Evidence map›Paper›PMID 38291268›Full record

Trial reportBreast cancer research and treatment2024

Trastuzumab and first-line taxane chemotherapy in metastatic breast cancer patients with a HER2-negative tumor and HER2-positive circulating tumor cells: a phase II trial.

Noortje Verschoor, Manouk K Bos, Ingeborg E de Kruijff, Mai N Van, Jaco Kraan, Jan C Drooger, Johanna M Zuetenhorst, Saskia M Wilting, Stefan Sleijfer, Agnes Jager and 1 more

Abstract readClinical Trial, Phase II
In one paragraph

Trial report in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Noortje VerschoorDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. n.verschoor@erasmusmc.nl.ORCID http://orcid.org/0000-0003-4465-253X
Manouk K BosDepartment of Internal Medicine, Breast Cancer Center South Holland South, Ikazia Hospital, Rotterdam, The Netherlands.
Ingeborg E de KruijffDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Mai N VanDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Jaco KraanDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Jan C DroogerDepartment of Internal Medicine, Breast Cancer Center South Holland South, Ikazia Hospital, Rotterdam, The Netherlands.
Johanna M ZuetenhorstDepartment of Medical Oncology, Franciscus Gasthuis & Vlietland, Rotterdam/Schiedam, The Netherlands.
Saskia M WiltingDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Stefan SleijferDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Agnes JagerDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
John W M MartensDepartment of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.

Funding

EU-FP7 601760-2
6 · The paper itself

Abstract

purposeHER2 overexpressing circulating tumor cells (CTCs) are observed in up to 25% of HER2-negative metastatic breast cancer patients. Since targeted anti-HER2 therapy has drastically improved clinical outcomes of patients with HER2-positive breast cancer, we hypothesized that patients with HER2 overexpressing CTCs might benefit from the addition of trastuzumab to chemotherapy.

methodsIn this single-arm, phase II trial, patients with HER2-positive CTCs received trastuzumab as addition to first-line treatment with taxane chemotherapy. Patients with detectable CTCs but without HER2 overexpression that received taxane chemotherapy only, were used as control group. The primary outcome measure was progression-free rate at 6 months (PFR6), with a target of 80%. In November 2022, the study was terminated early due to slow patient accrual.

results63 patients were screened, of which eight patients had HER2-positive CTCs and were treated with trastuzumab. The median number of CTCs was 15 per 7.5 ml of blood (range 1-131) in patients with HER2-positive CTCs, compared to median 5 (range 1-1047) in the control group. PFR6 was 50% in the trastuzumab group and 54% in the taxane monotherapy group, with no significant difference in median PFS (8 versus 9 months, p = 0.51).

conclusionNo clinical benefit of trastuzumab was observed, although this study was performed in a limited number of patients. Additionally, we observed a strong correlation between the number of evaluable CTCs and the presence of HER2-positive CTCs. We argue that randomized studies investigating agents that are proven to be solely effective in the HER2-positive patient group in patients with HER2-positive CTCs and HER2-negative tissue are currently infeasible. Several factors contribute to this impracticality, including the need for more stringent thresholds, and the rapidly evolving landscape of cancer treatments.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsErb-b2 Receptor Tyrosine KinasesNeoplastic Cells, CirculatingTaxoidsTrastuzumabAdultAgedBiomarkers, TumorBridged-Ring CompoundsFemaleHumansMiddle AgedNeoplasm MetastasisTreatment OutcomeBiomarkers, TumorBridged-Ring CompoundsERBB2 protein, humanErb-b2 Receptor Tyrosine KinasestaxaneTaxoidsTrastuzumabCirculating tumor cellsHER2Metastatic breast cancerPredictive biomarkerTrastuzumab

Identifiers

PMID38291268
PMCPMC11062986

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.