Favourable outcome of patients with breast cancer brain metastases treated with dual HER2 blockade of trastuzumab and pertuzumab.

Abstract

BACKGROUND:

Dual human epidermal growth factor receptor 2 (HER2) blockade with trastuzumab and pertuzumab (TP) is a standard therapy of metastatic and localized HER2-positive breast cancer (BC), but its activity in breast cancer brain metastases (BCBM) is unknown.

METHODS:

Patients with HER2-positive BCBM were identified from the Vienna Brain Metastasis Registry and clinical data including patient characteristics, therapies and overall survival (OS) were obtained. Patients were grouped into 'TP', 'other-HER2-targeted therapy' and 'no-HER2-targeted therapy' according to received first-line systemic therapy after diagnosis of BCBM. Radiological re-assessment of intracranial lesions was performed in patients treated with TP as systemic first-line therapy according to RANO response criteria for brain metastases (BM).

RESULTS:

A total of 252 HER2-positive BC patients with BM were available for this analysis. Patients treated with TP as systemic first-line therapy after diagnosis of BM had a significantly longer OS compared with treatment with other-HER2-targeted therapy and no-HER2-targeted therapy (44 versus 17 versus 3 months, p < 0.001; log-rank test). Among radiologically re-assessed patients treated with TP as systemic first-line therapy after diagnosis of BM, 5/14 patients (35.7%) had complete intracranial remission (CR), 8/14 patients (57.1%) partial intracranial remission (PR), 1/14 patients (7.1%) stable intracranial disease (SD) and 0/14 patients (0.0%) progressive intracranial disease (PD) as best response resulting in an intracranial objective response rate (iORR) of 92.9% and an intracranial clinical benefit rate (iCBR) of 100.0%.

CONCLUSION:

First-line therapy with dual HER2-inhibition of TP after BM diagnosis was associated with the longest median OS times in patients with BCBM.

• Authors: Elisabeth Sophie Bergen, Amelie Binter, Angelika Martina Starzer, Gerwin Heller, Barbara Kiesel, Kristina Tendl-Schulz, Zsuzsanna Bago-Horvath, Julia Furtner, Johannes Leitner, Ruth Exner, Florian Fitzal, Karin Dieckmann, Georg Widhalm, Matthias Preusser, Anna Sophie Berghoff, Rupert Bartsch
• Journal: Therapeutic advances in medical oncology (Ther Adv Med Oncol) Vol. 13 Pg. 17588359211009002 ( 2021) ISSN: 1758-8340 [Print] England
• PMID: 33995593 (Publication Type: Journal Article)
• Copyright: © The Author(s), 2021.