Open Access Highly Accessed Research article

Trastuzumab with either docetaxel or vinorelbine as first-line treatment for patients with HER2-positive advanced breast cancer: a retrospective comparison

Stefania Redana1, Michela Donadio2, Franco Nolè3, Maria Elena Jacomuzzi4, Alessandra Beano2, Rossella Martinello1, Anna Sapino5, Giuseppe Viale6, Massimo Aglietta1 and Filippo Montemurro1*

Author Affiliations

1 Institute for Cancer Research and Treatment, Division of Medical Oncology, Candiolo Italy

2 Molinette Hospital, Centro Oncologico Subalpino (COES), Turin, Italy

3 European Institute of Oncology (IEO), Department of Medical Oncology, Milan, Italy

4 Mauriziano Hospital, Division of Gynecology, Torino, Italy

5 University of Turin, Department of Biomedical Sciences and Human Oncology, Turin, Italy

6 European Institute of Oncology (IEO), Division of Surgical Pathology and Laboratory Medicine, Milan, Italy

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BMC Cancer 2010, 10:28  doi:10.1186/1471-2407-10-28

Published: 1 February 2010

Abstract

Background

Combinations of trastuzumab with either docetaxel or vinorelbine are considered valuable treatment options for HER2-positive metastatic breast cancer patients. We performed a retrospective comparison of the clinical outcomes associated with either one of these combinations.

Methods

From a multi-institutional database we retrieved 179 patients treated with either docetaxel or vinorelbine plus trastuzumab as first-line therapy for HER2-positive advanced breast cancer.

Results

Docetaxel-trastuzumab was superior to vinorelbine-trastuzumab in terms of response rate (RR: 77 vs 57%, p = 0.01) and median overall survival (OS: 35 vs 23 months, p = 0.04), but not in median time to progression (TTP: 12 vs 10 months, p = 0.53). At multivariate analysis, type of treatment was not associated with TTP but was an independent predictor of OS, with a significant reduction in the risk of death in favor of docetaxel-trastuzumab (HR 0.474, 95% IC 0,303-0.742, p < 0.01).

Conclusion

Docetaxel or vinorelbine, when combined with trastuzumab, provide excellent rates of tumor control in patients with previously untreated HER2-positive advanced breast cancer. Docetaxel may offer some advantage in terms of response rate and resulted in a significantly prolonged overall survival, which, because of the retrospective design of our study, deserves further investigation in prospective trials.