Epirubicin plus low-dose trastuzumab in HER2 positive metastatic breast cancer

Alessandra Gennari (1) , Michele Tursi (2) , Consiglia Carella (2) , Enrico Ricevuto (3) , Cinzia Orlandini (4) , Antonio Frassoldati (5) , Pierfranco Conte (5) , Paolo Bruzzi (1) , Stefano Iacobelli (2)

1 National Cancer Research Institute
2 Department of Medical Oncology
3 Department of Medical Oncology
4 Division of Medical Oncology
5 Department of Medical Oncology

This phase II study, evaluated the activity and cardiotoxicity of first-line epirubicin plus low-dose trastuzumab (LD-T) in patients with HER2 positive MBC. Patients received epirubicin 90 mg/sqm every 3 weeks plus weekly LD-T (2 mg/kg loading dose, then 1 mg/kg). After 6/8 cycles of epirubicin, single agent trastuzumab was continued. Cardiotoxicity was defined as signs or symptoms of congestive heart failure (CHF), or ≥15% decline in LVEF without symptoms, or <15% LVEF decline to less than 50%, without symptoms. Forty-five patients were enrolled. Twenty-three received prior adjuvant anthracyclines. Overall response rate was 61.4%. The median time to progression was 7.4 months and the median survival was 32.8 months. Two (4.5%) patients developed CHF. Epirubicin plus LD-T is an active regimen, however, the relatively high rate of cardiotoxicity together with the availability of less cardiotoxic and active trastuzumab-containing combinations precludes further evaluation of this regimen.

Mots clés: Low-dose trastuzumab; Epirubicin; Metastatic breast cancer

Alessandra Gennari, Michele Tursi, Consiglia Carella, Enrico Ricevuto, Cinzia Orlandini, et al.. Epirubicin plus low-dose trastuzumab in HER2 positive metastatic breast cancer. Breast Cancer Research and Treatment, 2008, 115 (1), pp.131-136. ⟨10.1007/s10549-008-0048-8⟩. ⟨hal-00478228⟩