Efficacy and tolerability of trastuzumab emtansine in advanced human epidermal growth factor receptor 2-positive breast cancer.

Autor:	Yeo W; Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong., Luk MY; Department of Clinical Oncology, Queen Mary Hospital, Pokfulam, Hong Kong., Soong IS; Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong., Yuen TY; Department of Clinical Oncology, Queen Elizabeth Hospital, Jordan, Hong Kong., Ng TY; Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong., Mo FK; Comprehensive Clinical Trials Unit, Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong., Chan K; Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong., Wong SY; Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong., Tsang J; Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong., Leung C; Department of Clinical Oncology, Queen Elizabeth Hospital, Jordan, Hong Kong., Suen JJ; Department of Clinical Oncology, Prince of Wales Hospital, Shatin, Hong Kong., Ngan RK; Department of Clinical Oncology, Queen Elizabeth Hospital, Jordan, Hong Kong.
Jazyk:	angličtina
Zdroj:	Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2018 Feb; Vol. 24 (1), pp. 56-62. Date of Electronic Publication: 2018 Jan 12.
DOI:	10.12809/hkmj176808
Abstrakt:	Introduction: The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer has changed dramatically with the introduction and widespread use of HER2-targeted therapies. There is, however, relatively limited real-world information about the effectiveness and safety of trastuzumab emtansine (T-DM1) in Hong Kong Chinese patients. We assessed the efficacy and toxicity profiles among local patients with HER2-positive advanced breast cancer who had received T-DM1 therapy in the second-line setting and beyond. Methods: This retrospective study involved five local centres that provide service for over 80% of the breast cancer population in Hong Kong. The study period was from December 2013 to December 2015. Patients were included if they had recurrent or metastatic histologically confirmed HER2+ breast cancer who had progressed after at least one line of anti-HER2 therapy including trastuzumab. Patients were excluded if they received T-DM1 as first-line treatment for recurrent or metastatic HER2+ breast cancer. Patient charts including biochemical and haematological profiles were reviewed for background information, T-DM1 response, and toxicity data. Adverse events were documented during chemotherapy and 28 days after the last dose of medication. Results: Among 37 patients being included in this study, 28 (75.7%) had two or more lines of anti-HER2 agents and 26 (70.3%) had received two or more lines of palliative chemotherapy. Response assessment revealed that three (8.1%) patients had a complete response, eight (21.6%) a partial response, 11 (29.7%) a stable disease, and 12 (32.4%) a progressive disease; three patients could not be assessed. The median duration of response was 17.3 (95% confidence interval, 8.4-24.8) months. The clinical benefit rate (complete response + partial response + stable disease, ≥12 weeks) was 37.8% (95% confidence interval, 22.2%-53.5%). The median progression-free survival was 6.0 (95% confidence interval, 3.3- 9.8) months and the median overall survival had not been reached by the data cut-off date. Grade 3 or 4 toxicities included thrombocytopaenia (13.5%), raised alanine transaminase (8.1%), anaemia (5.4%), and hypokalaemia (2.7%). No patient died as a result of toxicities. Conclusions: In patients with HER2-positive advanced breast cancer who have been heavily pretreated with anti-HER2 agents and cytotoxic chemotherapy, T-DM1 is well tolerated and provided a meaningful progression-free survival of 6 months and an overall survival that has not been reached. Further studies to identify appropriate patient subgroups are warranted.
Databáze:	MEDLINE
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