Impact of her2/neu status on survival after high-dose chemotherapy in high-risk breast cancer patients

Abstract

905 Background: The role of high-dose chemotherapy and autologous hematopoietic stem cell transplantation (HSCT) in breast cancer is still controversial. This retrospective study was designed to determine the impact of HER2/neu status on disease-free survival and overall survival after HSCT in breast cancer patients with at least 10 metastatic axillary lymph nodes.Methods: Between March 1997 and June 2004, totally 54 breast cancer patients with at least 10 metastatic lymph nodes underwent high-dose chemotherapy with HSCT. Depending on immunohistochemical HER2/neu status of their archival specimens, they were divided into HER2/neu negative (n=23) and positive (n=13) groups. Patients whose archival specimens were not available for analysis were excluded from this retrospective analysis. The Kaplan-Meier method was used to estimate curves for disease-free and overall survival, and comparisons were made with use of log-rank test. Results: HER2/neu negative and positive groups were comparable regarding age, number of patients enrolled, time elapsed from diagnosis to transplantation, number of previous chemotherapy cycles, number of total nucleated cells, number of CD34+ cells harvested, history of previous radiotherapy, preparative regimens and type of malignity, hormone receptor status, family history of breast cancer, posttransplant growth factor administered, menopausal status, presence of lymphatic invasion in tumor. Transplant related mortality did not differ between groups. No statistically significant differences were detected between HER2/neu negative and positive groups in 5-year disease-free survival (%30.5 and %43.7 respectively, p=0.74) and in overall survival (%48.5 and %58.2 respectively, p=0.86). Conclusions: Although not significant statistically, the survival rate in the HER2/neu positive group seems to be superior, which is in contrast with previous studies. This may be caused by short follow-up period, small sample size and delayed immunohistochemistry staining of archival specimens. To clarify the value of the HER2/neu status in predicting outcome after high-dose chemotherapy, further prospective randomized studies are needed. No significant financial relationships to disclose.