Real-world data of lapatinib and treatment after lapatinib in patients with previously treated HER2-positive metastatic breast cancer: A multicenter, retrospective study
Real-world data of lapatinib and treatment after lapatinib in patients with previously treated HER2-positive metastatic breast cancer: A multicenter, retrospective study
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拉帕替尼和拉帕替尼治疗既往接受过治疗的 HER2 阳性转移性乳腺癌患者的真实世界数据：一项多中心回顾性研究
DOI：
10.1002/cam4.2943
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发表时间：
2020-05-01
期刊：
影响因子：
4
通讯作者：
Wang, Biyun
中科院分区：
文献类型：
--
作者：
Xie, Yizhao;Ge, Rui;Wang, Biyun
拉帕替尼广泛用于 HER2 阳性转移性乳腺癌 (MBC) 的后期治疗。 EGF104900研究表明，在先前接受含曲妥珠单抗治疗方案后病情进展的患者中，拉帕替尼联合曲妥珠单抗比单独使用曲妥珠单抗具有更好的效果。然而，没有发现拉帕替尼加卡培他滨与拉帕替尼加曲妥珠单抗加化疗以及拉帕替尼进展后治疗的比较的证据。我们回顾性评估了 2015 年至 2018 年中国五家机构中所有 HER2 阳性 MBC 患者的病历，这些患者在既往接受含曲妥珠单抗治疗方案（高级环境）和紫杉烷（任何环境）后出现进展，并接受基于拉帕替尼的治疗。共有 242 名患者可供分析。其中，164 名（68%）患者接受拉帕替尼加卡培他滨（LX）治疗，78 名（32%）患者接受拉帕替尼加曲妥珠单抗和一种化疗（HLC）治疗。 HLC 组的中位无进展生存期 (PFS) 显着优于 LX 组（8.8 个月 vs 5.0 个月，P < 0.0000001）。两组中 3 级或更严重不良事件没有观察到显着差异 (P = .57)。共有 175 名患者可用于分析拉帕替尼治疗后的情况。与非抗 HER2 治疗相比，继续拉帕替尼显示出更好的 mPFS 结果（4 个月与 2 个月，P = .01），与改用其他抗 HER2 治疗相比，结果相似（4 个月与 4 个月，P = .88）。对于先前以曲妥珠单抗为基础的治疗出现进展的患者，HLC 为 HER2 阳性 MBC 患者的后续线治疗提供了新的双靶向治疗选择。此外，还提供了拉帕替尼跨线使用的证据。
Lapatinib is widely used in the later lines treatment of HER2 positive metastatic breast cancer (MBC). EGF104900 study suggested that among patients who experienced progression on prior trastuzumab-containing regimens, lapatinib plus trastuzumab had better effects than trastuzumab alone. However, no evidence was discovered in terms of lapatinib plus capetabine compared with lapatinib plus trastuzumab plus chemotherapy, as well as a treatment after progression on lapatinib. We evaluated the medical records retrospectively of all MBC patients with HER2 positive disease who progressed on prior trastuzumab-containing regimens (advanced setting) and a taxane (any setting) and received lapatinib-based treatment from 2015 to 2018 in five institutions in China. A total of 242 patients were available for analysis. Among them, 164 (68%) patients received lapatinib plus capetabine (LX) and 78 (32%) patients received lapatinib plus trastuzumab and one chemotherapy (HLC). The median progression-free survival (PFS) of the HLC group was significantly superior to the LX group (8.8 months vs 5.0 months, P < .0000001). No significant difference in grade 3 or worse adverse events was observed in two groups (P = .57). A total of 175 patients were available for the analysis of the postlapatinib treatment. Continuation of lapatinib showed superior mPFS results compared to the non-anti-HER2 treatment (4 months vs 2 months, P = .01) and similar results compared to switch to other anti-HER2 treatments (4 months vs 4 months, P = .88). In patients who had progressed on prior trastuzumab-base therapy, HLC provided a new dual-targeting treatment option for the later lines therapy of patients with HER2 positive MBC. Moreover, evidence of cross-line use of lapatinib was provided.