trastuzumab in Patients with HER2 Positive Small (pT1mi/a) Breast Cancers, a Multicenter Retrospective Study

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