Clinical benefit of treatment after trastuzumab emtansine for HER2-positive metastatic breast cancer: a real-world multi-centre cohort study in Japan (WJOG12519B)

Takamichi Yokoe, Sasagu Kurozumi, Kazuki Nozawa, Yukinori Ozaki, Tetsuyo Maeda, Shu Yazaki, Mai Onishi, Akihiro Fujimoto, Sayuka Nakayama, Yuko Tsuboguchi, Tsutomu Iwasa, Hitomi Sakai, Misato Ogata, Mitsuo Terada, Meiko Nishimura, Takuma Onoe, Jun Masuda, Michiko Kurikawa, Hirotsugu Isaka, Kanako HagioAkihiko Shimomura, Yuta Okumura, Manabu Futamura, Mototsugu Shimokawa, Toshimi Takano

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Trastuzumab emtansine (T-DM1) treatment for human epidermal growth factor receptor-2 (HER2)-positive metastatic breast cancer after taxane with trastuzumab and pertuzumab is standard therapy. However, treatment strategies beyond T-DM1 are still in development with insufficient evidence of their effectiveness. Here, we aimed to evaluate real-world treatment choice and efficacy of treatments after T-DM1 for HER2-positive metastatic breast cancer. Methods: In this multi-centre retrospective cohort study involving 17 hospitals, 325 female HER2-positive metastatic breast cancer patients whose post-T-DM1 treatment began between April 15, 2014 and December 31, 2018 were enrolled. The primary end point was the objective response rate (ORR) of post-T-DM1 treatments. Secondary end points included disease control rate (DCR), progression-free survival (PFS), time to treatment failure (TTF), and overall survival (OS). Results: The median number of prior treatments of post-T-DM1 treatment was four. The types of post-T-DM1 treatments included (1) chemotherapy in combination with trastuzumab and pertuzumab (n = 102; 31.4%), (2) chemotherapy concomitant with trastuzumab (n = 78; 24.0%), (3), lapatinib with capecitabine (n = 63; 19.4%), and (4) others (n = 82; 25.2%). ORR was 22.8% [95% confidence interval (CI): 18.1–28.0], DCR = 66.6% (95% CI 60.8–72.0), median PFS = 6.1 months (95% CI 5.3–6.7), median TTF = 5.1 months (95% CI 4.4–5.6), and median OS = 23.7 months (95% CI 20.7–27.4). Conclusion: The benefits of treatments after T-DM1 are limited. Further investigation of new treatment strategies beyond T-DM1 is awaited for HER2-positive metastatic breast cancer patients.

Original languageEnglish
Pages (from-to)581-591
Number of pages11
JournalBreast Cancer
Volume28
Issue number3
DOIs
Publication statusPublished - May 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

Fingerprint

Dive into the research topics of 'Clinical benefit of treatment after trastuzumab emtansine for HER2-positive metastatic breast cancer: a real-world multi-centre cohort study in Japan (WJOG12519B)'. Together they form a unique fingerprint.

Cite this