Effects on outcome of concomitant neoadjuvant chemotherapy-trastuzumab compared with sequential neoadjuvant chemotherapy followed by post-operative trastuzumab

SJ Howell; C Palmieri; IRJ Macpherson; K Yan; Moraes F Ades; P Riddle; R Ahmed; W Owadally; B Stanley; D Shah; O Gojis; A Januszewski; C Lewanski; R Asher; D Lythgoe; Azambuja E De; M Beresford

Effects on outcome of concomitant neoadjuvant chemotherapy-trastuzumab compared with sequential neoadjuvant chemotherapy followed by post-operative trastuzumab

SJ Howell
, C Palmieri
, IRJ Macpherson
, K Yan
, Moraes F Ades
, P Riddle
, R Ahmed
, W Owadally
, B Stanley
, D Shah
, O Gojis
, A Januszewski
, C Lewanski
, R Asher
, D Lythgoe
, Azambuja E De
, M Beresford

Research output: Contribution to conference › Poster

Abstract

Background:Neoadjuvant chemotherapy delivered with trastuzumab (NCT) has been shown to increase the rates of pathological complete response (pCR) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting has been associated with improved event free survival (EFS). However, no study has yet investigated the effect on outcomes of NCT compared to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT). This study sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early breast cancer.Methods:Women with HER2 positive invasive breast cancers treated with neoadjuvant chemotherapy between 2006-2010 were identified at each of 7 European institutions and the case notes reviewed. Preoperative clinical, radiological and pathological details, treatment details and pathology results following breast surgery were reviewed. To be defined as NCT at least one dose of trastuzumab needed to be given preoperatively. pCR was defined as absence of invasive disease in breast and lymph nodes. Multivariable Cox regression and logistic regression were used to Survival outcomes for event-free survival (EFS) were calculated by log rank analysis model the influence of a number of factors on event-free survival (EFS) and pCR respectively.Results:236 patients were identified; 138 (58%) received NCAT & 98 (42%) received NCT. The median follow up for the whole group was 53.7 months (IQR 41.7-68.8), 61.5 months (IQR 50.3-78.5) for NCAT group and 44.8 months (range 37-53.9) for NCT group. The 5-year EFS for NCAT vs NCT was 59.3% (95% CI: 49.8-67.6) and 69.6% (95% CI: 51.5-82.0) respectively. The unadjusted hazard ratio (HR) for EFS with NCT compared with the NCAT was 0.63 (95% CI 0.37–1.08; p=0.091). NCT significantly increased the odds of having pCR relative to NC (OR: 4.39 (2.18-8.86); p

Original language	English
Publication status	Published - Dec 2014
Event	San Antonio Breast Cancer Symposium - San Antonio, Texas, USA Duration: 8 Dec 2014 → 13 Dec 2014

Conference

Conference	San Antonio Breast Cancer Symposium
City	San Antonio, Texas, USA
Period	8/12/14 → 13/12/14

Cite this

Howell, SJ., Palmieri, C., Macpherson, IRJ., Yan, K., Ades, M. F., Riddle, P., Ahmed, R., Owadally, W., Stanley, B., Shah, D., Gojis, O., Januszewski, A., Lewanski, C., Asher, R., Lythgoe, D., De, A. E., & Beresford, M. (2014). Effects on outcome of concomitant neoadjuvant chemotherapy-trastuzumab compared with sequential neoadjuvant chemotherapy followed by post-operative trastuzumab. Poster session presented at San Antonio Breast Cancer Symposium, San Antonio, Texas, USA.

@conference{2e4b585a037244aab8169f13e1c2c183,

title = "Effects on outcome of concomitant neoadjuvant chemotherapy-trastuzumab compared with sequential neoadjuvant chemotherapy followed by post-operative trastuzumab",

abstract = "Background:Neoadjuvant chemotherapy delivered with trastuzumab (NCT) has been shown to increase the rates of pathological complete response (pCR) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting has been associated with improved event free survival (EFS). However, no study has yet investigated the effect on outcomes of NCT compared to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT). This study sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early breast cancer.Methods:Women with HER2 positive invasive breast cancers treated with neoadjuvant chemotherapy between 2006-2010 were identified at each of 7 European institutions and the case notes reviewed. Preoperative clinical, radiological and pathological details, treatment details and pathology results following breast surgery were reviewed. To be defined as NCT at least one dose of trastuzumab needed to be given preoperatively. pCR was defined as absence of invasive disease in breast and lymph nodes. Multivariable Cox regression and logistic regression were used to Survival outcomes for event-free survival (EFS) were calculated by log rank analysis model the influence of a number of factors on event-free survival (EFS) and pCR respectively.Results:236 patients were identified; 138 (58\%) received NCAT \& 98 (42\%) received NCT. The median follow up for the whole group was 53.7 months (IQR 41.7-68.8), 61.5 months (IQR 50.3-78.5) for NCAT group and 44.8 months (range 37-53.9) for NCT group. The 5-year EFS for NCAT vs NCT was 59.3\% (95\% CI: 49.8-67.6) and 69.6\% (95\% CI: 51.5-82.0) respectively. The unadjusted hazard ratio (HR) for EFS with NCT compared with the NCAT was 0.63 (95\% CI 0.37–1.08; p=0.091). NCT significantly increased the odds of having pCR relative to NC (OR: 4.39 (2.18-8.86); p",

author = "SJ Howell and C Palmieri and IRJ Macpherson and K Yan and Ades, \{Moraes F\} and P Riddle and R Ahmed and W Owadally and B Stanley and D Shah and O Gojis and A Januszewski and C Lewanski and R Asher and D Lythgoe and De, \{Azambuja E\} and M Beresford",

year = "2014",

month = dec,

language = "English",

note = "San Antonio Breast Cancer Symposium ; Conference date: 08-12-2014 Through 13-12-2014",

}

Howell, SJ, Palmieri, C, Macpherson, IRJ, Yan, K, Ades, MF, Riddle, P, Ahmed, R, Owadally, W, Stanley, B, Shah, D, Gojis, O, Januszewski, A, Lewanski, C, Asher, R, Lythgoe, D, De, AE & Beresford, M 2014, 'Effects on outcome of concomitant neoadjuvant chemotherapy-trastuzumab compared with sequential neoadjuvant chemotherapy followed by post-operative trastuzumab', San Antonio Breast Cancer Symposium, San Antonio, Texas, USA, 8/12/14 - 13/12/14.

TY - CONF

T1 - Effects on outcome of concomitant neoadjuvant chemotherapy-trastuzumab compared with sequential neoadjuvant chemotherapy followed by post-operative trastuzumab

AU - Howell, SJ

AU - Palmieri, C

AU - Macpherson, IRJ

AU - Yan, K

AU - Ades, Moraes F

AU - Riddle, P

AU - Ahmed, R

AU - Owadally, W

AU - Stanley, B

AU - Shah, D

AU - Gojis, O

AU - Januszewski, A

AU - Lewanski, C

AU - Asher, R

AU - Lythgoe, D

AU - De, Azambuja E

AU - Beresford, M

PY - 2014/12

Y1 - 2014/12

N2 - Background:Neoadjuvant chemotherapy delivered with trastuzumab (NCT) has been shown to increase the rates of pathological complete response (pCR) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting has been associated with improved event free survival (EFS). However, no study has yet investigated the effect on outcomes of NCT compared to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT). This study sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early breast cancer.Methods:Women with HER2 positive invasive breast cancers treated with neoadjuvant chemotherapy between 2006-2010 were identified at each of 7 European institutions and the case notes reviewed. Preoperative clinical, radiological and pathological details, treatment details and pathology results following breast surgery were reviewed. To be defined as NCT at least one dose of trastuzumab needed to be given preoperatively. pCR was defined as absence of invasive disease in breast and lymph nodes. Multivariable Cox regression and logistic regression were used to Survival outcomes for event-free survival (EFS) were calculated by log rank analysis model the influence of a number of factors on event-free survival (EFS) and pCR respectively.Results:236 patients were identified; 138 (58%) received NCAT & 98 (42%) received NCT. The median follow up for the whole group was 53.7 months (IQR 41.7-68.8), 61.5 months (IQR 50.3-78.5) for NCAT group and 44.8 months (range 37-53.9) for NCT group. The 5-year EFS for NCAT vs NCT was 59.3% (95% CI: 49.8-67.6) and 69.6% (95% CI: 51.5-82.0) respectively. The unadjusted hazard ratio (HR) for EFS with NCT compared with the NCAT was 0.63 (95% CI 0.37–1.08; p=0.091). NCT significantly increased the odds of having pCR relative to NC (OR: 4.39 (2.18-8.86); p

AB - Background:Neoadjuvant chemotherapy delivered with trastuzumab (NCT) has been shown to increase the rates of pathological complete response (pCR) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting has been associated with improved event free survival (EFS). However, no study has yet investigated the effect on outcomes of NCT compared to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT). This study sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early breast cancer.Methods:Women with HER2 positive invasive breast cancers treated with neoadjuvant chemotherapy between 2006-2010 were identified at each of 7 European institutions and the case notes reviewed. Preoperative clinical, radiological and pathological details, treatment details and pathology results following breast surgery were reviewed. To be defined as NCT at least one dose of trastuzumab needed to be given preoperatively. pCR was defined as absence of invasive disease in breast and lymph nodes. Multivariable Cox regression and logistic regression were used to Survival outcomes for event-free survival (EFS) were calculated by log rank analysis model the influence of a number of factors on event-free survival (EFS) and pCR respectively.Results:236 patients were identified; 138 (58%) received NCAT & 98 (42%) received NCT. The median follow up for the whole group was 53.7 months (IQR 41.7-68.8), 61.5 months (IQR 50.3-78.5) for NCAT group and 44.8 months (range 37-53.9) for NCT group. The 5-year EFS for NCAT vs NCT was 59.3% (95% CI: 49.8-67.6) and 69.6% (95% CI: 51.5-82.0) respectively. The unadjusted hazard ratio (HR) for EFS with NCT compared with the NCAT was 0.63 (95% CI 0.37–1.08; p=0.091). NCT significantly increased the odds of having pCR relative to NC (OR: 4.39 (2.18-8.86); p

M3 - Poster

T2 - San Antonio Breast Cancer Symposium

Y2 - 8 December 2014 through 13 December 2014

ER -

Effects on outcome of concomitant neoadjuvant chemotherapy-trastuzumab compared with sequential neoadjuvant chemotherapy followed by post-operative trastuzumab

Abstract

Conference

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