A retrospective, multicenter study of the efficacy of lapatinib plus trastuzumab in HER2-positive metastatic breast cancer patients previously treated with trastuzumab, lapatinib, or both: the Trastyvere study

• J. Gavilá ^[1] ; J. De La Haba ^[2] ; B. Bermejo ^[3] ; Á. Rodríguez-Lescure ^[4] ; A. Antón ^[5] ; E. Ciruelos ^[6] ; J. Brunet ^[7] ; E. Muñoz-Couselo ^[8] ; M. Santisteban ^[9] ; C. A. Rodríguez Sánchez ^[10] ; A. Santaballa ^[15] ; P. Sánchez Rovira ^[11] ; J. Á. García Sáenz ^[12] ; M. Ruiz-Borrego ^[13] ; A. L. Guerrero-Zotano ^[1] ; M. Huerta ^[3] ; A. Cotes-Sanchís ^[16] ; J. Lao Romera ^[5] ; E. Aguirre ^[17] ; J. Cortés ^[18] ; A. Llombart-Cussac ^[14]
  1. [1] Instituto Valenciano de Oncologia

     Instituto Valenciano de Oncologia

     Valencia, España

     
  2. [2] Hospital Universitario Reina Sofia

     Hospital Universitario Reina Sofia

     Cordoba, España

     
  3. [3] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  4. [4] Hospital General Universitario de Elche

     Hospital General Universitario de Elche

     Elche, España

     
  5. [5] Hospital Miguel Servet

     Hospital Miguel Servet

     Zaragoza, España

     
  6. [6] Hospital Universitario 12 de Octubre

     Hospital Universitario 12 de Octubre

     Madrid, España

     
  7. [7] Institute Catalá Oncología

     Institute Catalá Oncología

     Barcelona, España

     
  8. [8] Hospital Vall d'Hebron

     Hospital Vall d'Hebron

     Barcelona, España

     
  9. [9] Clínica Universitaria de Navarra

     Clínica Universitaria de Navarra

     Pamplona, España

     
  10. [10] Hospital Universitario de Salamanca

      Hospital Universitario de Salamanca

      Salamanca, España

      
  11. [11] Hospital Universitario de Jaén

      Hospital Universitario de Jaén

      Jaén, España

      
  12. [12] Hospital Clínico San Carlos de Madrid

      Hospital Clínico San Carlos de Madrid

      Madrid, España

      
  13. [13] Hospital Universitario Virgen del Rocío

      Hospital Universitario Virgen del Rocío

      Sevilla, España

      
  14. [14] Hospital Universitario Arnau de Vilanova

      Hospital Universitario Arnau de Vilanova

      Lérida, España

      
  15. [15] Hospital Universitari i Politècnic La Fe
  16. [16] Hospital General Elche
  17. [17] Hospital de Día QuirónSalud Zaragoza
  18. [18] Instituto de Oncología Vall d’Hebron

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 3 (March), 2020, págs. 420-428
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose To evaluate the efficacy and safety of lapatinib (L) and trastuzumab (T) combination in HER2-positive metastatic breast cancer (MBC) patients previously treated with T and/or L.

    Materials and methods We conducted a retrospective, post-authorized, multicenter study including patients with HER2-positive MBC or locally advanced breast cancer (ABC) treated with the combination of L–T. Concomitant endocrine therapy, as well as brain metastasis and/or prior exposure to L, were allowed.

    Results One hundred and fifteen patients from 14 institutions were included. The median age was 59.8 years. The median number of prior T regimens in the advanced setting was 3 and 73 patients had received a prior L regimen. The clinical benefit rate (CBR) was 34.8% (95% CI 26.1–43.5). Among other efficacy endpoints, the overall response rate was 21.7%, and median progression-free survival (PFS) and overall survival were 3.9 and 21.6 months, respectively. Heavily pretreated and ≥ 3 metastatic organ patients showed lower CBR and PFS than patients with a low number of previous regimens and < 3 metastatic organs. Moreover, CBR did not significantly change in L-pretreated compared with L-naïve patients (31.5% versus 40.5% for L-pretreated versus L-naïve). Grade 3/4 adverse events were reported in 19 patients (16.5%).

    Conclusion The combination of L–T is an effective and well-tolerated regimen in heavily pretreated patients and remains active among patients progressing on prior L-based therapy. Our study suggests that the L–T regimen is a safe and active chemotherapy-free option for MBC patients previously treated with T and/or L.