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

被引：5

作者：

Pizzuti, Laura ^{[1
]}

Krasniqi, Eriseld ^{[1
]}

Barchiesi, Giacomo ^{[1
]}

Della Giulia, Marina ^{[1
]}

Izzo, Fiorentino ^{[1
]}

Sanguineti, Giuseppe ^{[2
]}

Marchetti, Paolo ^{[3
,4
]}

Mazzotta, Marco ^{[3
]}

Giusti, Raffaele ^{[3
]}

Botticelli, Andrea ^{[4
]}

Gamucci, Teresa ^{[5
]}

Natoli, Clara ^{[6
]}

Grassadonia, Antonino ^{[6
]}

Tinari, Nicola ^{[6
]}

Iezzi, Laura ^{[6
]}

Tomao, Silverio ^{[7
]}

Tomao, Federica ^{[8
]}

Tonini, Giuseppe ^{[9
]}

Santini, Daniele ^{[9
]}

Astone, Antonio ^{[10
]}

Michelotti, Andrea ^{[11
]}

De Angelis, Claudia ^{[11
]}

Mentuccia, Lucia ^{[12
]}

Vaccaro, Angela ^{[12
]}

Magnolfi, Emanuela ^{[12
]}

Gelibter, Alain ^{[4
]}

Magri, Valentina ^{[4
]}

Cortesi, Enrico ^{[4
]}

D'Onofrio, Loretta ^{[9
]}

Cassano, Alessandra ^{[13
,14
]}

Rossi, Ernesto ^{[13
]}

Cazzaniga, Marina ^{[15
]}

Moscetti, Luca ^{[16
]}

Omarini, Claudia ^{[16
]}

Piacentini, Federico ^{[16
]}

Fabbri, Maria A. ^{[17
]}

Scinto, Angelo F. ^{[18
]}

Corsi, Domenico ^{[18
]}

Carbognin, Luisa ^{[19
]}

Bria, Emilio ^{[13
,14
]}

La Verde, Nicla ^{[20
]}

Samaritani, Riccardo ^{[21
]}

Garufi, Carlo ^{[22
]}

Barni, Sandro ^{[23
]}

Mirabelli, Rosanna ^{[24
]}

Sarmiento, Roberta ^{[25
]}

Veltri, Enzo M. ^{[26
]}

D'Auria, Giuliana ^{[5
]}

Paris, Ida ^{[19
]}

Giotta, Francesco ^{[27
]}

机构：

[1] NCI, IRCCS Regina Elena, Div Med Oncol 2, Via Elio Chianesi 53, I-00144 Rome, Italy

[2] NCI, IRCCS Regina Elena, Dept Radiat Oncol, Rome, Italy

[3] Azienda Osped Univ St Andrea, Med Oncol Unit, Rome, Italy

[4] Policlin Umberto 1, Med Oncol Unit B, Rome, Italy

[5] Sandro Pertini Hosp, Med Oncol, Rome, Italy

[6] Ctr Sci Invecchiamento & Med Traslazionale CeSI M, Dept Med Oral & Biotechnol Sci, Chieti, Italy

[7] Sapienza Univ Rome, Dept Radiol Oncol & Anatomo Pathol Sci, Policlin Umberto I, Rome, Italy

[8] Sapienza Univ Rome, Dept Gynecol Obstet & Urol, Rome, Italy

[9] Univ Campus Biomed Rome, Dept Oncol, Rome, Italy

[10] Villa San Pietro Hosp, Div Med Oncol, Rome, Italy

[11] Azienda Osped Univ Pisana, S Chiara Hosp, UO Oncol Med 1, Dipartimentodi Oncol Del Trapianti & Nuove Tecnol, Pisa, Italy

[12] ASL Frosinone, Med Oncol Unit, Frosinone, Italy

[13] Policlin Univ A Gemelli, Dept Med Oncol, Rome, Italy

[14] Univ Cattolica Sacro Cuore, Rome, Italy

[15] ASST Monza, Res Unit Phase & Trials & Oncol Unit, Monza, Italy

[16] Univ Hosp Modena, Dept Oncol & Hematol, Div Med Oncol, Modena, Italy

[17] Belcolle Hosp, Med Oncol Unit, Viterbo, Italy

[18] Fatebenefratelli Hosp, Med Oncol Unit, Rome, Italy

[19] Univ Cattolica Sacro Cuore, Gynecol Oncol Unit, Rome, Italy

[20] ASST Fatebenefratelli Sacco Presidio Ospedaliero, Oncol Unit, Milan, Italy

[21] Regina Margherita Hosp, Med Oncol Unit, Rome, Italy

[22] Osped Pescara, Div Med Oncol, Pescara, Italy

[23] ASST Bergamo Ovest, Oncol Unit, Dept Oncol, Treviglio, Italy

[24] Azienda Osped Pugliese Ciaccio, Dept Hematol & Oncol, Catanzaro, Italy

[25] San Filippo Neri Hosp, Oncol Unit, Rome, Italy

[26] S Maria Goretti Hosp, Oncol Unit, Latina, Italy

[27] Giovanni Paololl Inst, Dept Med Oncol, Bari, Italy

[28] Formia Hosp, Oncol Unit, Asl Latina, Italy

[29] San Giovanni Hosp, Div Oncol, Rome, Italy

[30] Univ Laquila, Dept Biotechnol & Appl Clin Sci, Med Oncol, Laquila, Italy

[31] Univ Roma Tor Vergata, Dept Syst Med, Med Oncol, Rome, Italy

[32] Univ Messina, Med Oncol Unit AO Papardo, Messina, Italy

[33] Univ Messina, Dept Human Pathol, Messina, Italy

[34] Univ Palermo, Dept Surg Oncol & Oral Sci, Sect Med Oncol, Palermo, Italy

[35] Univ Politecn Marche, Osped Riuniti Ancona, Oncol Clin, Ancona, Italy

[36] Univ Verona, Azienda Osped Univ Integrata, UOC Oncol, Verona, Italy

[37] St Salvatore Hosp, Med Oncol, Laquila, Italy

[38] Santo Spirito Hosp, Oncol Unit, ASL Roma 1, Rome, Italy

[39] UOC Lanciano Vasto, Vasto, Italy

[40] Med Oncol, PO Narni Amelia, Terni, Italy

[41] Mater Salutis Hosp, Dept Pathol Surg & Oncol, Verona, Italy

[42] St Orsola Marcello Malpighi Hosp, Addarii Inst Oncol, Med Oncol Unit, Bologna, Italy

[43] AO Osped Insegnamento S Crocee Carle, Med Oncol, Cuneo, Italy

[44] Lucca Hosp, Dept Oncol, Lucca, Italy

[45] Univ Florence, Radiat Oncol Unit, Florence, Italy

[46] Univ Florence, Dept Clin & Expt Biomed Sci Mario Serio, Azienda Osped Univ Careggi, Florence, Italy

[47] ASL Nuoro, Dept Med Oncol, Nuoro, Italy

[48] Reggio Calabria Gen Hosp, Div Med Oncol, Reggio Di Calabria, Italy

[49] ASST Cremona, Breast Canc Unit, Cremona, Italy

[50] ASST Cremona, Translat Res Unit, Cremona, Italy

来源：

INTERNATIONAL JOURNAL OF CANCER | 2020年 / 146卷 / 07期

关键词：

advanced breast cancer; HER2; positive; pertuzumab; trastuzumab; T-DM1; real world; EARLY BREAST-CANCER; PATHOLOGICAL COMPLETE RESPONSE; TRASTUZUMAB EMTANSINE; OPEN-LABEL; SURVIVAL; CHEMOTHERAPY; MULTICENTER; LAPATINIB; COMBINATION; PERTUZUMAB;

D O I：

10.1002/ijc.32583

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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-naive 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.

引用

页码：1917 / 1929

页数：13

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