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dc.contributor.authorPalmieri, C
dc.contributor.authorMacpherson, I
dc.contributor.authorYan, K
dc.contributor.authorAdes, F
dc.contributor.authorRiddle, P
dc.contributor.authorAhmed, R
dc.contributor.authorOwadally, W
dc.contributor.authorStanley, B
dc.contributor.authorShah, D
dc.contributor.authorGojis, O
dc.contributor.authorJanuszewski, A
dc.contributor.authorLewanski, C
dc.contributor.authorAsher, R
dc.contributor.authorLythgoe, D
dc.contributor.authorde Azambuja, E
dc.contributor.authorBeresford, M
dc.contributor.authorHowell, Sacha J
dc.date.accessioned2015-10-26T10:48:12Zen
dc.date.available2015-10-26T10:48:12Zen
dc.date.issued2015-08-21en
dc.identifier.citationNeoadjuvant chemotherapy and trastuzumab versus neoadjuvant chemotherapy followed by post-operative trastuzumab for patients with HER2-positive breast cancer. 2015: Oncotargeten
dc.identifier.issn1949-2553en
dc.identifier.pmid26334099en
dc.identifier.urihttp://hdl.handle.net/10541/581088en
dc.description.abstractNeoadjuvant chemotherapy plus trastuzumab (NCT) increases the rate of pathological complete response (pCR) and event-free survival (EFS) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting is associated with improved EFS. Whether NCT preferentially improves EFS in comparison to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT) has not been addressed. Using clinical data from women with HER2 positive BC treated at 7 European institutions between 2007 and 2010 we sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early BC. The unadjusted hazard ratio (HR) for event free survival with NCT compared with NCAT was 0.63 (95% CI 0.37-1.08; p = 0.091). Multivariable analysis revealed that treatment group, tumour size and ER status were significantly associated with EFS from diagnosis. In the whole group NCT was associated with a reduced risk of an event relative to NCAT, an effect that was confined to ER negative (HR: 0.25; 95% CI, 0.10-0.62; p = 0.003) as opposed to ER positive tumours (HR: 1.07; 95% CI, 0.46-2.52; p = 0.869). HER2 positive/ER negative BC treated with NC gain greatest survival benefit when trastuzumab is administered in both the neoadjuvant and adjuvant period rather than in the adjuvant period alone. These data support the early introduction of targeted combination therapy in HER2 positive/ER negative BC.
dc.languageENGen
dc.language.isoenen
dc.rightsArchived with thanks to Oncotargeten
dc.titleNeoadjuvant chemotherapy and trastuzumab versus neoadjuvant chemotherapy followed by post-operative trastuzumab for patients with HER2-positive breast cancer.en
dc.typeArticleen
dc.contributor.departmentAcademic Department of Medical Oncology, Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UKen
dc.identifier.journalOncotargeten
html.description.abstractNeoadjuvant chemotherapy plus trastuzumab (NCT) increases the rate of pathological complete response (pCR) and event-free survival (EFS) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting is associated with improved EFS. Whether NCT preferentially improves EFS in comparison to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT) has not been addressed. Using clinical data from women with HER2 positive BC treated at 7 European institutions between 2007 and 2010 we sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early BC. The unadjusted hazard ratio (HR) for event free survival with NCT compared with NCAT was 0.63 (95% CI 0.37-1.08; p = 0.091). Multivariable analysis revealed that treatment group, tumour size and ER status were significantly associated with EFS from diagnosis. In the whole group NCT was associated with a reduced risk of an event relative to NCAT, an effect that was confined to ER negative (HR: 0.25; 95% CI, 0.10-0.62; p = 0.003) as opposed to ER positive tumours (HR: 1.07; 95% CI, 0.46-2.52; p = 0.869). HER2 positive/ER negative BC treated with NC gain greatest survival benefit when trastuzumab is administered in both the neoadjuvant and adjuvant period rather than in the adjuvant period alone. These data support the early introduction of targeted combination therapy in HER2 positive/ER negative BC.


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