HER2 and Choice of Adjuvant Chemotherapy for Invasive Breast Cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-15

摘要: Background Recent retrospective analyses have suggested that breast cancer patients whose tumors overexpress HER2 derive preferential benefit from treatment with anthracyclines such as doxorubicin. This has led some clinicians to propose should be used a predictive marker in choosing between anthracycline-based regimens and combination chemotherapy cyclophosphamide, methotrexate, 5-fluorouracil (CMF). We evaluated this recommendation study of National Surgical Adjuvant Breast Bowel Project Protocol B-15, which received doxorubicin cyclophosphamide (AC), CMF, or AC followed by CMF. hypothesized would superior CMF only the HER2-positive patients. Methods Immunohistochemical detection was performed on tumor sections 2034 2295 eligible statistical analysis evaluate interaction efficacy assigned treatments overexpression. All tests were two-sided. Results Tumor 599 (29%) stained positive for HER2. only, although differences outcomes did not reach significance. In cohort, relative risks failure (i.e., after compared treatment) 0.84 disease-free survival (DFS) (95% confidence interval [CI] = 0.65--1.07; P =.15), 0.82 CI 0.63--1.06; =.14), 0.80 recurrence-free (RFS) 0.62--1.04; =.10). Tests status suggestive but statistically significant (P =.19 DFS, =.11 survival, =.08 RFS). Conclusions These results, together overview results indicating minor overall superiority indicate preference regimen tumors. Both may considered HER2-negative