Anti-HER2 plus endocrine therapy versus anti-HER2 plus chemotherapy in hormone receptor-positive and HER2-positive metastatic breast cancer: a retrospective study.
Zhenhua Fan, Yang Yuan, Xiaoyan Chen, Tao Wang, Shaohua Zhang, Li Bian, Xueli Mo
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引用次数: 0
Abstract
Background: No clinical trials demonstrated anti-HER2 plus chemotherapy (anti-HER2 + ChT) was superior to anti-HER2 plus endocrine therapy (anti-HER2 + ET) in HR + /HER2 + MBC. This study aims to compare efficacy of anti-HER2 + ET with anti-HER2 + ChT in real-world clinical practice, and analyze clinical outcome of anti-HER2 + ET as maintenance therapy after benefiting from anti-HER2 + ChT.
Methods: This study retrospectively compared two regimens: anti-HER2 + ChT vs anti-HER2 + ET, utilizing chi-square tests for response rate comparisons and Kaplan-Meier approach for survival analysis.
Results: Totally, 241 eligible patients were included in this study. In first-line setting, 197 patients (81.7%) received anti-HER2 + ChT and 44 (18.3%) received anti-HER2 + ET. Objective response rate (54.3% vs 11.4%, P < 0.001) and clinical benefit rate (82.7% vs 68.2%, P = 0.029) of anti-HER2 + ChT group were higher than those of anti-HER2 + ET. PFS analysis showed there was no significant difference between anti-HER2 + ChT and anti-HER2 + ET in first-line (mPFS, 15.0 m [95%CI 12.1-17.9] vs 9.0 m [95%CI 0.5-17.5]; HR 1.32 [0.88-1.98]; P = 0.162) and the front two lines of treatment (PFS-2, 26.0 m [95%CI 23.0-29.0] vs 24.0 m [95%CI 15.9-32.1]; HR 1.03 [0.64-1.64]; P = 0.919). Notably, PFS of patients with anti-HER2 + ChT maintained by anti-HER2 + ET was superior to anti-HER2 + ET (24.0 m [95%CI 18.0-30.0] vs 17.0 m [95%CI 9.5-24.5]; HR 0.53 [0.32-0.89]; P = 0.005) and other anti-HER2 + ChT group (24.0 m vs 12.0 m [95%CI 9.1-15.0]; HR 0.52 [0.36-0.76]; P < 0.001).
Conclusion: While anti-HER2 + ChT showed superior disease control over anti-HER2 + ET, it didn't confer a survival advantage, possibly due to small sample size or retrospective design constraints. For patients deriving benefit from anti-HER2 + ChT, transitioning to maintenance therapy with anti-HER2 + ET may represent an optional strategy.
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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