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Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer.

Publication ,  Journal Article
Tolaney, SM; Guo, H; Pernas, S; Barry, WT; Dillon, DA; Ritterhouse, L; Schneider, BP; Shen, F; Fuhrman, K; Baltay, M; Dang, CT; Yardley, DA ...
Published in: J Clin Oncol
August 1, 2019

PURPOSE: The Adjuvant Paclitaxel and Trastuzumab trial was designed to address treatment of patients with small human epidermal growth factor receptor 2 (HER2)-positive breast cancer. The primary analysis of the Adjuvant Paclitaxel and Trastuzumab trial demonstrated a 3-year disease-free survival (DFS) of 98.7%. In this planned secondary analysis, we report longer-term outcomes and exploratory results to characterize the biology of small HER2-positive tumors and genetic factors that may predispose to paclitaxel-induced peripheral neuropathy (TIPN). PATIENTS AND METHODS: In this phase II study, patients with HER2-positive breast cancer with tumors 3 cm or smaller and negative nodes received paclitaxel (80 mg/m2) with trastuzumab for 12 weeks, followed by trastuzumab for 9 months. The primary end point was DFS. Recurrence-free interval (RFI), breast cancer-specific survival, and overall survival (OS) were also analyzed. In an exploratory analysis, intrinsic subtyping by PAM50 (Prosigna) and calculation of the risk of recurrence score were performed on the nCounter analysis system on archival tissue. Genotyping was performed to investigate TIPN. RESULTS: A total of 410 patients were enrolled from October 2007 to September 2010. After a median follow-up of 6.5 years, there were 23 DFS events. The 7-year DFS was 93% (95% CI, 90.4 to 96.2) with four (1.0%) distant recurrences, 7-year OS was 95% (95% CI, 92.4 to 97.7), and 7-year RFI was 97.5% (95% CI, 95.9 to 99.1). PAM50 analyses (n = 278) showed that most tumors were HER2-enriched (66%), followed by luminal B (14%), luminal A (13%), and basal-like (8%). Genotyping (n = 230) identified one single-nucleotide polymorphism, rs3012437, associated with an increased risk of TIPN in patients with grade 2 or greater TIPN (10.4%). CONCLUSION: With longer follow-up, adjuvant paclitaxel and trastuzumab is associated with excellent long-term outcomes. Distribution of PAM50 intrinsic subtypes in small HER2-positive tumors is similar to that previously reported for larger tumors.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

August 1, 2019

Volume

37

Issue

22

Start / End Page

1868 / 1875

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Trastuzumab
  • Risk
  • Recurrence
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • Polymorphism, Single Nucleotide
  • Poisson Distribution
  • Peripheral Nervous System Diseases
  • Paclitaxel
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tolaney, S. M., Guo, H., Pernas, S., Barry, W. T., Dillon, D. A., Ritterhouse, L., … Winer, E. P. (2019). Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Clin Oncol, 37(22), 1868–1875. https://doi.org/10.1200/JCO.19.00066
Tolaney, Sara M., Hao Guo, Sonia Pernas, William T. Barry, Deborah A. Dillon, Lauren Ritterhouse, Bryan P. Schneider, et al. “Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer.J Clin Oncol 37, no. 22 (August 1, 2019): 1868–75. https://doi.org/10.1200/JCO.19.00066.
Tolaney SM, Guo H, Pernas S, Barry WT, Dillon DA, Ritterhouse L, et al. Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Clin Oncol. 2019 Aug 1;37(22):1868–75.
Tolaney, Sara M., et al. “Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer.J Clin Oncol, vol. 37, no. 22, Aug. 2019, pp. 1868–75. Pubmed, doi:10.1200/JCO.19.00066.
Tolaney SM, Guo H, Pernas S, Barry WT, Dillon DA, Ritterhouse L, Schneider BP, Shen F, Fuhrman K, Baltay M, Dang CT, Yardley DA, Moy B, Marcom PK, Albain KS, Rugo HS, Ellis MJ, Shapira I, Wolff AC, Carey LA, Overmoyer B, Partridge AH, Hudis CA, Krop IE, Burstein HJ, Winer EP. Seven-Year Follow-Up Analysis of Adjuvant Paclitaxel and Trastuzumab Trial for Node-Negative, Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer. J Clin Oncol. 2019 Aug 1;37(22):1868–1875.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

August 1, 2019

Volume

37

Issue

22

Start / End Page

1868 / 1875

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Trastuzumab
  • Risk
  • Recurrence
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • Polymorphism, Single Nucleotide
  • Poisson Distribution
  • Peripheral Nervous System Diseases
  • Paclitaxel