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
- Autori: 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.
- Anno di pubblicazione: 2021
- Tipologia: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/558103
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.