Background: The evolution of therapeutic landscape of human epidermal growth factor receptor-2 (HER2)-positive breast cancer (BC) has led to an unprecedented outcome improvement, even if the optimal sequence strategy is still debated. To address this issue and to provide a picture of the advancement of anti-HER2 treatments, we performed a large, multicenter, retrospective study of HER2-positive BC patients. Methods: The observational PANHER study included 1,328 HER2-positive advanced BC patients treated with HER2 blocking agents since June 2000 throughout July 2020. Endpoints of efficacy were progression-free survival (PFS) and overall survival (OS). Results: Patients who received a first-line pertuzumab-based regimen showed better PFS (p < 0.0001) and OS (p = 0.004) than those receiving other treatments. Median PFS and mOS from second-line starting were 8 and 28 months, without significant differences among various regimens. Pertuzumab-pretreated patients showed a mPFS and a mOS from second-line starting not significantly affected by type of second line, that is, T-DM1 or lapatinib/capecitabine (p = 0.80 and p = 0.45, respectively). Conversely, pertuzumab-naïve patients receiving second-line T-DM1 showed a significantly higher mPFS compared with that of patients treated with lapatinib/capecitabine (p = 0.004). Median OS from metastatic disease diagnosis was higher in patients treated with trastuzumab-based first line followed by second-line T-DM1 in comparison to pertuzumab-based first-line and second-line T-DM1 (p = 0.003), although these data might be partially influenced by more favorable prognostic characteristics of patients in the pre-pertuzumab era. No significant differences emerged when comparing patients treated with ‘old’ or ‘new’ drugs (p = 0.43), even though differences in the length of the follow-up between the two cohorts should be taken into account. Conclusion: Our results confirmed a relevant impact of first-line pertuzumab-based treatment and showed lower efficacy of second-line T-DM1 in trastuzumab/pertuzumab pretreated, as compared with pertuzumab-naïve patients. Our findings may help delineate a more appropriate therapeutic strategy in HER2-positive metastatic BC. Prospective randomized trials addressing this topic are awaited.

PANHER study: a 20-year treatment outcome analysis from a multicentre observational study of HER2-positive advanced breast cancer patients from the real-world setting / Pizzuti, L.; Krasniqi, E.; Sperduti, I.; Barba, M.; Gamucci, T.; Mauri, M.; Veltri, E. M.; Meattini, I.; Berardi, R.; Di Lisa, F. S.; Natoli, C.; Pistelli, M.; Iezzi, L.; Risi, E.; D'Ostilio, N.; Tomao, S.; Ficorella, C.; Cannita, K.; Riccardi, F.; Cassano, A.; Bria, E.; Fabbri, M. A.; Mazzotta, M.; Barchiesi, G.; Botticelli, A.; D'Auria, G.; Ceribelli, A.; Michelotti, A.; Russo, A.; Salimbeni, B. T.; Sarobba, G.; Giotta, F.; Paris, I.; Saltarelli, R.; Marinelli, D.; Corsi, D.; Capomolla, E. M.; Sini, V.; Moscetti, L.; Mentuccia, L.; Tonini, G.; Raffaele, M.; Marchetti, L.; Minelli, M.; Ruggeri, E. M.; Scavina, P.; Bacciu, O.; Salesi, N.; Livi, L.; Tinari, N.; Grassadonia, A.; Fedele Scinto, A.; Rossi, R.; Valerio, M. R.; Landucci, E.; Stani, S.; Fratini, B.; Maugeri-Sacca, M.; De Tursi, M.; Maione, A.; Santini, D.; Orlandi, A.; Lorusso, V.; Cortesi, E.; Sanguineti, G.; Pinnaro, P.; Cappuzzo, F.; Landi, L.; Botti, C.; Tomao, F.; Cappelli, S.; Bon, G.; Pelle, F.; Cavicchi, F.; Fiorio, E.; Foglietta, J.; Scagnoli, S.; Marchetti, P.; Ciliberto, G.; Vici, P.. - In: THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY. - ISSN 1758-8340. - 13:(2021). [10.1177/17588359211059873]

PANHER study: a 20-year treatment outcome analysis from a multicentre observational study of HER2-positive advanced breast cancer patients from the real-world setting

Pizzuti L.
Primo
;
Sperduti I.;Barba M.;Di Lisa F. S.;Risi E.;Tomao S.;Fabbri M. A.;Mazzotta M.;Barchiesi G.;Botticelli A.;D'Auria G.;Marinelli D.;Sini V.;Mentuccia L.;Santini D.;Cortesi E.;Tomao F.;Bon G.;Pelle F.;Scagnoli S.;Marchetti P.;
2021

Abstract

Background: The evolution of therapeutic landscape of human epidermal growth factor receptor-2 (HER2)-positive breast cancer (BC) has led to an unprecedented outcome improvement, even if the optimal sequence strategy is still debated. To address this issue and to provide a picture of the advancement of anti-HER2 treatments, we performed a large, multicenter, retrospective study of HER2-positive BC patients. Methods: The observational PANHER study included 1,328 HER2-positive advanced BC patients treated with HER2 blocking agents since June 2000 throughout July 2020. Endpoints of efficacy were progression-free survival (PFS) and overall survival (OS). Results: Patients who received a first-line pertuzumab-based regimen showed better PFS (p < 0.0001) and OS (p = 0.004) than those receiving other treatments. Median PFS and mOS from second-line starting were 8 and 28 months, without significant differences among various regimens. Pertuzumab-pretreated patients showed a mPFS and a mOS from second-line starting not significantly affected by type of second line, that is, T-DM1 or lapatinib/capecitabine (p = 0.80 and p = 0.45, respectively). Conversely, pertuzumab-naïve patients receiving second-line T-DM1 showed a significantly higher mPFS compared with that of patients treated with lapatinib/capecitabine (p = 0.004). Median OS from metastatic disease diagnosis was higher in patients treated with trastuzumab-based first line followed by second-line T-DM1 in comparison to pertuzumab-based first-line and second-line T-DM1 (p = 0.003), although these data might be partially influenced by more favorable prognostic characteristics of patients in the pre-pertuzumab era. No significant differences emerged when comparing patients treated with ‘old’ or ‘new’ drugs (p = 0.43), even though differences in the length of the follow-up between the two cohorts should be taken into account. Conclusion: Our results confirmed a relevant impact of first-line pertuzumab-based treatment and showed lower efficacy of second-line T-DM1 in trastuzumab/pertuzumab pretreated, as compared with pertuzumab-naïve patients. Our findings may help delineate a more appropriate therapeutic strategy in HER2-positive metastatic BC. Prospective randomized trials addressing this topic are awaited.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1637023
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