The Long-HER study: Clinical and molecular analysis of advanced HER2+ breast cancer treated with trastuzumab and associated to long-term survival.

Breast Cancer - HER2/ER
Session Type and Session Title: 
General Poster Session, Breast Cancer - HER2/ER
Abstract Number: 
J Clin Oncol 31, 2013 (suppl; abstr 608)
Enrique Espinosa, Angelo Gámez-Pozo, Ramon Maria Perez Carrion, Luis Manso, Carmen Crespo, Cesar Mendiola, Isabel Alvarez, Mireia Margeli, Juan L. Bayo, Xavier Gonzalez, Ana Santaballa, Eva Ciruelos, Miguel Angel Cabrera, Antonio Anton, Gustavo Catalan, José Valero Álvarez Gallego, Jose Miramon, Rocio Lopez Vacas, Pilar Zamora; Hospital Universitario La Paz, Madrid, Spain; Hospital La Paz, IdiPAZ, Madrid, Spain; Hospital Quirón, Madrid, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Ramon y Cajal, Madrid, Spain; Hospital Donostia, Donostia, Spain; Institut Català d'Oncologia - Hospital Germans Trias i Pujol, Barcelona, Spain; Hospital Juan Ramon Jimenez, Huelva, Spain; Hospital Clínic, Barcelona, Spain; Hospital Universitari i Politècnic La Fe, Valencia, Spain; University Hospital 12 de Octubre, Madrid, Spain; Hospital Ntra. Sra. de la Candelaria, Tenerife, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain; Hospital Son Llatzer, Palma de Mallorca, Spain; Hospital Provincial de Zamora, Zamora, Spain; Hospital Serranía de Ronda, Ronda - Málaga, Spain; Department of Oncology, Hospital La Paz, Madrid, Spain

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Abstract Disclosures


Background: Some patients with advanced HER2+ breast cancer survive in the long-term after receiving trastuzumab-based therapy. Long-HER study was an observational, multicenter study that compared long-term survivors and a control group from the clinical and molecular point of view. Methods: Patients with metastatic HER2+ breast cancer that had been treated with trastuzumab-based therapy and had an objective response or stable disease for at least 3 years were included. A control group having a progression in the first year of therapy was selected for comparison (similar first-line therapy). A microarray platform was used to assess whole genome expression analysis in paraffin-embedded samples. Differential expression, ontology and analysis of metabolic pathways were performed. Results: 103 patients were registered, 71 of who had a long-term complete remission. Only 5 of these patients had received trastuzumab in the adjuvant setting: this was the only clinical factor associated to long-term survival. The molecular study included 35 Long-HER and 18 control samples. Gene expression ontology revealed alterations in HIF, apoptosis, and EGF, PI3K and p53 pathways. The PI3K pathway was mostly related with a poor response to therapy. Conclusions: trastuzumab-based therapy achieves long-term survival in a selected group of women with advanced HER2-positive breast cancer. Whole genome analysis comparing such a group with a control group found some alterations that may predict early progression to trastuzumab.