Outcomes of Women with Early Stage HER2 Overexpressing Breast Cancer Receiving Adjuvant Trastuzumab: A Population Based Analysis.
Notice bibliographique
Résumé
Abstract Background: Approximately 15% of early breast cancers have amplification of the human epidermal receptor-2 (HER-2) gene, which portends a poor prognosis. Large randomized trials assessing the benefit of adjuvant trastuzumab in early stage HER-2+ breast cancer have demonstrated a 50% reduction in disease recurrence and a 30% improvement in survival. This prompted the widespread use of trastuzumab (T) in clinical practice in 2005. The objective of this study was to describe the utilization and outcomes of women who received adjuvant trastuzumab for HER-2 positive breast cancer in British Columbia since publicly funded population based use was initiated in July 2005.Methods: Women with stage I-III breast cancer positive for HER-2 overexpression by immunohistochemistry (3+) or amplification by fluorescence in situ hybridization (ratio ≥ 2.0) diagnosed from July 2004 to December 2006 were included in this study. Demographic information, tumour characteristics and outcomes on all identified patients were obtained from the BCCA Breast Cancer Outcomes Unit database. Cases were matched with the provincial BCCA pharmacy data repository to determine the proportion of women who received adjuvant T and to differentiate groups according to type of systemic treatment, including sequential versus concurrent chemotherapy (CT) with T. Kaplan-Meier curves were used to illustrate survival outcomes.Results: 704 HER-2 positive patients were identified in this retrospective study. 68% (n=480) received T. Nearly 100% of patients receiving adjuvant T underwent chemotherapy versus 28% of patients who did not receive T (n=224). The majority of patients received T concurrent with CT (71%) versus sequentially (29%). Median follow-up was 2.1 years.Two-year relapse-free survival (RFS) in patients receiving trastuzumab was 95.9% (95% CI, 93.4-97.5) and overall survival (OS) was 99.3% (95% CI, 97.9-99.8). First site of distant metastases was brain in 17.8% of relapsing patients (35% of relapsing patients who received T). The 2-year RFS among patients receiving concurrent chemotherapy + T was 94.7% whereas sequential CT followed by T was 98.4%. In the T treated cohort, the 2-year RFS rates among node negative and node positive patients were 97.8% and 94.4% respectively (p=0.06). In the cohort of HER-2 positive patients who did not receive T, the 2-year RFS rates among node negative and node positive patients were 90.7% and 75.5% respectively (p=0.007). The corresponding 2-year distant RFS in this same cohort was 93.1% and 80.3% respectively (p=0.01).Conclusions: A population based analysis of adjuvant trastuzumab use among Canadian women demonstrates highly favorable outcomes at the 2 year follow-up period. Although retrospective in nature, this is one of the first studies to observe breast cancer outcomes in a more generalized population with widespread publicly funded use of trastuzumab. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5086.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».