Autoimmunity and Benefit from Trastuzumab Treatment in Breast Cancer: Results from the HERA Trial

Anticancer Res. 2019 Feb;39(2):797-802. doi: 10.21873/anticanres.13177.

Abstract

Background/aim: This study sought to determine whether an autoimmune background could identify patients with HER2-positive early breast cancer (EBC) who derive differential benefit from primary adjuvant trastuzumab-based therapy.

Patients and methods: HERA is an international randomized trial of 5,102 women with HER2-positive EBC, who were enrolled to either receive adjuvant trastuzumab or not. In this exploratory analysis, the interaction between autoimmune history and the magnitude of trastuzumab benefit was evaluated.

Results: A total of 5,099 patients were included in the current analysis. Among them, 325 patients (6.4%) had autoimmune disease history, 295 of whom had active disease. Patients were randomly assigned to trastuzumab or no-trastuzumab groups. Similar reductions in the risk of events in patients with and without autoimmune history were observed (interaction p=0.95 for disease-free survival, and p=0.62 for overall survival).

Conclusion: No evidence of a differential benefit from trastuzumab in patients with a medical history of autoimmune disease was found.

Keywords: Autoimmunity; HER2; breast cancer; trastuzumab.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Autoimmune Diseases / complications*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / immunology*
  • Chemotherapy, Adjuvant / adverse effects
  • Disease-Free Survival
  • Female
  • Humans
  • International Cooperation
  • Middle Aged
  • Proportional Hazards Models
  • Risk
  • Trastuzumab / therapeutic use*
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Trastuzumab