Ten-year survival of neoadjuvant dual HER2 blockade in patients with HER2-positive breast cancer
Copyright © 2022 Elsevier Ltd. All rights reserved..
BACKGROUND: Dual anti-HER2-targeted therapy in breast cancer (BC) significantly increased the rate of pathological complete response (pCR) compared to single blockade when added to chemotherapy. However, limited data exist on the long-term impact on survival of the additional increase in pCR.
METHODS: Neoadjuvant lapatinib and/or trastuzumab treatment optimisation (NCT00553358) is an international, randomised, open-label, phase III study investigating the addition of lapatinib to chemotherapy plus trastuzumab in HER2-positive early BC. Ten-year event-free survival (EFS), overall survival (OS) and safety were assessed on intention-to-treat population. The association between pCR and EFS or OS was investigated in landmark population.
RESULTS: A total of 455 patients were randomised to receive lapatinib (154), trastuzumab (149) or the combination (152). Ten-year EFS estimates were 63% (95% confidence interval [CI], 54%-71%) in the lapatinib group, 64% (95% CI, 55%-72%) in the trastuzumab group and 67% (95% CI, 58%-74%) in the combination group. Ten-year OS rates were 76% (95% CI, 67%-83%), 75% (95% CI, 66%-82%) and 80% (95% CI, 73%-86%) in the lapatinib, trastuzumab and combination groups, respectively. Women who achieved a pCR had improved EFS (hazard ratio 0.48, 95% CI, 0.31-0.73) and OS (hazard ratio 0.37, 95% CI, 0.20-0.63) compared with those who did not. The numerical difference in survival according to pCR status was greater in women treated with the combination and those with hormone-receptor-negative tumours. There were no new or long-term safety concerns.
CONCLUSIONS: Patients with HER2-positive BC showed a durable survival benefit of neoadjuvant anti-HER2, irrespective of treatment arm. Patients who achieve pCR have significantly better outcomes than patients without pCR.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:181 |
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| Enthalten in: |
European journal of cancer (Oxford, England : 1990) - 181(2023) vom: 15. März, Seite 92-101 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nuciforo, Paolo [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 14.02.2023 Date Revised 25.03.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ejca.2022.12.020 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Ten-year survival of neoadjuvant dual HER2 blockade in patients with HER2-positive breast cancer |
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| 500 | |a Date Revised 25.03.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Dual anti-HER2-targeted therapy in breast cancer (BC) significantly increased the rate of pathological complete response (pCR) compared to single blockade when added to chemotherapy. However, limited data exist on the long-term impact on survival of the additional increase in pCR | ||
| 520 | |a METHODS: Neoadjuvant lapatinib and/or trastuzumab treatment optimisation (NCT00553358) is an international, randomised, open-label, phase III study investigating the addition of lapatinib to chemotherapy plus trastuzumab in HER2-positive early BC. Ten-year event-free survival (EFS), overall survival (OS) and safety were assessed on intention-to-treat population. The association between pCR and EFS or OS was investigated in landmark population | ||
| 520 | |a RESULTS: A total of 455 patients were randomised to receive lapatinib (154), trastuzumab (149) or the combination (152). Ten-year EFS estimates were 63% (95% confidence interval [CI], 54%-71%) in the lapatinib group, 64% (95% CI, 55%-72%) in the trastuzumab group and 67% (95% CI, 58%-74%) in the combination group. Ten-year OS rates were 76% (95% CI, 67%-83%), 75% (95% CI, 66%-82%) and 80% (95% CI, 73%-86%) in the lapatinib, trastuzumab and combination groups, respectively. Women who achieved a pCR had improved EFS (hazard ratio 0.48, 95% CI, 0.31-0.73) and OS (hazard ratio 0.37, 95% CI, 0.20-0.63) compared with those who did not. The numerical difference in survival according to pCR status was greater in women treated with the combination and those with hormone-receptor-negative tumours. There were no new or long-term safety concerns | ||
| 520 | |a CONCLUSIONS: Patients with HER2-positive BC showed a durable survival benefit of neoadjuvant anti-HER2, irrespective of treatment arm. Patients who achieve pCR have significantly better outcomes than patients without pCR | ||
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Dual anti-HER2 blockade | |
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| 700 | 1 | |a Colleoni, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Aspitia, Alvaro Moreno |e verfasserin |4 aut | |
| 700 | 1 | |a Gomez, Henry |e verfasserin |4 aut | |
| 700 | 1 | |a Gombos, Andrea |e verfasserin |4 aut | |
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| 700 | 1 | |a Tseng, Ling-Ming |e verfasserin |4 aut | |
| 700 | 1 | |a Kunz, Georg |e verfasserin |4 aut | |
| 700 | 1 | |a Lerzo, Guillermo |e verfasserin |4 aut | |
| 700 | 1 | |a Sohn, Joohyuk |e verfasserin |4 aut | |
| 700 | 1 | |a Semiglazov, Vladimir |e verfasserin |4 aut | |
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