Trastuzumab Provides a Comparable Prognosis in Patients With HER2-Positive Breast Cancer to Those With HER2-Negative Breast Cancer: Post Hoc Analyses of a Randomized Controlled Trial of Post-Mastectomy Hypofractionated Radiotherapy

Background and Purpose We investigated the locoregional effect of trastuzumab, and determined whether patients with human epidermal growth factor receptor (HER)2-positive breast cancer (BC) treated with trastuzumab could achieve comparable efficacy to that of patients with HER2-negative BC. Materials and Methods This was post hoc analyses of data of 793 BC patients from a randomized controlled trial comparing post-mastectomy hypofractionated radiotherapy with conventional fractionated radiotherapy. Survival rates were analyzed by the Kaplan-Meier method and compared by the log-rank test. Results Patients were classified into three groups: HER2-negative (HER2(-); n = 547), HER2-positve with trastuzumab (HER2(+) + T; n = 136), and HER2-positive without trastuzumab (HER2(+) - T; n = 110). The HER2(+) + T group had significantly lower locoregional recurrence (LRR, 6.0% vs. 13.9%), distant metastasis (DM, 17.4% vs. 33.8%) and higher disease-free survival (DFS, 81.2% vs. 61.9%) at 5 years than that of the HER2(+) - T group (P <.05). The HER2(-) group had significantly lower LRR (6.8% vs. 13.9%), DM (22.4% vs. 33.8%) and higher DFS (76.1% vs. 61.9%) at 5 years than that of the HER2(+) - T group (P <.05). The difference in LRR, DM and DFS at 5 years was not significant between the HER2(+) + T group and HER2(-) group (P >.05). Different annual LRR patterns was found among groups according to HR status. Conclusion Trastuzumab reduces LRR in patients with locally advanced HER2-positive BC who have received post-mastectomy radiotherapy. It provides comparable DFS to that with patients with HER2-negative BC.

Automated summary

This study compared the efficacy of trastuzumab in HER2-positive breast cancer patients with that of HER2-negative patients, showing that trastuzumab can reduce locoregional recurrence and improve disease-free survival. Trastuzumab treatment in HER2-positive breast cancer patients provides comparable outcomes to those in HER2-negative patients.