Addition of endocrine therapy to dual anti-HER2 targeted therapy in initial treatment of HER2 + /HR + metastatic breast cancer.


Journal

Breast cancer research and treatment
ISSN: 1573-7217
Titre abrégé: Breast Cancer Res Treat
Pays: Netherlands
ID NLM: 8111104

Informations de publication

Date de publication:
Feb 2023
Historique:
received: 18 07 2022
accepted: 29 12 2022
pubmed: 10 1 2023
medline: 1 2 2023
entrez: 9 1 2023
Statut: ppublish

Résumé

Dual anti-HER2 targeted therapy and chemotherapy is the current first-line standard of care for HER2 + metastatic breast cancer (MBC), with endocrine therapy (ET) the backbone of treatment in hormone receptor positive (HR +) disease. The potential ET benefit in HER2 + /HR + patients is unknown as pivotal dual anti-HER2 clinical trials precluded ET use. Real-world data from a multi-site registry of consecutive HER2 + MBC patients treated at clinician discretion were examined. Patients that were HR + (ER + and/or PR +) and had received first-line chemotherapy alongside trastuzumab and pertuzumab were explored. Of 362 patients in the registry, 215 were excluded due to being HR- (n = 210) or not receiving chemotherapy (n = 5). Of the 147 patients included, 91 (62%) received concurrent ET and 56 (38%) had not. Comparing the groups, there were no significant differences in age, performance status, metastatic sites, use of previous therapy and de novo metastatic disease. More patients with ER + PR + disease versus those with ER + PR- or ER-PR + received ET (73 vs 45%). The addition of ET was associated with significantly improved 5-year PFS (HR 0.58, CI 0.37-0.89, p = 0.014) and OS (HR 0.52, CI 0.31-0.90, p = 0.018), with no increase in adverse events noted. The addition of ET to first-line dual anti-HER2 therapy post chemotherapy in patients with HER2 + /HR + MBC was associated with major gains in PFS and OS with no safety concerns evident. Further studies of this combination are justified, along with studies of how best to integrate other agents that are active in this patient subset, including CDK4/6 inhibitors.

Identifiants

pubmed: 36624321
doi: 10.1007/s10549-022-06856-1
pii: 10.1007/s10549-022-06856-1
doi:

Substances chimiques

Receptor, ErbB-2 EC 2.7.10.1
Trastuzumab P188ANX8CK

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

67-74

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Matthew Loft (M)

Division of Personalised Oncology, Walter and Eliza Hall, 1G Royal Pde, Parkville, VIC, 3052, Australia. matthewjloft@gmail.com.
Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia. matthewjloft@gmail.com.

Sheau Wen Lok (SW)

Division of Personalised Oncology, Walter and Eliza Hall, 1G Royal Pde, Parkville, VIC, 3052, Australia.
Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Richard De Boer (R)

Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Laeeq Malik (L)

Department of Medical Oncology, Canberra Hospital, Garran, ACT, Australia.

Sally Greenberg (S)

Department of Medical Oncology, Western Health, Footscray, VIC, Australia.

Belinda Yeo (B)

Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia.

Angelyn Anton (A)

Division of Personalised Oncology, Walter and Eliza Hall, 1G Royal Pde, Parkville, VIC, 3052, Australia.
Department of Medical Oncology, Eastern Health, Box Hill, VIC, Australia.
Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.

Michelle Nottage (M)

Department of Medical Oncology, Royal Brisbane Hospital, Herston, QLD, Australia.

Vanessa Wong (V)

Division of Personalised Oncology, Walter and Eliza Hall, 1G Royal Pde, Parkville, VIC, 3052, Australia.
Department of Medical Oncology, Ballarat Health, Ballarat, VIC, Australia.

Louise Nott (L)

Department of Medical Oncology, Royal Hobart Hospital, Hobart, TAS, Australia.

Ian M Collins (IM)

Department of Medical Oncology, South West Healthcare, Warrnambool, VIC, Australia.

Javier Torres (J)

Department of Medical Oncology, Goulburn Valley Health, Shepparton, VIC, Australia.

Frances Barnett (F)

Department of Medical Oncology, Northern Hospital, Epping, VIC, Australia.

Janine M Lombard (JM)

Department of Medical Oncology, Newcastle Private Hospital, New Lambton Heights, NSW, Australia.

Peter Gibbs (P)

Division of Personalised Oncology, Walter and Eliza Hall, 1G Royal Pde, Parkville, VIC, 3052, Australia.
Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.
Department of Medical Oncology, Western Health, Footscray, VIC, Australia.

Lucy Gately (L)

Division of Personalised Oncology, Walter and Eliza Hall, 1G Royal Pde, Parkville, VIC, 3052, Australia.
Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.

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