Effectiveness of second-line anti-HER2 treatment in HER2-positive metastatic breast cancer patients previously treated with trastuzumab:A real-world study

作     者：Wei Zhao Li Bian Tao Wang Shaohua Zhang Jianbin Li Fengrui Xu Zefei Jiang Wei Zhao;Li Bian;Tao Wang;Shaohua Zhang;Jianbin Li;Fengrui Xu;Zefei Jiang

作者机构：Department of Breast OncologyAcademy of Military Medical SciencesBeijing 100850China Department of Breast Oncologythe Fifth Medical Center of Chinese PLA General HospitalBeijing 100071China PLA Rocket Force Characteristic Medical CenterBeijing 100088China 

出 版 物：《Chinese Journal of Cancer Research》 (中国癌症研究（英文版）)

年 卷 期：2020年第32卷第3期

页      面：361-369页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Capital Clinical Medicine Special Project(No.Z181100001718215) National Natural Science Foundation of China(No.81602314).Research number:CSCO-BC RWS 16002 

主　　题：Metastatic breast cancer trastuzumab failure second-line real-world study 

摘      要：Objective:Several studies have demonstrated different benefits for patients whose disease progressed despite previous trastuzumab *** to limited real-world data,we evaluate the effectiveness of anti-human epidermal growth factor receptor 2(HER2)therapy(lapatinib or trastuzumab)plus chemotherapy or chemotherapy alone in patients who were previously treated with trastuzumab-containing regimens and investigate factors associated with *** we further show the effectiveness of the two anti-HER2 therapy ***:A total of 342 HER2-positive metastatic breast cancer(MBC)patients whose disease progressed during prior anti-HER2(trastuzumab)and standard chemotherapy therapy from Department of Breast Oncology,the Fifth Medical Center of Chinese PLA General Hospital,from August 2010 to December 2016 were ***-eight patients received standard chemotherapy only,148 patients continued to receive trastuzumab and switched to other chemotherapy drugs,and 116 patients received tyrosine-kinase inhibitors(TKIs;lapatinib)and *** main outcome measures were progression-free survival(PFS),overall response rate(ORR),and clinical benefit rate(CBR).Subgroup analyses were conducted to identify patient characteristics associated with the greatest clinical ***:After a median follow-up of 26.2(range,2.0-56.0)months,PFS significantly improved with anti-HER2 therapy compared with chemotherapy alone:median 6.0 months with lapatinib[95%confidence interval(95%CI),4.53-7.47],4.5 months with trastuzumab(95%CI,3.99-5.01)vs.3.0 months with chemotherapy alone(95%CI,2.42-3.58);stratified hazard ratio(HR)=0.70,95%CI,0.60-0.81;P*** ORR values were 33.6%,25.0%and 12.8%,respectively,the CBR values were 60.3%,48.6%and 26.9%,*** effectiveness of lapatinib group and trastuzumab group were further *** multivariate analysis,lapatinib group was associated with a longer PFS,after controlling other potential confounders(HR=0.6