Clinical benefit of treatment after trastuzumab emtansine for HER2-positive metastatic breast cancer: a real-world multi-centre cohort study in Japan (WJOG12519B)

Autor: Manabu Futamura, Yukinori Ozaki, Mai Onishi, Tsutomu Iwasa, Tetsuyo Maeda, Meiko Nishimura, Mototsugu Shimokawa, Mitsuo Terada, Yuko Tsuboguchi, Kazuki Nozawa, Takamichi Yokoe, Jun Masuda, Hirotsugu Isaka, Yuta Okumura, Misato Ogata, Shu Yazaki, Michiko Kurikawa, Hitomi Sakai, Takuma Onoe, Sayuka Nakayama, Akihiko Shimomura, Akihiro Fujimoto, Toshimi Takano, Kanako Hagio, Sasagu Kurozumi
Rok vydání: 2021
Předmět:
Zdroj: Breast Cancer (Tokyo, Japan)
ISSN: 1880-4233
1340-6868
Popis: Background Trastuzumab emtansine (T-DM1) treatment for human epidermal growth factor receptor-2 (HER2)-positive metastatic breast cancer after taxane with trastuzumab and pertuzumab is standard therapy. However, treatment strategies beyond T-DM1 are still in development with insufficient evidence of their effectiveness. Here, we aimed to evaluate real-world treatment choice and efficacy of treatments after T-DM1 for HER2-positive metastatic breast cancer. Methods In this multi-centre retrospective cohort study involving 17 hospitals, 325 female HER2-positive metastatic breast cancer patients whose post-T-DM1 treatment began between April 15, 2014 and December 31, 2018 were enrolled. The primary end point was the objective response rate (ORR) of post-T-DM1 treatments. Secondary end points included disease control rate (DCR), progression-free survival (PFS), time to treatment failure (TTF), and overall survival (OS). Results The median number of prior treatments of post-T-DM1 treatment was four. The types of post-T-DM1 treatments included (1) chemotherapy in combination with trastuzumab and pertuzumab (n = 102; 31.4%), (2) chemotherapy concomitant with trastuzumab (n = 78; 24.0%), (3), lapatinib with capecitabine (n = 63; 19.4%), and (4) others (n = 82; 25.2%). ORR was 22.8% [95% confidence interval (CI): 18.1–28.0], DCR = 66.6% (95% CI 60.8–72.0), median PFS = 6.1 months (95% CI 5.3–6.7), median TTF = 5.1 months (95% CI 4.4–5.6), and median OS = 23.7 months (95% CI 20.7–27.4). Conclusion The benefits of treatments after T-DM1 are limited. Further investigation of new treatment strategies beyond T-DM1 is awaited for HER2-positive metastatic breast cancer patients.
Databáze: OpenAIRE