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Vinorelbine-based salvage therapy in HER2-positive metastatic breast cancer patients progressing during trastuzumab-containing regimens: a retrospective study.
- Source :
-
BMC cancer [BMC Cancer] 2008 Jul 24; Vol. 8, pp. 209. Date of Electronic Publication: 2008 Jul 24. - Publication Year :
- 2008
-
Abstract
- Background: The vinka-alkaloyd vinorelbine is a potentially valuable treatment in patients with HER2-positive, trastuzumab-resistant advanced breast cancer. We sought to document the clinical activity of vinorelbine-based salvage treatments in this clinical setting.<br />Methods: We analyzed a cohort of 424 consecutive women receiving trastuzumab-based therapy for HER2-positive advanced breast cancer. Of these, 299 were identified as progressing during the initial trastuzumab-based treatment, and 77 received vinorelbine-based therapy as first salvage treatment. Central review of pathological specimens revealed that 70 patients had HER2-amplification detected by FISH. For these patients we determined overall response rate (ORR = complete-CR + partial-PR) and clinical benefit (CB = CR+PR+ Stable disease lasting at least 6 months), time to progression (TTP) and overall survival (OS) from the initiation of vinorelbine-based salvage therapy.<br />Results: In 60 patients who were evaluable for tumor response, ORR and CB rates were 28% (95% C.I. 18%-41%) and 50% (95% C.I. 38%-62%), respectively. Median follow-up from the initiation of salvage therapy was 15 months (range 1-63 months). Median TTP and OS were 7.1 months (95% C.I. 6.6-7.7 months) and 21 months (95% C.I. 14.3-27.7 months), respectively. No differences in clinical outcomes were observed according to whether vinorelbine was administered as a single agent or in combination with other cytostatics, or whether trastuzumab was stopped or continued beyond disease progression.<br />Conclusion: our findings suggests that vinorelbine-based combinations are active and should be further evaluated in studies conducted in trastuzumab-resistant patients, including those evaluating newer HER2-targeting agents.
- Subjects :
- Adult
Aged
Antibodies, Monoclonal pharmacology
Antibodies, Monoclonal therapeutic use
Antibodies, Monoclonal, Humanized
Breast Neoplasms enzymology
Breast Neoplasms genetics
Disease Progression
Drug Resistance, Neoplasm
Female
Gene Amplification
Humans
In Situ Hybridization, Fluorescence
Middle Aged
Receptor, ErbB-2 genetics
Retrospective Studies
Trastuzumab
Vinblastine administration & dosage
Vinblastine analogs & derivatives
Vinorelbine
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms drug therapy
Receptor, ErbB-2 biosynthesis
Salvage Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2407
- Volume :
- 8
- Database :
- MEDLINE
- Journal :
- BMC cancer
- Publication Type :
- Academic Journal
- Accession number :
- 18652678
- Full Text :
- https://doi.org/10.1186/1471-2407-8-209