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Title
Prediktivni i prognostički značaj statusa hormonskih receptora za efikasnost ciljane molekularne terapije trastuzumabom kod bolesnica sa metastatskim HER2 pozitivnim karcinomom dojke
Creator
Cvetanović, Ana S.
Copyright date
2019
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Autorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
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Dozvoljavate samo preuzimanje i distribuciju dela, ako/dok se pravilno naznačava ime autora, bez ikakvih promena dela i bez prava komercijalnog korišćenja dela. Ova licenca je najstroža CC licenca. Osnovni opis Licence: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/deed.sr_LATN. Sadržaj ugovora u celini: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/legalcode.sr-Latn
Language
Serbian
Cobiss-ID
1026485485
Academic metadata
Theses Type
Doktorska disertacija
description
Datum odbrane: 03.12.2019.
Other responsibilities
mentor
Pejčić, Ivica
predsednik komisije
Vrbić, Svetislav
član komisije
Jovičić Milentijević, Maja
član komisije
Đorđević, Nebojša
član komisije
Popović, Lazar
Academic Expertise
Medicinske nauke
University
Univerzitet u Nišu
Faculty
Medicinski fakultet
Group
Katedra za radiologiju, nuklearnu medicinu i osnovi kliničke onkologije
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Abstract (en)
This study focuses on the influence of the status of hormone receptors on the efficacy of trastuzumab in patients with metastatic HER2 positive breast cancer treated with first line trastuzumab in combination with taxane-based chemotherapy. A prospective study was carried out at the Clinic for Oncology, Clinical Centre in Niš, during the year 2018.All 121 patients were treated with first line trastuzumab in combination with taxane-based chemotherapy. Clinical benefit rate was present in 77.7% of the patients, including partial response (PR) in 38%, stable disease (SD) in 31.4%, and progression of disease 22.3%.Complete response (CR) occurred in less than 10% of the patients (8.3%). Clinical benefit rate was significantly higher in patients with hormone receptor negative (HR-) disease versus hormone receptor positive (HR+) (p=0,029). Progression-free survival (PFS) in the entire group of patients amounted to 11 months, whereas overall survival (OS) was 29 months.Progression-free survival (PFS) was significantly different according to hormonal receptor status.Progression-free survival (PFS) in the HR negative tumor group was significantly longer compared to patients with HR positive tumor (15 months vs 8 months).Furthermore, overall survival was significantly different according to hormonal receptor status(p=0,034).Patients with HR negative tumor have longer overall survival compared to patients with HR positive (43 months vs 35 months).Patients with HR- tumor have 43% lower relapse risk compared to patients with HR+ tumor(HR 0.576;95%CI 0.342-0.972, p=0.039).Patients who were treated with second line antiHER2 therapy lapatinib plus capecitabine have significantly longer overall survival compared to patients who weren’t treated (522 months vs 30 months, HR 0.199; 95%CI 0.106-0.373, p<0.001). The aforementioned data indicate different response to antiHER2 therapy in patients with HER2+ mBC regarding HR status, thus emphasizing that ER most likely represents an escape pathway for response to antiHER2 target therapy, and vice versa. Combining hormonotherapy with antiHER2 therapy surely represents a promising strategy which could help overcome resistance to trastuzumab and other anti HER2 agents.