A retrospective multicentric observational study of trastuzumab emtansine in HER2 positive metastatic breast cancer: A real-world experience
| Autor: | Vici, Patrizia, Pizzuti, Laura, Michelotti, Andrea, Sperduti, Isabella, Natoli, Clara, Mentuccia, Lucia, Di Lauro, Luigi, Sergi, Domenico, Marchetti, Paolo, Santini, Daniele, Magnolfi, Emanuela, Iezzi, Laura, Moscetti, Luca, Fabbri, Agnese, Cassano, Alessandra, Grassadonia, Antonino, Omarini, Claudia, Piacentini, Federico, Botticelli, Andrea, Bertolini, Ilaria, Scinto, Angelo Fedele, Zampa, Germano, Mauri, Maria, D'Onofrio, Loretta, Sini, Valentina, Barba, Maddalena, Maugeri-saccã , Marcello, Rossi, Ernesto, Landucci, Elisabetta, Tomao, Silverio, Alberti, Antonio Maria, Giotta, Francesco, Ficorella, Corrado, Adamo, Vincenzo, Russo, Antonio, Lorusso, Vito, Cannita, Katia, Barni, Sandro, Laudadio, Lucio, Greco, Filippo, Garrone, Ornella, Della Giulia, Marina, Marolla, Paolo, Sanguineti, Giuseppe, Di Cocco, Barbara, Ciliberto, Gennaro, De Maria, Ruggero, Gamucci, Teresa |
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| Přispěvatelé: | Vici, P., Pizzuti, L., Michelotti, A., Sperduti, I., Natoli, C., Mentuccia, L., Di Lauro, L., Sergi, D., Marchetti, P., Santini, D., Magnolfi, E., Iezzi, L., Moscetti, L., Fabbri, A., Cassano, A., Grassadonia, A., Omarini, C., Piacentini, F., Botticelli, A., Bertolini, I., Scinto, A., Zampa, G., Mauri, M., D'Onofrio, L., Sini, V., Barba, M., Maugeri-Saccà , M., Rossi, E., Landucci, E., Tomao, S., Alberti, A., Giotta, F., Ficorella, C., Adamo, V., Russo, A., Lorusso, V., Cannita, K., Barni, S., Laudadio, L., Greco, F., Garrone, O., Della Giulia, M., Marolla, P., Sanguineti, G., Di Cocco, B., Ciliberto, G., De Maria, R., Gamucci, T. |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Oncology HER2 positive real-world medicine.medical_specialty T-DM1 metastatic breast cancer previous pertuzumab Metastatic breast cancer Previous pertuzumab Real-world oncology ECOG Performance Status law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial Settore MED/04 - PATOLOGIA GENERALE law Internal medicine Medicine Univariate analysis Settore MED/06 - ONCOLOGIA MEDICA business.industry Cancer medicine.disease Log-rank test trastuzumab 030104 developmental biology chemistry Trastuzumab emtansine 030220 oncology & carcinogenesis HER2 positive Metastatic breast cancer Previous pertuzumab Real-world T-DM1 Oncology Pertuzumab business medicine.drug Research Paper |
| Zdroj: | Oncotarget |
| Popis: | We addressed trastuzumab emtansine (T-DM1) efficacy in HER2+ metastatic breast cancer patients treated in real-world practice, and its activity in pertuzumab-pretreated patients. We conducted a retrospective, observational study involving 23 cancer centres, and 250 patients. Survival data were analyzed by Kaplan Meier curves and log rank test. Factors testing significant in univariate analysis were tested in multivariate models. Median follow-up was 15 months and median T-DM1 treatment-length 4 months. Response rate was 41.6%, clinical benefit 60.9%. Median progression-free and median overall survival were 6 and 20 months, respectively. Overall, no differences emerged by pertuzumab pretreatment, with median progression-free and median overall survival of 4 and 17 months in pertuzumab-pretreated (p=0.13), and 6 and 22 months in pertuzumab-naïve patients (p=0.27). Patients who received second-line T-DM1 had median progression-free and median overall survival of 3 and 12 months (p=0.0001) if pertuzumab-pretreated, and 8 and 26 months if pertuzumab-naïve (p=0.06). In contrast, in third-line and beyond, median progression-free and median overall survival were 16 and 18 months in pertuzumab-pretreated (p=0.05) and 6 and 17 months in pertuzumab-naïve patients (p=0.30). In multivariate analysis, lower ECOG performance status was associated with progression-free survival benefit (p < 0.0001), while overall survival was positively affected by lower ECOG PS (p < 0.0001), absence of brain metastases (p 0.05), and clinical benefit (p < 0.0001). Our results are comparable with those from randomized trials. Further studies are warranted to confirm and interpret our data on apparently lower T-DM1 efficacy when given as second-line treatment after pertuzumab, and on the optimal sequence order. |
| Databáze: | OpenAIRE |
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