Clinical outcome of HER2-positive breast cancer patients after failure on adjuvant trastuzumab: The potential of the time to relapse

摘要

Sir - We read with great interest the paper by Lang et al. [1]. The authors reported that trastuzumab combined with taxane is an effective and well-tolerated first-line treatment for patients relapsing on trastuzumab-based adjuvant therapy. We provide additional data suggesting that the timing of relapse matters in the management of these patients. Among cases treated in the first quarter of 2013 at INT, Milan, relapses occurred during (early) or after (late) adjuvant therapy in 12 (30%) and 28 (70%) patients. Early and late relapses shared a similar distribution of hormone receptor-positive and -negative status (35% versus 25%, P = 0.73). Early relapses were less likely to affect lung, bone and multiple metastatic sites; liver was involved in 42 and 29% of early and late relapses, respectively (P = 0.48). Trastuzumab and tyrosine kinase inhibitors were prescribed in 78 and 18% of cases. At a median follow-up of 21.3 (0.6-98.6) months, the median time-to-progression (TTP) was 12.7 (95% confidence interval: 9.0-15) months.