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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

2388 - Impact of hormone receptor status in HER2+ early breast cancer: a paradigm shift in the trastuzumab era

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Alexandre De Nonneville

Citation

Annals of Oncology (2018) 29 (suppl_8): viii58-viii86. 10.1093/annonc/mdy270

Authors

A. De Nonneville1, A. Gonçalves1, J. Boher2, M. Cohen3, F. Reyal4, J. Classe5, S. Giard6, P. Colombo7, X. Muracciol8, E. Darai9, E. Jouve10, C. Mazouni11, P. Gimbergues12, A. Azuar13, E. Barranger14, R. Rouzier15, R. Villet16, N. Chopin17, E. Lambaudie3, G. Houvenaeghel3

Author affiliations

  • 1 Department Of Medical Oncology, Institute Paoli Calmettes, 13274 - Marseille/FR
  • 2 Department Of Clinical research And Investigation, Biostatistics And Methodology Unit, Institute Paoli Calmettes, 13009 - Marseille/FR
  • 3 Department Of Surgical oncology, Institute Paoli Calmettes, 13009 - Marseille/FR
  • 4 Department Of Surgical oncology, Institut Curie, Paris/FR
  • 5 Department Of Surgical oncology, ICO Institut de Cancerologie de l'Ouest René Gauducheau, 44805 - Saint-Herblain/FR
  • 6 Department Of Surgical oncology, Centre Oscar Lambret, Lille/FR
  • 7 Department Of Surgical oncology, CLCC Val d'Aurelle, Montpellier/FR
  • 8 Radiotherapy, Hopital de la Timone, Marseille/FR
  • 9 Department Of Gynecologic And Breast Cancers, Hôpital Tenon, Paris/FR
  • 10 Department Of Surgical oncology, Centre Claudius Regaud, Toulouse/FR
  • 11 Department Of Surgical oncology, Institut Gustave Roussy, Villejuif/FR
  • 12 Department Of Surgical oncology, Centre Jean-Perrin, Clermont-Ferrand/FR
  • 13 Department Of Surgical oncology, Hôpital de Grasse, Grasse/FR
  • 14 Department Of Surgical oncology, Centre Antoine Lacassagne, 6100 - Nice/FR
  • 15 Surgery, Institut Curie, 75248 cedex5 - Paris/FR
  • 16 Department Of Surgical oncology, Hôpital des Diaconnesses, Paris/FR
  • 17 Department Of Surgical oncology, Centre Leon Berard, Lyon/FR
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Resources

Abstract 2388

Background

While hormone receptor-positive (HR+) and negative (HR-) HER2+ breast cancers (BC) are thought to be distinct diseases, only few studies have investigated the impact of HR status in the context of trastuzumab (TRZ)-treated BC. We evaluated the impact of HR status on outcomes of HER2+ early BC, before and after generalization of TRZ.

Methods

Patients were identified from a cohort of 23,374 women who underwent primary surgery in 18 centers between 2000 and 2017. Since the year 2005 marked the generalization of TRZ, we conducted distinct analyses in patients treated between 2000 and 2004 and those treated between 2005 and 2017. Impact of HR status analyses were done with censorship of events occurring after 5 years in both cohorts. Proportionality tests included all events.

Results

Of 970 HER2+ patients, 349 were treated between 2000 and 2004 without TRZ, and 621 between 2005 and 2017, with TRZ-based adjuvant chemotherapy. Endocrine therapy was received by 92 and 94% of HR+ patients, respectively. In the first group, HR status impacted disease-free survival (DFS) in univariate analysis (Hazard ratio: 2.44 [1.43-4.19]; p < 0.001, log-rank test). Conversely, HR status did not significantly impact DFS in the cohort with TRZ (1.34 [0.66-2.71], p = 0.414). Overall survival was also impacted by HR status in the group without TRZ (Hazard ratio: 2.49 [1.23-5.04]; p = 0.009), but not in the TRZ group (0.68 [0.23-2.00]; p = 0.482). These results were maintained in multivariate analysis including age, LVI, lymph node involvement, histology, grade and tumor size. Evolution of Hazard ratio over time for cumulative incidence of first recurrence according to HR status in patients without TRZ showed a non-proportionality of risks on metastatic (p = 0.027, AD-test) recurrences, with a decreasing risk for HR- over time. Conversely, the analysis of cumulative incidence of first recurrence did not show such a trend in patients treated with TRZ, suggesting the proportionality of the risks over time for HR status.

Conclusions

Instead patients treated without TRZ, HR status was no longer determinant of outcomes when patients received TRZ. These observations are supported by the analysis of Hazard ratio’s evolution over time for cumulative incidence of first metastatic recurrence.

Clinical trial identification

Legal entity responsible for the study

Gilles Houvenaeghel.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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