Ado-trastuzumab emtansine (T-DM1) in HER2+ advanced breast cancer patients: does pretreatment with pertuzumab matter?

Future Oncol. 2017 Dec;13(30):2791-2797. doi: 10.2217/fon-2017-0336. Epub 2017 Nov 28.

Abstract

Aim: We evaluated the outcomes of patients treated with ado-trastuzumab emantasine (T-DM1) after first-line pertuzumab/trastuzumab, compared with those receiving a trastuzumab-only-based regimen.

Patients & methods: Patients who received second-line T-DM1 after pertuzumab/trastuzumab (n = 34) were compared with those who received only trastuzumab (n = 73).

Results: Overall response rate was 33.3% in patients with prior pertuzumab and 57.1% in the remaining subjects. Disease control rate was 47 and 43%, respectively, and the clinical benefit rate was 43.3 and 71.1%, respectively. Median progression-free survival was 5.0 and 11.0 months, respectively (hazard ratio: 2.02; 95% CI: 1.14-3.58; p = 0.01).

Conclusion: Patients treated with T-DM1 who previously received pertuzumab present poorer clinical outcomes compared with those receiving a trastuzumab-only-based regimen in the first-line setting.

Keywords: HER2 second-line; HER2-positive tumors; T-DM1; metastatic breast cancer; pertuzumab.

Publication types

  • Multicenter Study

MeSH terms

  • Ado-Trastuzumab Emtansine
  • Adult
  • Aged
  • Antineoplastic Agents, Immunological / pharmacology
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Female
  • Humans
  • Maytansine / analogs & derivatives*
  • Maytansine / pharmacology
  • Maytansine / therapeutic use
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Receptor, ErbB-2 / metabolism*
  • Retreatment
  • Survival Analysis
  • Trastuzumab / pharmacology
  • Trastuzumab / therapeutic use*
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Maytansine
  • Receptor, ErbB-2
  • Trastuzumab
  • Ado-Trastuzumab Emtansine