Real-World Outcomes of Different Treatments in
the Management of Patients with HER-2 Positive
Breast Cancer: A Retrospective Study
Imjai Chitapanarux MD*, Hongsin Trakultivakorn MD**,
Songpol Srisukho MD**, Areewan Somwangprasert MD**, Kirati Watcharachan MD**,
Jirawattana Srikawin RN*, Benjaporn Chaiwun MD***, Patrinee Traisathit PhD****
Affiliation :
* Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
** Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*** Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
**** Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
Objective : To investigate the treatment outcome in terms of relapse free survival and overall survival, and explore the
determinants of the clinical outcome in HER-2/neu positive breast cancer patients who received or not received adjuvant
trastuzumab.
Material and Method: The authors reviewed retrospectively of newly diagnosed non-metastatic breast cancer patients at
the Faculty of Medicine, Chiang Mai University between January 2004 and December 2007. Comparisons were made
between the two cohorts, women who did not receive adjuvant trastuzumab (100 patients) and women who received adjuvant
trastuzumab (14 patients).
Results : The median follow-up time was 4.7 years. Four-year relapse-free survival (RFS) and overall survival (OS) in
patients receiving trastuzumab was 92.3% and 100%, respectively. In the cohort of HER-2 positive patients who did not
receive trastuzumab, the 4-year RFS in this group was 68.2% and 4-year OS was 87.8%. The difference was not statistically
significant between the 4-year RFS rates (p = 0.103) and the 4-year OS rates (p = 0.214). By multivariate Cox regression
analyses, only nodal status was identified as the independent predictors for superior RFS (hazard ratio 2.93; 95% CI, 1.07
to 5.88; p = 0.034) and none of the clinical parameters were significant predictors for 4-year overall survival.
Conclusion : A hospital-based analysis of adjuvant Trastuzumab use in our center does not demonstrate the different treatment
outcome. However, there is a trend of favorable outcome in the group receiving adjuvant trastuzumab.
Keywords : Breast cancer, Adjuvant trastuzumab, Retrospective study
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