Published March 2023
| Version v1
Journal article
Clinical outcome of patients with isolated central nervous system progression on first-line pertuzumab and trastuzumab treatment for HER2-positive metastatic breast cancer in a real-life cohort
Creators
- Collet, Laetitia
- Eberst, Lauriane
- Ludovic, Gauthier
- Debled, Marc
- Hrab, Loana
- Mouret-Reynier, Marie-Ange
- Desmoulins, Isabelle
- Goncalves, Anthony
- Campone, Mario
- Ferrero, Jean-Marc
- Brain, Etienne
- Uwer, Lionel
- Eymard, Jean-Christophe
- Diéras, Véronique
- Simon, Gaëtane
- Leheurteur, Marianne
- Dalenc, Florence
- Vanlemmens, Laurence
- Darlix, Amélie
- Arnedos, Monica
- Bachelot, Thomas
Contributors
Others:
- Department of Medical Oncology [Lyon] ; Centre Léon Bérard [Lyon]
- Institut de Cancérologie de Strasbourg Europe (ICANS)
- Institut régional de Cancérologie de Montpellier (ICM)
- Institut Bergonié [Bordeaux] ; UNICANCER
- Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC) ; Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)
- Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP) ; UNICANCER
- Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL) ; UNICANCER
- Institut Paoli-Calmettes (IPC) ; Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)
- Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO) ; UNICANCER
- Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL) ; UNICANCER-Université Côte d'Azur (UniCA)
- Institut Curie - Saint Cloud (ICSC)
- Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL) ; UNICANCER
- Institut Jean Godinot [Reims] ; UNICANCER
- CRLCC Eugène Marquis (CRLCC) ; UNICANCER
- UNICANCER
- Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)
- Institut Claudius Regaud
- Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille) ; Université de Lille-UNICANCER
- Institut de Génomique Fonctionnelle (IGF) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)
- Institut Gustave Roussy (IGR)
Description
Background: More than 10% of HER2-positive metastatic breast cancer (mBC) will develop Central Nervous System (CNS) metastases as first and isolated site of relapse on trastuzumab and pertuzumab first-line therapy. However, few clinical data are available to guide the best strategy in this setting.Methods: Patients experiencing isolated CNS progression on trastuzumab and pertuzumab first-line therapy were retrospectively identified from the French Epidemiological Strategy and Medical Economics (ESME) real-life database between 2008 and 2016.Results: Among 995 patients treated with first-line trastuzumab and pertuzumab for HER2-positive mBC, 132 patients (13%) experienced isolated CNS progression with a median time of 12 months after mBC diagnosis. Twelves patients did not receive any treatment and were excluded from the analysis. Among the 120 patients considered, 76 (63%) received CNS-directed local therapy, 73 (60%) continued trastuzumab and pertuzumab, whereas 47 (39%) started another systemic treatment. After a median follow-up of 21 months, there was no difference in progression-free survival for patient who continued trastuzumab-pertuzumab or switched to another systemic treatment. In multivariate analysis, trastuzumab-pertuzumab continuation was associated with longer OS (HR 0,28 IC 95%: 0,14-0,54 p < 0,001). mOS was not reached (95% 37.6-NE) and was 23.2 months (95% CI 15.5-53.6) in patients who continued trastuzumab and pertuzumab therapy and in patients who switched for another systemic therapy, respectively.Conclusion: In this real-life cohort, trastuzumab-pertuzumab continuation after local treatment for isolated CNS progression did not negatively impact PFS and OS. Prospective trials and assessment of new strategies are warranted in this specific situation.
Abstract
International audienceAdditional details
Identifiers
- URL
- https://hal.science/hal-04205863
- URN
- urn:oai:HAL:hal-04205863v1