Clinical outcome of patients with isolated central nervous system progression on first-line pertuzumab and trastuzumab treatment for HER2-positive metastatic breast cancer in a real-life cohort.

Humans Female Trastuzumab / therapeutic use Breast Neoplasms / pathology Retrospective Studies Prospective Studies Receptor, ErbB-2 Neoplasm Recurrence, Local / drug therapy Central Nervous System / pathology Antineoplastic Combined Chemotherapy Protocols / therapeutic use Treatment Outcome

Brain metastases Breast neoplasms Pertuzumab Trastuzumab Tyrosine kinase-type cell surface receptor HER2

Journal

Breast cancer (Tokyo, Japan)

ISSN: 1880-4233

Titre abrégé: Breast Cancer

Pays: Japan

ID NLM: 100888201

Informations de publication

Date de publication:
Mar 2023

Historique:

received: 12 10 2022

accepted: 14 12 2022

pubmed: 12 1 2023

medline: 3 3 2023

entrez: 11 1 2023

Statut: ppublish

Résumé

More than 10% of HER2-positive metastatic breast cancer (mBC) will develop Central Nervous System (CNS) metastases as first and isolated site of relapse on trastuzumab and pertuzumab first-line therapy. However, few clinical data are available to guide the best strategy in this setting. Patients experiencing isolated CNS progression on trastuzumab and pertuzumab first-line therapy were retrospectively identified from the French Epidemiological Strategy and Medical Economics (ESME) real-life database between 2008 and 2016. Among 995 patients treated with first-line trastuzumab and pertuzumab for HER2-positive mBC, 132 patients (13%) experienced isolated CNS progression with a median time of 12 months after mBC diagnosis. Twelves patients did not receive any treatment and were excluded from the analysis. Among the 120 patients considered, 76 (63%) received CNS-directed local therapy, 73 (60%) continued trastuzumab and pertuzumab, whereas 47 (39%) started another systemic treatment. After a median follow-up of 21 months, there was no difference in progression-free survival for patient who continued trastuzumab-pertuzumab or switched to another systemic treatment. In multivariate analysis, trastuzumab-pertuzumab continuation was associated with longer OS (HR 0,28 IC 95%: 0,14-0,54 p < 0,001). mOS was not reached (95% 37.6-NE) and was 23.2 months (95% CI 15.5-53.6) in patients who continued trastuzumab and pertuzumab therapy and in patients who switched for another systemic therapy, respectively. In this real-life cohort, trastuzumab-pertuzumab continuation after local treatment for isolated CNS progression did not negatively impact PFS and OS. Prospective trials and assessment of new strategies are warranted in this specific situation.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

Patients experiencing isolated CNS progression on trastuzumab and pertuzumab first-line therapy were retrospectively identified from the French Epidemiological Strategy and Medical Economics (ESME) real-life database between 2008 and 2016.

RESULTS RESULTS

Among 995 patients treated with first-line trastuzumab and pertuzumab for HER2-positive mBC, 132 patients (13%) experienced isolated CNS progression with a median time of 12 months after mBC diagnosis. Twelves patients did not receive any treatment and were excluded from the analysis. Among the 120 patients considered, 76 (63%) received CNS-directed local therapy, 73 (60%) continued trastuzumab and pertuzumab, whereas 47 (39%) started another systemic treatment. After a median follow-up of 21 months, there was no difference in progression-free survival for patient who continued trastuzumab-pertuzumab or switched to another systemic treatment. In multivariate analysis, trastuzumab-pertuzumab continuation was associated with longer OS (HR 0,28 IC 95%: 0,14-0,54 p < 0,001). mOS was not reached (95% 37.6-NE) and was 23.2 months (95% CI 15.5-53.6) in patients who continued trastuzumab and pertuzumab therapy and in patients who switched for another systemic therapy, respectively.

CONCLUSION CONCLUSIONS

In this real-life cohort, trastuzumab-pertuzumab continuation after local treatment for isolated CNS progression did not negatively impact PFS and OS. Prospective trials and assessment of new strategies are warranted in this specific situation.

Identifiants

DOI: 10.1007/s12282-022-01427-0 PMID: 36630013

pubmed: 36630013

doi: 10.1007/s12282-022-01427-0

pii: 10.1007/s12282-022-01427-0

doi:

Substances chimiques

Trastuzumab P188ANX8CK

pertuzumab K16AIQ8CTM

Receptor, ErbB-2 EC 2.7.10.1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

329-341

Informations de copyright

Références

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