T-DM1 as a New Treatment Option for Patients with Metastatic HER2-positive Breast Cancer in Clinical Practice

Anticancer Res. 2015 Sep;35(9):5085-90.

Abstract

Aim: To compare results of trastuzumab-emtansine (T-DM1) treatment in our clinical practice with data from phase III clinical trials.

Patients and methods: A retrospective chart review of all 23 patients with metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer who were started on T-DM1 until April 2014 was performed.

Results: Four patients (17.4%) received T-DM1 as first-line, three (13.0%) as second-line, six (26.0%) as third-line, and 10 (43.5%) as fifth- or further-line therapy. Overall, the response rate (ORR) was 26.0%, disease control rate 78.3% and median progression-free survival (PFS) 8.4 months. The only toxicities of grade 3 or more were fatigue (21.7%), thrombocytopenia (4.3%) and elevation of liver enzymes (8.7%). ORR and PFS were similar to the TH3RESA and EMILIA trials. Compared to the EMILIA study, we recorded higher rates of newly-diagnosed cerebral metastasis and cerebral progression in patients with stable peripheral metastases.

Conclusion: T-DM1 is effective and well-tolerated even in intensively pre-treated patients.

Keywords: HER2-positive metastatic breast cancer; T-DM1; chemotherapy.

MeSH terms

  • Ado-Trastuzumab Emtansine
  • Adult
  • Aged
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / secondary
  • Cohort Studies
  • Disease Progression
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Maytansine / adverse effects
  • Maytansine / analogs & derivatives*
  • Maytansine / therapeutic use
  • Middle Aged
  • Neoplasm Metastasis
  • Practice Patterns, Physicians'*
  • Receptor, ErbB-2 / metabolism*
  • Trastuzumab
  • Treatment Outcome

Substances

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