Comparison of the efficacy of trastuzumab emtansine between patients with metastatic human epidermal growth factor receptor 2-positive breast cancers previously treated with combination trastuzumab and pertuzumab and with trastuzumab only in Japanese population.

Abstract

BACKGROUND:

Trastuzumab emtansine (T-DM1) has been approved since 2013 for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) who had received trastuzumab (Tmab) and taxane. However, no clinical trial has evaluated the efficacy of T-DM1 in those who have previously received pertuzumab (Pmab). This study aimed to compare the efficacy of T-DM1 between patients who had received Tmab and Pmab and those who had received Tmab only in Japanese population.

METHODS:

We identified all patients with HER2-positive MBC who received T-DM1 between April 1, 2014 and February 28, 2017 in our institution. The patients were divided into the Tmab group (i.e., those who received only Tmab before T-DM1 treatment) and the Tmab/Pmab group (i.e., those who received Tmab and Pmab before T-DM1 treatment), and progression-free survival (PFS) and best response were compared between the two groups.

RESULTS:

A total of 42 patients were enrolled for outcome analysis. The median follow-up period was 4.8 months, and the median number of prior chemotherapy regimens for metastatic disease before T-DM1 was 1 (range 1-2) in the Tmab/Pmab group and 2 (range 0-6) in the Tmab group. The median PFS was 2.8 months in the Tmab/Pmab group (95% confidence interval [CI] 1.7-4.8 months) and 7.8 months in the Tmab group (95% CI 5.5-15.9 months) (p = 0.0030). The best response was lower in the Tmab/Pmab group (11.1% vs. 25.0%).

CONCLUSIONS:

Patients with HER2-positive MBC who received Tmab and Pmab treatment before T-DM1 have fewer benefits from T-DM1.

• Authors: Shoko Noda-Narita, Akihiko Shimomura, Asuka Kawachi, Hitomi Sumiyoshi-Okuma, Kazuki Sudo, Tatsunori Shimoi, Emi Noguchi, Kan Yonemori, Chikako Shimizu, Yasuhiro Fujiwara, Kenji Tamura
• Journal: Breast cancer (Tokyo, Japan) (Breast Cancer) Vol. 26 Issue 4 Pg. 492-498 (Jul 2019) ISSN: 1880-4233 [Electronic] Japan
• PMID: 30737616 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Maytansine
• ERBB2 protein, human
• Receptor, ErbB-2
• pertuzumab
• Trastuzumab
• Ado-Trastuzumab Emtansine

Topics

• Ado-Trastuzumab Emtansine (administration & dosage)
• Adult
• Aged
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Asian People
• Breast Neoplasms (drug therapy, mortality, pathology)
• Female
• Humans
• Kaplan-Meier Estimate
• Maytansine (administration & dosage)
• Middle Aged
• Receptor, ErbB-2 (metabolism)
• Retrospective Studies
• Trastuzumab (administration & dosage, therapeutic use)
• Treatment Outcome