Treatment Landscape and Prognosis After Treatment with Trastuzumab Emtansine

Abstract

Purpose Pertuzumab and T-DM1 are two efficient anti-HER2 treatments for patients with HER2-positive advanced breast cancer. While pertuzumab is usually given in first-line treatment and T-DM1 in second-line treatment, standard therapy options seem to be exhausted up to now after the treatment of patients with these two therapy options. Therefore, it is important to have data that describes the therapy situation and prognosis after T-DM1 treatment. Methods The PRAEGNANT metastatic breast cancer registry (NCT02338167) is a prospective registry for breast cancer patients with a focus on molecular biomarkers. Patients of all therapy lines with any kind of treatment are eligible. Collected data comprises therapies, adverse events, quality of life and other patient reported outcomes. Here we report on the patient characteristics and descriptive prognostic data for HER2-positive patients who have completed a treatment with T-DM1. Therapy patterns after T-DM1 and progression-free survival are reported as well as overall survival. Results A total of 85 patients were identified for the study who were prospectively observed during therapy after the termination of T-DM1. The main reason for T-DM1 termination was progress. Following T-DM1, lapatinib, trastuzumab and chemotherapy were the main therapy choices. Median progression-free survival was 4.8 months (95% CI: 3.2 – 6.3) and median overall survival was 18.4 months (95% CI: 15.5 – 21.3). Conclusions Therapy options after T-DM1 in a real-world setting seem to exhibit a relevant clinical efficacy, supporting the concept of continuous anti-HER2 treatments in the advanced therapy setting for breast cancer patients. Novel therapies are needed to improve the rather short median progression-free survival.

HER2 Positive Breast Cancer Therapy - A Challenging and Continuously Moving Pathway – A Narrative Literature Review

“…The latest clinical trials that studied resistance mechanisms to anti-HER2 therapies have revealed positive prognostic improvements, suggesting the necessity of additional trials in patients who have a high probability of benefitting from further anti-HER2 treatments. 36…”

Einführung von CDK4/6-Hemmern und deren Auswirkung auf die Behandlungslandschaft bei Patientinnen mit Brustkrebs im fortgeschrittenen Stadium – Real-World-Daten aus dem PRAEGNANT-Register

“…Die Studie Prospective Academic Translational Research Network for the Optimization of the Oncological Health Care Quality in the Adjuvant and Advanced/Metastatic Setting (PRAEGNANT, NCT02 338 167 31 ) ist ein laufendes prospektives Brustkrebsregister mit einem Dokumentationssystem, das dem in klinischen Studien verwendeten ähnelt. Die Ziele von PRAEGNANT bestehen darin, die Behandlungsmuster und Lebensqualität zu bewerten sowie Patienten zu identifizieren, die für klinische Studien oder spezifische gezielte Behandlungen in Frage kommen 31 32 33 34 35 . Die Patienten können zu jedem Zeitpunkt ihres Krankheitsverlaufs einbezogen werden.…”

Implementation of CDK4/6 Inhibitors and its Influence on the Treatment Landscape of Advanced Breast Cancer Patients – Data from the Real-World Registry PRAEGNANT

“…The Prospective Academic Translational Research Network for the Optimization of the Oncological Health Care Quality in the Adjuvant and Advanced/Metastatic Setting study (PRAEGNANT, NCT02338167 31 ) is an ongoing prospective breast cancer registry with a documentation system similar to that used in clinical trials. The aims of PRAEGNANT are to assess treatment patterns and quality of life and to identify patients who may be eligible for clinical trials or specific targeted treatments 31 , 32 , 33 , 34 , 35 . Patients can be included at any point during the course of their disease.…”