scholarly journals Palbociclib Plus Fulvestrant or Everolimus Plus Exemestane for Pretreated Advanced Breast Cancer with Lobular Histotype in ER+/HER2− Patients: A Propensity Score-Matched Analysis of a Multicenter Retrospective Patient Series

2020 ◽  
Vol 10 (4) ◽  
pp. 291
Author(s):  
Armando Orlandi ◽  
Elena Iattoni ◽  
Laura Pizzuti ◽  
Agnese Fabbri ◽  
Andrea Botticelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Propensity Score ◽  
Progesterone Receptors ◽  
Metastatic Breast ◽  
Hormonal Treatment ◽  
Progression Free Survival ◽  
Second Line ◽  
Optimal Sequence ◽  
Therapeutic Sequence

Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) show meaningful efficacy and tolerability in patients with metastatic breast cancer (MBC), but the optimal sequence of ET has not been established. It is not clear if patients with lobular breast carcinomas (LBC) derive the same benefits when receiving second line CDK4/6i. This retrospective study compared the efficacy of palbociclib plus fulvestrant (PALBO–FUL) with everolimus plus exemestane (EVE–EXE) as second-line ET for hormone-resistant metastatic LBC. From 2013 to 2018, patients with metastatic LBC positivity for estrogen and/or progesterone receptors and HER2/neu negativity, who had relapsed during adjuvant hormonal therapy or first-line hormonal treatment, were enrolled from six centers in Italy in this retrospective study. A total of 74 out of 376 patients (48 treated with PALBO–FUL and 26 with EVE–EXE) with metastatic LBC were eligible for inclusion. Progression-free survival (PFS) was longer in patients receiving EVE–EXE compared with PALBO–FUL (6.1 vs. 4.5 months, univariate HR 0.58, 95% CI 0.35–0.96; p = 0.025). On the propensity score (PS) analysis, PFS was confirmed to be significantly longer for patients treated with EVE–EXE compared to PALBO–FUL (6.0 vs. 4.6 months, p = 0.04). This retrospective analysis suggests that EVE–EXE is more effective than PALBO–FUL for second line ET of metastatic LBC, allowing us to speculate on the optimal therapeutic sequence.

Bevacizumab (BEV) plus second-line taxane (TAX) or other chemotherapy (CT) for triple-negative breast cancer (TNBC): Subgroup analysis of RIBBON-2.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 290-290
Author(s):  
A. Brufsky ◽  
V. Valero ◽  
B. Tiangco ◽  
S. R. Dakhil ◽  
A. Brize ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Endpoint ◽  
Small Sample Size ◽  
Objective Response ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Small Sample ◽  
Second Line ◽  
First Line ◽  
Free Survival

290 Background: In three randomized trials in the first-line metastatic breast cancer (MBC) setting, combining BEV with CT significantly improved progression-free survival (PFS; primary endpoint) and objective response rate (ORR) vs. CT alone. BEV also showed a significant PFS benefit in the second-line MBC setting (RIBBON-2) when combined with TAX or other CT. We analyzed data from the subgroup of patients (pts) with TNBC in RIBBON-2. Methods: Eligible pts had MBC that had progressed on first-line CT without BEV. Second-line CT (TAX, gemcitabine, capecitabine, or vinorelbine) was chosen before 2:1 randomization to CT with either BEV (10 mg/kg q2w or 15 mg/kg q3w) or placebo (PLA). All pts could receive BEV at progression. The primary endpoint was PFS. Results: RIBBON-2 included 684 pts; 159 (23%) had TNBC and of these, 67 (42%) received TAX with BEV/PLA. Baseline characteristics were broadly similar in the two treatment arms. In an exploratory analysis of pts with TNBC, BEV + CT led to significantly improved PFS and ORR vs. CT alone, and a trend toward improved overall survival (OS). The magnitude of the effect was particularly pronounced in pts receiving TAX CT. Conclusions: Pts with TNBC derive significant ORR and PFS benefit from BEV combined with second-line CT. Despite the small sample size, there was a trend (HR 0.624; p = 0.0534) toward OS benefit in pts treated with BEV, especially with TAX CT. [Table: see text]

scholarly journals Systemic control and encephalic response with lapatinib plus capecitabine as second-line therapy in HER2-positive, metastatic breast cancer

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 110-115
Author(s):  
Raffaele Ardito ◽  
Fiorella Restaino Marino
Keyword(s):  
Breast Cancer ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Second Line ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Free Survival ◽  
Systemic Control ◽  
Epidermal Growth

Overexpression of the human epidermal growth factor receptor (HER2) oncoprotein in breast cancer patients, is one of the biological characteristics of the disease that determines the choice of appropriate systemic treatment. We report the case of a 41-year-old woman, with relapsing HER2-positive breast cancer in cerebral and pulmonary cells. The patient underwent multimodal first Iine treatment including pertuzumab, trastuzumab and docetaxel and panencephalic radiotherapy with good response and progression-free survival for approximately 16 months. Subsequently, further to a encephalic progression of the disease, the patient was treated in second line with the combination lapatinib + capecitabine which induced further encephalic response and disease control for additional 20 months (Oncology).

Trastuzumab and pertuzumab-based versus other therapy as second-line therapy in HER2-positive metastatic breast cancer: A retrospective study from single center.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 616-616
Author(s):  
Daniel Fontes Santos De Teive E Argolo ◽  
Lillian Mary Smyth ◽  
Neil M. Iyengar ◽  
Sujata Patil ◽  
Larry Norton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Retrospective Study ◽  
Metastatic Breast ◽  
Second Line ◽  
Single Center ◽  
Her2 Positive ◽  
Second Line Therapy ◽  
Line Therapy

Fulvestrant versus everolimus plus exemestane for patients with metastatic breast cancer resistant to aromatase inhibitors: Clinical experience from real world.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12522-e12522
Author(s):  
Yi Li ◽  
Yizhao Xie ◽  
Yannan Zhao ◽  
Xi-Chun Hu ◽  
Jian Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Propensity Score ◽  
Target Therapy ◽  
Real Life ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Treatment Patterns ◽  
Hormone Receptor Positive ◽  
Significant Difference

e12522 Background: To present treatment patterns and the outcome of pure endocrine therapy fulvestrant (FUL) versus Exemestane (EXE)and target therapy everolimus (EVE) combination among hormone receptor-positive (HR+)/human epidermal growth factor 2 (HER2)-negative metastatic breast cancer (MBC) after progression on aromatase inhibitor (AI) in the real-life setting. Methods: Patients with HR+/HER2- MBC after AI who received FUL or EVE-EXE between June 2013 and June 2016 were identified from electronic database. Outcome measures included progression free survival (PFS), overall survival (OS) and safety profile. Propensity score matching (PSM) was applied to minimize potential confounders. Results: Among the 168 patients included, 124 patients received FUL and 44 patients treated with EVE-EXE. Patients that received EVE-EXE were significantly younger, more likely to have visceral, liver, multiple sites of metastases and had received more prior chemotherapy than FUL group. There was no significant difference in PFS after adjusted for propensity score between two groups (HR,1.173; 95%CI, 0.797-1.727; p = 0.419). In subgroup analysis, treatment effects were consistent across predefined subgroups except for the subgroup of multiple metastatic sites which the median PFS was significantly longer in EVE-EXE group than in FUL group (6.1vs3.2months, respectively; HR = 0.508;95%CI,0.299-0.862; p = 0.012). The toxicity of FUL regimen was more manageable. More patients discontinued the treatment due to intolerable toxicity in EVE-EXE group than FUL group. Conclusions: We observed substantial changes in treatment patterns in patients received EVE-EXE and FUL. Treatment outcomes were comparable between two schedules after adjusted for confounding factors, while FUL has been better tolerated. Clinical trial information: NCT03695341.

scholarly journals Clinical usefulness of eribulin as first- or second-line chemotherapy for recurrent HER2-negative breast cancer: a randomized phase II study (JBCRG-19)

2021 ◽  
Author(s):  
Kenjiro Aogi ◽  
Kenichi Watanabe ◽  
Masahiro Kitada ◽  
Takashi Sangai ◽  
Shoichiro Ohtani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Statistical Significance ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
Hazard Ratio ◽  
Second Line ◽  
Open Label ◽  
Minimization Method ◽  
Second Line Chemotherapy ◽  
Line Chemotherapy

Abstract Background Anthracycline (A) or taxane T-based regimens are the standard early-line chemotherapy for metastatic breast cancer (BC). A previous study has shown a survival benefit of eribulin in heavily pretreated advanced/recurrent BC patients. The present study aimed to compare the benefit of eribulin with treatment of physician’s choice (TPC) as first- or second-line chemotherapy for recurrent HER2-negative BC. Methods Patients with recurrent HER2-negative BC previously receiving anthracycline and taxane AT-based chemotherapy in the adjuvant or first-line setting were eligible for this open-label, randomized, parallel-group study. Patients were randomized 1:1 by the minimization method to receive either eribulin (1.4 mg/m2 on day one and eight of each 21-day cycle) or TPC (paclitaxel, docetaxel, nab-paclitaxel or vinorelbine) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). Secondary endpoints included time to treatment failure (TTF), overall response rate (ORR), duration of response, and safety (UMIN000009886). Results Between May 2013 and January 2017, 58 patients were randomized, 57 of whom (26 eribulin and 31 TPC) were analyzed for efficacy. The median PFS was 6.6 months with eribulin versus 4.2 months with TPC (hazard ratio: 0.72 [95% confidence interval (CI), 0.40–1.30], p = 0.276). Median TTF was 6.0 months with eribulin versus 3.6 months with TPC (hazard ratio: 0.66 [95% CI, 0.39–1.14], p = 0.136). Other endpoints were also similar between groups. The most common grade ≥ 3 adverse event was neutropenia (22.2% with eribulin versus 16.1% with TPC). Conclusions Eribulin seemed to improve PFS or TTF compared with TPC without statistical significance. Further validation studies are needed.

scholarly journals 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

2021 ◽  
Vol 13 ◽  
pp. 175883592110598
Author(s):  
Laura Pizzuti ◽  
Eriseld Krasniqi ◽  
Isabella Sperduti ◽  
Maddalena Barba ◽  
Teresa Gamucci ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Progression Free Survival ◽  
Disease Diagnosis ◽  
New Drugs ◽  
Outcome Analysis ◽  
Second Line ◽  
Breast Cancer Patients ◽  
First Line ◽  
Her2 Positive ◽  
Optimal Sequence

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.

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