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RESEARCH PRODUCT
Distinct HR expression patterns significantly affect the clinical behavior of metastatic HER2+ breast cancer and degree of benefit from novel anti-HER2 agents in the real world setting
Isacco DesideriG. ToniniEmanuela MagnolfiL. PizzutiJennifer FogliettaMarina Elena CazzanigaAdamoPatrizia ViciEnrico CortesiEmanuela RisiG. D'auriaLoretta D'onofrioMario RoselliIsabella SperdutiN. TinariNicola D’ostilioA. VaccaroIcro MeattiniFederica TomaoGiacomo BarchiesiB Di CoccoF CardilloEnzo VeltriClaudia OmariniMirco PistelliClara NatoliCarlo GarufiE. LanducciM. MauriRosanna MirabelliFederico PiacentiniDomenico CorsiA.f. ScintoAlice VillaAlain GelibterC. De AngelisMarco MazzottaGennaro CilibertoClaudio ZamagniGiuseppe SanguinetiFiorentino IzzoElizabeth H. BaldiniRossana BerardiGrr RicciardiMaddalena BarbaOrnella GarroneIda ParisLuisa CarbogninA. BotticelliGiuseppina SarobbaSilverio TomaoAntonio AstoneLucia MentucciaP Del MedicoLorussoDaniele SantiniM. Della GiuliaRiccardo SamaritaniFrancesco GiottaAlessandra CassanoLaura IezziMaria Agnese FabbriR De MariaEriseld KrasniqiRaffaele GiustiSiniLorenzo LiviErnesto RossiAndrea MichelottiEmilio BriaA Di LeoLuca MoscettiCorrado FicorellaAntonino GrassadoniaRoberta SarmientoKatia CannitaFilippo GrecoSandro BarniElena FiorioTeresa GamucciMagriAntonio RussoM. De TursiN. La VerdeDaniele GeneraliPaolo Marchettisubject
OncologyCancer ResearchMultivariate analysisSettore MED/06 - Oncologia MedicaReceptor ErbB-2T-DM1Estrogen receptor0302 clinical medicineErbB-2TrastuzumabReceptorsAntineoplastic Combined Chemotherapy Protocols80 and overMolecular Targeted TherapyNeoplasm MetastasisCancer Therapy and PreventionProgesteroneAged 80 and overadvanced breast cancerTumorreal worldMiddle AgedPrognosisMetastatic breast cancerImmunohistochemistryGene Expression Regulation NeoplastictrastuzumabOncologyReceptors Estrogen030220 oncology & carcinogenesisImmunohistochemistryFemaleadvanced breast cancer; HER2 positive; pertuzumab; real world; T-DM1; trastuzumab; Adult; Aged; Aged 80 and over; Antineoplastic Combined Chemotherapy Protocols; Biomarkers Tumor; Breast Neoplasms; Female; Humans; Immunohistochemistry; Middle Aged; Molecular Targeted Therapy; Neoplasm Metastasis; Neoplasm Staging; Prognosis; Receptor ErbB-2; Receptors Estrogen; Receptors Progesterone; Gene Expression Regulation NeoplasticPertuzumabReceptors ProgesteroneHER2 positive; T-DM1; advanced breast cancer; pertuzumab; real world; trastuzumabmedicine.drugReceptorAdultHER2 positivemedicine.medical_specialtyT‐DM1advanced breast cancer; HER2 positive; pertuzumab; real world; T-DM1; trastuzumab; chemotherapyBreast Neoplasms03 medical and health sciencesBreast cancerSettore MED/04 - PATOLOGIA GENERALEpertuzumabInternal medicinemedicineBiomarkers TumorHumansAgedNeoplasm StagingNeoplasticbusiness.industrymedicine.diseaseEstrogenSettore CHIM/08 - Chimica FarmaceuticaGene Expression RegulationMED/06 - ONCOLOGIA MEDICAbusinessBiomarkersHormonedescription
We analyzed data from 738 HER2‐positive metastatic breast cancer (mbc) patients treated with pertuzumab‐based regimens and/or T‐DM1 at 45 Italian centers. Outcomes were explored in relation to tumor subtype assessed by immunohistochemistry (IHC). The median progression‐free survival at first‐line (mPFS1) was 12 months. Pertuzumab as first‐line conferred longer mPFS1 compared to other first‐line treatments (16 vs. 9 months, p = 0.0001), regardless of IHC subtype. Median PFS in second‐line (mPFS2) was 7 months, with no difference by IHC subtype, but it was more favorable with T‐DM1 compared to other agents (7 vs. 6 months, p = 0.03). There was no PFS2 gain in patients with tumors expressing both hormonal receptors (HRs; p = 0.17), while a trend emerged for tumors with one HR (p = 0.05). Conversely, PFS2 gain was significant in HRs‐negative tumors (p = 0.04). Median overall survival (mOS) was 74 months, with no significant differences by IHC subtypes. Survival rates at 2 and 3 years in patients treated with T‐DM1 in second‐line after pertuzumab were significantly lower compared to pertuzumab‐naïve patients (p = 0.01). When analyzed by IHC subtype, the outcome was confirmed if both HRs or no HRs were expressed (p = 0.02 and p = 0.006, respectively). Our results confirm that HRs expression impacts the clinical behavior and novel treatment‐related outcomes of HER2‐positive tumors when treatment sequences are considered. Moreover, multivariate analysis showed that HRs expression had no effect on PFS and OS. Further studies are warranted to confirm our findings and clarify the interplay between HER2 and estrogen receptor pathways in HER2‐positive (mbc) patients.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-01-01 |