Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study.

Autor: Sanglier T; F. Hoffmann-La Roche, Basel, Switzerland. Electronic address: thibaut.sanglier@roche.com., Shim J; F. Hoffmann-La Roche, Basel, Switzerland., Lamarre N; Genesis Research, Hoboken, NJ, USA., Peña-Murillo C; F. Hoffmann-La Roche, Basel, Switzerland., Antao V; Genentech Inc., South San Francisco, CA, USA., Montemurro F; Candiolo Cancer Institute, FPO-IRCCS, Italy.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2023 Jun; Vol. 69, pp. 441-450. Date of Electronic Publication: 2023 Jan 16.
DOI: 10.1016/j.breast.2023.01.007
Abstrakt: Background: Trastuzumab emtansine (T-DM1) has demonstrated improvements in survival and neurological symptoms in patients with breast cancer with brain metastases (BCBM). This real-world study investigated the effectiveness of T-DM1 versus lapatinib plus capecitabine (LC) in patients with BCBM.
Methods: This retrospective, observational study evaluated patients with HER2-positive BCBM using a real-world database. Eligible patients had initiated T-DM1 or LC with a prior diagnosis of brain metastasis and ≥1 prior metastatic breast cancer treatment. The primary endpoint was overall survival (OS); secondary endpoints were time to next relevant treatment or death (TTNT) and real-world progression-free survival (rwPFS). An inverse probability of treatment weighting (IPTW) approach was used to account for differences in potential baseline characteristics between treatment groups. Outcomes were described using the Kaplan-Meier method, and the average treatment effect of initiating T-DM1 versus LC was estimated using weighted Cox proportional hazard models and hazard ratio (HR).
Results: A total of 214 patients were available for analysis (T-DM1, n = 161; LC, n = 53). Demographics and baseline characteristics were generally well-balanced between treatment groups after weighting. After weighting, median OS was 17.7 (T-DM1) versus 9.6 (LC) months (HR, 0.55 [95% CI, 0.34-0.89]; P=0.013). Median TTNT was 9.0 (T-DM1) versus 6.0 (LC) months (HR, 0.55 [95% CI, 0.36-0.85]; P = 0.005). After weighting, median rwPFS was 6.0 (T-DM1) versus 4.0 (LC) months (HR, 0.50 [95% CI, 0.36-0.69]; P < 0.001).
Conclusions: These results support the superior effectiveness and clinical relevance of T-DM1 versus LC in patients with HER2-positive BCBM in the real world.
Competing Interests: Declaration of competing interest Dr. T. Sanglier, J. Shim, and Dr. C. Peña-Murillo report employment and stock ownership at Roche. Dr. N. Lamarre reports employment with Genesis Research as a third-party contractor for Genentech, Inc. Dr. V. Antao reports employment and stock ownership at Genentech, Inc. At the time the study was conducted. Dr. F. Montemurro reports honoraria from Roche and consulting/advisory fees from Novartis, Seagen, Eli Lilly, Pierre Fabre, AstraZeneca, Pfizer, and MSD.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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