• Clara Natoli, Patrizia Vici, Isabella Sperduti, Antonino Grassadonia, Giancarlo Bisagni, Nicola Tinari, Andrea Michelotti, Germano Zampa, Stefania Gori, Luca Moscetti, Michele De Tursi, Michele Panebianco, Maria Mauri, Ilaria Ferrarini, Laura Pizzuti, Corrado Ficorella, Riccardo Samaritani, Lucia Mentuccia, Stefano Iacobelli, and Teresa Gamucci.
• Medical Oncology Unit, Department of Experimental and Clinical Sciences, University G d'Annunzio, 66013 Chieti, Italy. natoli@unich.it
• J. Cancer Res. Clin. Oncol. 2013 Jul 1;139(7):1229-40.

PurposeTrastuzumab and chemotherapy is the current standard of care in HER2+ early or locally advanced breast cancer, but there are scanty literature data of its real world effectiveness.MethodsWe retrospectively reviewed 205 patients with HER2+ breast cancer diagnosed in 10 Italian Medical Oncology Units between July 2003 and October 2011. All patients received neoadjuvant systemic therapy (NST) with trastuzumab in association with chemotherapy. Many different chemotherapy regimens were used, even if 90 % of patients received schemes including anthracyclines and 99 % received taxanes. NST was administered for more than 21 weeks (median: 24) in 130/205 (63.4 %) patients, while trastuzumab was given for more than 12 weeks (median: 12 weeks) in 101/205 (49.3 %) patients. pCR/0 was defined as ypT0+ypN0, and pCR/is as ypT0/is+ypN0.ResultspCR/0 was obtained in 24.8 % and pCR/is in 46.8 % of the patients. At multivariate logistic regression, nonluminal/HER2+ tumors (P < 0.0001) and more than 12 weeks of neoadjuvant trastuzumab treatment (P = 0.03) were independent predictors of pCR/0. Median disease-free survival (DFS) and cancer-specific survival (CSS) have not been reached at the time of analysis. At multivariate analysis, nonluminal/HER2+ subclass (DFS: P = 0.01 and CSS: P = 0.01) and pathological stage II-III at surgery (DFS: P < 0.0001 and CSS: P = 0.001) were the only variables significantly associated with a worse long-term outcome.ConclusionsOur data set the relevance of molecular subclasses and residual tumor burden after neoadjuvant as the most relevant prognostic factors for survival in this cohort of patients.

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