Long-term outcome with targeted therapy in advanced/metastatic HER2-positive breast cancer: The Royal Marsden experience
Purpose Agents targeting the human epidermal growth factor receptor 2 (HER2) have improved outcomes of advanced HER2-positive breast cancer with durable responses. We evaluated first-line therapy long-term outcomes in patients responding for more than 1 year. Methods We retrospectively identified patients on first-line anti-HER2 therapy at The Royal Marsden Hospital for at least 1 year from 2001 to 2016. Demographics, disease characteristics, treatments and adverse events were recorded. Simple statistics, Fisher’s, Chi squared and log-rank tests were used. Results 208 patients on treatment for at least 1 year had a median age of 54 years (31–88). 38.0% had de novo metastatic disease and 55.9% were ER positive. Of the relapsed cases, 54.4% previously had trastuzumab. At the time of presentation of metastatic disease, 27.4% of the entire cohort had pulmonary, 43.7% liver and 10.6% brain involvement. 97.1% received trastuzumab and 1.44% lapatinib; 33.2% pertuzumab and trastuzumab. 82.7% received chemotherapy (usually taxanes). 47.6% received maintenance endocrine therapy. Median progression-free survival was 39.5 months and overall survival 81.0 months. Overall response rate was 87.5%. Cardiotoxicity occurred in 4.8% of cases. Seven patients stopped treatment electively after 17–87 months and, so far, all remain in complete remission. Conclusions First-line anti-HER2 treatment is associated with median overall survival longer than 6 years in half of the patients free from disease progression after a year, but most still relapse eventually. Response prediction would be key to inform trial design and treatment decisions in this setting..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:178 |
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| Enthalten in: |
Breast cancer research and treatment - 178(2019), 2 vom: 20. Aug., Seite 401-408 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Battisti, Nicolò Matteo Luca [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
| doi: |
10.1007/s10549-019-05406-6 |
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| 520 | |a Purpose Agents targeting the human epidermal growth factor receptor 2 (HER2) have improved outcomes of advanced HER2-positive breast cancer with durable responses. We evaluated first-line therapy long-term outcomes in patients responding for more than 1 year. Methods We retrospectively identified patients on first-line anti-HER2 therapy at The Royal Marsden Hospital for at least 1 year from 2001 to 2016. Demographics, disease characteristics, treatments and adverse events were recorded. Simple statistics, Fisher’s, Chi squared and log-rank tests were used. Results 208 patients on treatment for at least 1 year had a median age of 54 years (31–88). 38.0% had de novo metastatic disease and 55.9% were ER positive. Of the relapsed cases, 54.4% previously had trastuzumab. At the time of presentation of metastatic disease, 27.4% of the entire cohort had pulmonary, 43.7% liver and 10.6% brain involvement. 97.1% received trastuzumab and 1.44% lapatinib; 33.2% pertuzumab and trastuzumab. 82.7% received chemotherapy (usually taxanes). 47.6% received maintenance endocrine therapy. Median progression-free survival was 39.5 months and overall survival 81.0 months. Overall response rate was 87.5%. Cardiotoxicity occurred in 4.8% of cases. Seven patients stopped treatment electively after 17–87 months and, so far, all remain in complete remission. Conclusions First-line anti-HER2 treatment is associated with median overall survival longer than 6 years in half of the patients free from disease progression after a year, but most still relapse eventually. Response prediction would be key to inform trial design and treatment decisions in this setting. | ||
| 650 | 4 | |a Breast cancer |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a HER2 positive |7 (dpeaa)DE-He213 | |
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| 650 | 4 | |a Advanced stage |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Tong, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Ring, Alistair |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Ian |e verfasserin |4 aut | |
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