TY - JOUR
T1 - Clinical Outcomes of Patients with HER2 Positive Metastatic Breast Cancer to the Brain, with First-Line Trastuzumab, Pertuzumab and Chemotherapy, in a Real-World Setting
AU - Sharman Moser, Sarah
AU - Apter, Lior
AU - Livnat, Idit
AU - Ginsburg, Roni
AU - Yarden, Adva
AU - Drori, Michal
AU - Drizon, Anat
AU - Chodick, Gabriel
AU - Siegelmann-Danieli, Nava
N1 - Publisher Copyright:
© 2024 Sharman Moser et al.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Background: In this observational study, we analyzed the treatment patterns and clinical outcomes of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (mBC) who developed brain metastases during their disease in a 2.7 million-member public health-provider in Israel. Methods: Newly diagnosed patients with mBC who initiated first-line treatment between January 2013 and June 2021 were identified. Time on treatment (ToT) and overall survival (OS) were assessed at a minimum of 6 months follow-up (cutoff: December 2021). Results: We identified a total of 61 patients: 98.4% females, median age 50 years (IQR = 44–63), 85% invasive ductal tumors, 44% hormone receptor positive, 51% performance status 0–1. The median duration of follow-up was 6.2 years. All patients initiated a combination treatment of trastuzumab, pertuzumab, and chemotherapy (TPC), and 72% moved to second-line treatment during the study follow-up period (82% ado-trastuzumab emtansine). The median ToT for first-line and second-line treatments were 16.9 months (95% CI = 13.9–27.7) and 7.9 months (95% CI = 5.6–10.9), respectively. The median overall survival (OS) was 45.5 months (95% CI = 35.4–71.2) from the initiation of first-line treatment. When considering the timing of brain metastases, the median OS was 36.3 months (95% CI = 10.0–NR) for those diagnosed upfront (n = 15, 25%), 59.1 months (95% CI = 32.5–NR) for those diagnosed while on TPC (n = 25, 41%), and 40.8 months (95% CI = 35.4–NR) for those diagnosed at a later stage (n = 21, 34%). The median OS from brain metastases diagnosis was 25.1 months (95% CI = 17.0–34.6). Conclusion: Patients with upfront brain involvement at the time of mBC diagnosis had shorter survival compared to those who started TPC without brain metastases. Nonetheless, the overall results from this study compare favorably with previous studies and contribute to understanding the value of traditional treatment options, which will serve as a baseline for future treatment strategies in the real-world setting.
AB - Background: In this observational study, we analyzed the treatment patterns and clinical outcomes of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (mBC) who developed brain metastases during their disease in a 2.7 million-member public health-provider in Israel. Methods: Newly diagnosed patients with mBC who initiated first-line treatment between January 2013 and June 2021 were identified. Time on treatment (ToT) and overall survival (OS) were assessed at a minimum of 6 months follow-up (cutoff: December 2021). Results: We identified a total of 61 patients: 98.4% females, median age 50 years (IQR = 44–63), 85% invasive ductal tumors, 44% hormone receptor positive, 51% performance status 0–1. The median duration of follow-up was 6.2 years. All patients initiated a combination treatment of trastuzumab, pertuzumab, and chemotherapy (TPC), and 72% moved to second-line treatment during the study follow-up period (82% ado-trastuzumab emtansine). The median ToT for first-line and second-line treatments were 16.9 months (95% CI = 13.9–27.7) and 7.9 months (95% CI = 5.6–10.9), respectively. The median overall survival (OS) was 45.5 months (95% CI = 35.4–71.2) from the initiation of first-line treatment. When considering the timing of brain metastases, the median OS was 36.3 months (95% CI = 10.0–NR) for those diagnosed upfront (n = 15, 25%), 59.1 months (95% CI = 32.5–NR) for those diagnosed while on TPC (n = 25, 41%), and 40.8 months (95% CI = 35.4–NR) for those diagnosed at a later stage (n = 21, 34%). The median OS from brain metastases diagnosis was 25.1 months (95% CI = 17.0–34.6). Conclusion: Patients with upfront brain involvement at the time of mBC diagnosis had shorter survival compared to those who started TPC without brain metastases. Nonetheless, the overall results from this study compare favorably with previous studies and contribute to understanding the value of traditional treatment options, which will serve as a baseline for future treatment strategies in the real-world setting.
KW - HER2 positive
KW - breast cancer
KW - metastatic
KW - observational study
KW - real-world
UR - http://www.scopus.com/inward/record.url?scp=85187148671&partnerID=8YFLogxK
U2 - 10.2147/BCTT.S439158
DO - 10.2147/BCTT.S439158
M3 - Article
C2 - 38464505
AN - SCOPUS:85187148671
SN - 1179-1314
VL - 16
SP - 105
EP - 116
JO - Breast Cancer: Targets and Therapy
JF - Breast Cancer: Targets and Therapy
ER -