Evaluation On Efficacy Of Trastuzumab In Her-2 Positive Breast Cancer Patients And Its Analysis Of Prognosis Influencing Factors

Breast cancer has become one of the most common female cancer. Her-2 overexpression occurs in approximately 15 to 23% of human breast cancers and is associated with an aggressive clinical phenotype and a worse prognosis. Trastuzumab is a molecular targeted drug used in Her-2 positive breast cancer, which plays an important role in combination with chemotherapy. As a first-line drug, it is not widely in clinical use due to its expensive price. We reviewed retrospectively efficacy of trastuzumab in Her-2 positive breast cancer patients and explored the influencing factors of prognosis.(1) Evaluation on efficacy of trastuzumab combined with neoadjuvant chemotherapy in Her-2 positive breast cancer patients and analysis of influencing factors of prognosisObjective: To assess the efficacy of trastuzumab combined with neoadjuvant chemotherapy in the treatment of Her-2 positive breast cancer patients. Methods: The clinical and pathologic data of 149 Her-2 positive breast cancer patients who had already been treated by neoadjuvant chemotherapy were reviewed retrospectively. They were divided into the trastuzumab cohorts(NAC+H) and the neoadjuvant chemotherapy cohorts(NAC). SPSS 19.0 software was employed to calculate and analyze their clinical characteristics. The statistical results with p<0.05 were statistically significant. The survival rate and prognosis were analyzed by Kaplan-Meier method and Log-rank test, while Cox regression was applied to the univariate and multivariate analysis with the 95% confidence interval. Results: Among the 149 Her-2 positive breast cancer patients, 35 cases were treated with trastuzumab, 114 cases were treated without trastuzumab. The disease-free survival(DFS) and overall survival(OS) in NAC+H group and NAC group had significant difference(p=0.007, p=0.049). There were significant differences in Miller and Payne(MP) classification, node status after surgery and p CR between these two cohorts(p=0.009, p=0.006, p=0.014). The result of multivariate analysis indicated that clinical tumor size and clinical node status were the independent influencing factors of DFS and OS in the Her-2 positive breast cancer patients with neoadjuvant chemotherapy. Conclusion: The NAC+H cohorts could achieve much better remission in both primary lesion and axillary lymph nodes. In addition, they were more likely to achieve p CR than the NAC cohorts. The combination of trastuzumab and neoadjuvant chemotherapy can significantly improve the DFS and OS and has a positive influence in the prognosis of Her-2 positive breast cancer patients.(2) Evaluation on efficacy of trastuzumab combined with adjuvant treatment in Her-2 positive breast cancer patients and analysis of influencing factors of prognosisObjective: To assess the efficacy of trastuzumab in the adjuvant treatment of Her-2 positive breast cancer patients, and to explore its influencing factors of prognosis. Methods: Based on whether using trastuzumab or not, 149 Her-2 positive breast cancer patients who had undergone surgery were divided into the trastuzumab cohorts and the adjuvant cohorts. Their clinical and pathologic characteristics were retrospectively by SPSS 19.0 software. The statistical results with p<0.05 were statistically significant. The survival rate and prognosis were analyzed by Kaplan-Meier method and Log-rank test, while Cox regression was applied to the univariate and multivariate analysis with the 95% confidence interval. Results: Among the 448 Her-2 positive breast cancer patients, 70 cases were treated with trastuzumab, 378 cases were treated without trastuzumab. The DFS in trastuzumab group and adjuvant group had significant difference(p=0.007), but there was no significant difference of OS between two groups(p=0.074). The result of multivariate analysis indicated that pathologic node status was the independent influencing factors of DFS in the Her-2 positive breast cancer patients, while pathologic node status and endocrinotherapy were the influencing factors of OS. Conclusion: The combination of trastuzumab in adjuvant treatment can significantly improve the DFS and has a positive influence in the prognosis of Her-2 positive breast cancer patients. The patients with lymph node metastasis or without endocrinotherapy have the worse prognosis.