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

Nikolina Dukic; Zdenka Gojkovic; Jelena Vladicic-Masic; Srdjan Masic; Nenad Lalovic; Sladjana Popovic

doi:10.2298/AOO181112006D

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.

DOI: https://doi.org/10.2298/AOO181112006D

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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