Concurrent trastuzumab with adjuvant radiotherapy in HER2-positive breast cancer patients: acute toxicity analyses from the French multicentric study

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Serval ID
serval:BIB_1DF774408A24
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Concurrent trastuzumab with adjuvant radiotherapy in HER2-positive breast cancer patients: acute toxicity analyses from the French multicentric study
Journal
Annals of Oncology : Official Journal of the European Society For Medical Oncology
Author(s)
Belkacémi Y., Gligorov J., Ozsahin M., Marsiglia H., De Lafontan B., Laharie-Mineur H., Aimard L., Antoine E.C., Cutuli B., Namer M., Azria D.
ISSN
1569-8041 (Electronic)
ISSN-L
0923-7534
Publication state
Published
Issued date
2008
Volume
19
Number
6
Pages
1110-1116
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Trastuzumab (T) combined with chemotherapy has been recently shown to improve outcome in HER2-positive breast cancer (BC). The aim of this study was to evaluate the toxic effects of concurrent radiation therapy (RT) and T administration in the adjuvant setting.
PATIENTS AND METHODS: Data of 146 patients with stages II-III HER2-positive BC were recorded. Median age was 46 years. In all, 32 (23%) and 114 (77%) patients received a weekly and a 3-week T schedule, respectively. A median dose of 50 Gy was delivered after surgery. Internal mammary chain (IMC) was irradiated in 103 (71%) patients.
RESULTS: Grade >2 dermatitis and esophagitis were noted in 51% and 12%, respectively. According to the Common Toxicity Criteria v3.0 scale and HERA (HERceptin Adjuvant) trial criteria, respectively, 10% and 6% of the patients had a grade >/=2 of left ventricular ejection fraction (LVEF) decrease after RT. Multivariate analyses revealed two independent prognostic factors: weekly T administration (for LVEF decrease) and menopausal status (for dermatitis). Higher level of T cumulative dose (>1600 mg) was only borderline of statistical significance for acute esophagitis toxicity.
CONCLUSION: We showed that weekly concurrent T and RT are feasible in daily clinical practice with, however, a decrease of LVEF. Cardiac volume sparing and patient selections for IMC irradiation are highly recommended. Longer follow-up is warranted to evaluate late toxic effects.
Keywords
Antibodies, Monoclonal/adverse effects, Antineoplastic Agents/adverse effects, Breast Neoplasms/drug therapy, Breast Neoplasms/metabolism, Breast Neoplasms/therapy, Combined Modality Therapy/adverse effects, Dermatitis/etiology, Esophagitis/etiology, Radiotherapy, Adjuvant/adverse effects, Receptor, ErbB-2/metabolism
Pubmed
Web of science
Open Access
Yes
Create date
13/07/2018 10:00
Last modification date
25/09/2019 7:08
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