Responses to subsequent anti-HER2 therapy after treatment with trastuzumab-DM1 in women with HER2-positive metastatic breast cancer
Responses to subsequent anti-HER2 therapy after treatment with trastuzumab-DM1 in women with HER2-positive metastatic breast cancer
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DOI：
10.1093/annonc/mdr061
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发表时间：
2012-01-01
影响因子：
50.5
通讯作者：
Burstein, H. J.
中科院分区：
文献类型：
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作者：
Olson, E. M.;Lin, N. U.;Burstein, H. J.
背景：人类表皮生长因子受体2(HER2)阳性的转移性乳腺癌(MBC)患者可对多种抗HER2治疗方案产生反应。尚不清楚这些患者在曲妥珠单抗-MCC-DM1(T-DM1)治疗后是否会获得进一步的临床益处。患者和方法：我们回顾了接受T-DM1治疗的HER2阳性MBC患者，并描述了后续抗HER2治疗的结果。疗效通过放射学的盲法回顾来确定。使用Kaplan-Meier估计进行时间相关分析。结果：我们确定了23名接受单药T-DM1治疗的患者，并报告了20名停止方案治疗的患者。所有患者在T-DM1开始前都接受了基于曲妥珠单抗的转移治疗[中位数为7个方案(范围3-14)]。在这20名患者中，75%(15/20)的患者在停用T-DM1后接受了或不使用抗HER2药物的进一步治疗。在15名接受治疗的患者中，有5名(33%)对一线或二线后续治疗(S)有部分反应，包括接受含有曲妥珠单抗和/或拉帕替尼的治疗方案的33%(4/12)。T-DM1后第一次和第二次后续治疗的中位持续时间分别为5.5个月和6.4个月。结论：在经过大量预治疗的HER2阳性MBC患者中，预先暴露于T-DM1并不会耗尽正在进行的曲妥珠单抗和/或拉帕替尼抗HER2治疗的潜在益处。
Background: Women with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) can respond to multiple lines of anti-HER2 therapy. It is unknown whether these patients will derive further clinical benefit following treatment with trastuzumab-MCC-DM1 (T-DM1).Patients and methods: We retrospectively identified HER2-positive MBC patients treated with T-DM1 and characterized outcomes during subsequent lines of anti-HER2 therapy. Response was determined by a blinded radiology review. Time-dependent analyses were carried out using Kaplan-Meier estimates.Results: We identified 23 patients treated with single-agent T-DM1 and report on the 20 patients who discontinued protocol therapy. All patients received trastuzumab-based metastatic therapy before initiation of T-DM1 [median 7 regimens (range 3-14)]. Of these 20 patients, 75% (15 of 20) received further therapy with or without anti-HER2 agents after discontinuing T-DM1. Partial response to either first-or second-subsequent line(s) of therapy was seen in 5 of 15 (33%) treated patients, including 33% (4 of 12) who received a regimen containing trastuzumab and/or lapatinib. Median durations of therapy to first- and second-subsequent regimens after T-DM1 were 5.5 and 6.4 months, respectively.Conclusions: In heavily pretreated HER2-positive MBC patients, prior exposure to T-DM1 does not exhaust the potential benefit of ongoing anti-HER2 therapy with trastuzumab-and/or lapatinib-based regimens.