Author/Editor     Veitch, Zachary; Ribnikar, Domen; Tilley, Derek; Tang, Patricia; King, Karen; Bedard, Philippe L.; Lupichuk, Sasha; Cescon, David W.
Title     No evidence of disease versus residual disease in long-term responders to first-line HER2-targeted therapy for metastatic breast cancer
Type     članek
Vol. and No.     , št. Vol. 126
Publication year     2022
Volume     str. 881‐888
ISSN     0007-0920 - British Journal of Cancer
Language     eng
Abstract     Long-term response to HER2-targeted therapies is infrequent in metastatic breast cancer (MBC). We evaluated clinical characteristics of HER2-positive MBC patients with no evidence of disease (NED) vs residual disease (RES) experiencing long-term response to first-line HER2-targeted therapy. Methods: Patients receiving first-line chemotherapy-trastuzumab (CT) or taxane-trastuzumab-pertuzumab (THP) with response duration s2-fold higher than in phase II/III trials (CT [18.2 months]; THP [40.4 months]) were included. Clinical characteristics and radiographic review for NED or RES was evaluated by Cox-regression (hazard ratio; HR) or Kaplan-Meier (log-rank). Characteristics associated with NED were evaluated by logistic regression (Odds; OR). Results: From 01/2005-01/2016, N = 103 (4.6%) patients were identified. In multivariate analyses, NED (N = 46) showed improved progression-free (PFS) and overall survival (OS) [p < 0.001] versus RES (N = 57), with high 5-year PFS/OS for NED (93.2%/97.4%) relative to RES (10.6%/61.3%). Premenopausal status (p = 0.006), de-novo metastases (p = 0.002), and no palliative radiotherapy (p = 0.01) were associated with NED. Overall, 6/7 (85.7%) patients with NED were alive and disease-free after discontinuing HER2 treatment (s1 year) versus 1/17 (5.9%) with RES. Conclusions: Long-term responders with NED have better survival compared to RES. Premenopausal status and de novo metastatic disease are associated with NED. Prospective studies of HER2 therapy discontinuation with NED in MBC are warranted.
Keywords     rak dojke
metastatski rak
tarčno zdravljenje
kemoterapija
breast cancer
metastatic cancer
targeted therapy
chemotherapy