The trastuzumab and vinorelbine combination: an alternative to taxane-based chemotherapy for early stage and locally advanced HER2+ breast cancer

  • K. Esfahani Sir Mortimer B. Davis Jewish General Hospital
  • C. Ferrario Sir Mortimer B. Davis Jewish General Hospital
  • P. Le Sir Mortimer B. Davis Jewish General Hospital
  • L. Panasci Sir Mortimer B. Davis Jewish General Hospital
Keywords: Breast cancer, small tumours, early breast cancer, her2- positivity, trastuzumab, Herceptin, vinorelbine, Navelbine

Abstract

Background

Anthracyclines and taxanes have historically constituted the backbone of chemotherapy regimens for patients with breast cancer positive for the human epidermal growth factor receptor 2 (her2). For a subset of patients who categorically refuse alopecia, or for those with a contraindication to those drugs, there is an urgent need to define alternative regimens. Here, we report our institutional experience with trastuzumab and vinorelbine (tv), a combination with good clinical activity and a good side effect profile for patients with her2-positive breast cancer.

Methods

In a retrospective analysis, outcomes data were extracted for patients receiving tv as their only chemotherapy in the non-metastatic setting at the Jewish General Hospital. For the most part, tv was administered weekly for 6 months, followed by trastuzumab for 6 months.

Results

The analysis identified 46 patients (mean age: 64 years) who received tv between 2003 and 2012 (n = 36 adjuvant, n = 10 neoadjuvant). Of the patients in the adjuvant group, 81% had stage i disease. In the neoadjuvant group, 3 patients experienced a complete pathologic response. Only 1 patient experienced local recurrence after a short course (3 months) of adjuvant tv. Overall survival and breast cancer–specific survival were 94% and 98% respectively at a median 5 years of follow-up. Febrile neutropenia–induced sepsis resulted in the death of 1 patient with significant medical comorbidities; 2 other patients died of comorbidities unrelated to their cancer or treatment. Grades 3 or 4 adverse events included neutropenia (23%), febrile neutropenia (10%), fatigue (2%), and anemia (2%).

Conclusions

For patients with non-metastatic breast cancer refusing alopecia, or for patients who are not candidates for standard chemotherapy, tv is a reasonable alternative to standard adjuvant chemotherapy.


Published
2014-07-03
How to Cite
Esfahani, K., Ferrario, C., Le, P., & Panasci, L. (2014). The trastuzumab and vinorelbine combination: an alternative to taxane-based chemotherapy for early stage and locally advanced HER2+ breast cancer. Current Oncology, 21(5), e723-e727. https://doi.org/10.3747/co.21.2069
Section
Short Communication