Adjuvant application of trastuzumab in HER2 positive breast cancer and impact on time to relapse

  • Nikolina Dukic University Hospital Foca, Center for Internal Medicine, Republic of Srpska, Bosnia and Herzegovina; Faculty of Medicine University of East Sarajevo, Foca,Republic of Srpska, Bosnia and Herzegovina.
  • Zdenka Gojkovic Clinical Center of RS, Oncology Clinic, Republic of Srpska, Bosnia and Herzegovina
  • Jelena Vladicic-Masic University Hospital Foca, Center for Internal Medicine, Republic of Srpska, Bosnia and Herzegovina; Faculty of Medicine University of East Sarajevo, Foca,Republic of Srpska, Bosnia and Herzegovina.
  • Srdjan Masic Faculty of Medicine,Department of Primary Health Care and Public Health,University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina.
  • Nenad Lalovic University Hospital Foca, Center for Surgery,Republic of Srpska, Bosnia and Herzegovina; Faculty of Medicine University of East Sarajevo, Foca,Republic of Srpska, Bosnia and Herzegovina.
  • Sladjana Popovic University Hospital Foca, Center for Internal Medicine, Republic of Srpska, Bosnia and Herzegovina; Faculty of Medicine University of East Sarajevo, Foca,Republic of Srpska, Bosnia and Herzegovina.
Keywords: Cancer, HER2, Tyrosine kinase receptor, Trastuzumab, Prognosis, Breast, Antibodies,

Abstract


Background: Of all breast cancers 20-25% are HER2 positive. Overexpression of HER2 protein on the surface of the malignant cell leads to excessive cell proliferation through different signaling pathways. Trastuzumab is a human monoclonal antibody that binds to domain IV of HER2 receptor and blocks signaling pathway for proliferation. The result is an improved prognosis for HER 2 positive breast cancer patients, even when compared to patients with other types of breast cancers. Methods: The study presents 74 women patients with early HER2 positive breast cancer who were previously operated (either radicaly or using breast conserving surgery), and received adjuvant chemo- and radiotherapy.  Fourty four patients received adjuvant trastuzumab for one year, and 30 patients did not (control group). Observed time to relapse of the disease was 60 months. Results: There was a significant difference in survival in favor of the group that received trastuzumab (p<0.001). Application of trastuzumab also delayed relapse of the disease by 51.7%. No significant difference was observed between estrogen receptor positive and estrogen receptor negative cancers., In the control group there was a significant difference in relapse free survival in favor of estrogen and progesteron receptor positive tumors (p<0.001). Conclusion: Survival of patients with a HER2 positive breast cancer whose prognosis was initially worse compared to  HER2 negative patients, significantly improved after administration of trastuzumab.

 

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Published
2019/11/26
Section
Original Scientific Paper