COMPARISON OF RESPONSE TO TREATMENT IN LINES SUBSEQUENT TO T-DM1 IN PATIENTS WITH METASTATIC HER2 POSITIVE BREAST CANCER
Introduction: Breast cancer has a strong epidemiological impact. Approximately 20% of them are HER-2 positive. In the metastatic setting, first-line treatment with pertuzumab, trastuzumab and taxane is consolidated by the CLEOPATRA study and second-line treatment, until recently, with trastuzumab-emtansine (T-DM1) by the EMILIA study. Sequencing after using T-DM1 lacks consistent information. Objectives: the primary outcome was the comparison of the response rate of patients undergoing subsequent line to T-DM1, in HER2-positive metastatic breast cancer. Secondary objectives were to compare Overall Survival (OS), Progression-Free Survival to T-DM1 (PFS), Progression-Free Survival to subsequent line (PFS2), Time to Treatment Failure (TFT) and adverse events. Methods: Retrospective, single-center study, including 67 patients with HER2-positive metastatic breast cancer exposed to T-DM1 between August 2013 and December 2021. Of the 67 patients, 38 received subsequent lines of treatment, with a median follow-up of 34 months. Treatments subsequent to T-DM1 were divided into 3 groups: Group 1 = capecitabine + lapatinib (21 patients); Group 2 = trastuzumab-deruxtecan (5 patients) and Group 3 = anti-HER2 associated with chemotherapy (12 patients). Results: The response rate was 19% in group 1, 60% in group 2 and patients in group 3 showed disease stability. The DFS was 15 months. The median OS of T-DM1 was 47 months. No patient in Group 2 experienced progression or death. There was no significant difference in PFS between groups 1 and 3. Conclusion: The response rate varied according to the subsequent line, being favorable to trastuzumab-deruxtecan, which also had lower toxicity. Comparison of OS between groups was not possible due to the number of patients included and events.
COMPARISON OF RESPONSE TO TREATMENT IN LINES SUBSEQUENT TO T-DM1 IN PATIENTS WITH METASTATIC HER2 POSITIVE BREAST CANCER
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DOI: 10.22533/at.ed.1593942316113
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Palavras-chave: breast cancer; HER2; trastuzumab-emtansine
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Keywords: breast cancer; HER2; trastuzumab-emtansine
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Abstract:
Introduction: Breast cancer has a strong epidemiological impact. Approximately 20% of them are HER-2 positive. In the metastatic setting, first-line treatment with pertuzumab, trastuzumab and taxane is consolidated by the CLEOPATRA study and second-line treatment, until recently, with trastuzumab-emtansine (T-DM1) by the EMILIA study. Sequencing after using T-DM1 lacks consistent information. Objectives: the primary outcome was the comparison of the response rate of patients undergoing subsequent line to T-DM1, in HER2-positive metastatic breast cancer. Secondary objectives were to compare Overall Survival (OS), Progression-Free Survival to T-DM1 (PFS), Progression-Free Survival to subsequent line (PFS2), Time to Treatment Failure (TFT) and adverse events. Methods: Retrospective, single-center study, including 67 patients with HER2-positive metastatic breast cancer exposed to T-DM1 between August 2013 and December 2021. Of the 67 patients, 38 received subsequent lines of treatment, with a median follow-up of 34 months. Treatments subsequent to T-DM1 were divided into 3 groups: Group 1 = capecitabine + lapatinib (21 patients); Group 2 = trastuzumab-deruxtecan (5 patients) and Group 3 = anti-HER2 associated with chemotherapy (12 patients). Results: The response rate was 19% in group 1, 60% in group 2 and patients in group 3 showed disease stability. The DFS was 15 months. The median OS of T-DM1 was 47 months. No patient in Group 2 experienced progression or death. There was no significant difference in PFS between groups 1 and 3. Conclusion: The response rate varied according to the subsequent line, being favorable to trastuzumab-deruxtecan, which also had lower toxicity. Comparison of OS between groups was not possible due to the number of patients included and events.
- Vinicius Bernardo Boscariol
- Marcelle Goldner Cesca
- Solange Moraes Sanches
