Primary predictors of survival outcomes for HER2-positive advanced breast cancer patients initiating ado-trastuzumab emtansine. (August 2019)

• Record Type: Journal Article
• Authors: Hopkins, Ashley M.; Rowland, Andrew; Logan, Jessica M.; Sorich, Michael J.
• Is Part Of: Breast. Volume 46(2019)
• Page Start: 90
• Page End: 94
• Publication Date: 2019-08
• Subjects: Ado-trastuzumab emtansine -- Advanced breast cancer -- Prognostic model -- Survival -- Progression; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2019.05.011
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Objectives: Common therapies for HER2-positive advanced breast cancer (ABC) are associated with heterogeneity in prognosis and treatment benefit. Prognostic models of survival outcomes with ado-trastuzumab-emtansine (T-DM1) have not been evaluated. Material and methods: A pre-treatment prognostic model for overall survival (OS) and progression-free survival (PFS) based on clinicopathological factors was developed for HER2-positive ABC patients initiating second-line and later T-DM1 using data from the randomised clinical trials EMILIA and TH3RESA (n = 893). Pre-treatment prognostic groups were identified via recursive partitioning analysis. Results: The most significant OS/PFS pre-treatment risk predictors were metastatic sites count (≤2 versus > 2) and ECOG performance-status (0 versus ≥ 1) (P < 0.05). Based on these two factors, patients can be characterised as one of three prognostic groups (good = 0 factors; intermediate = 1 factor; poor = 2 factors). The prognostic groups were identified as significantly associated with OS (P < 0.001) and PFS (P < 0.001). Median OS for the good, intermediate and poor prognostic groups were 40 (95%CI: 36–48), 25 (23–30) and 16 (14–19) months, respectively, and median PFS was 12 (10–15), 8 (7–9) and 6 (4–7) months. Conclusion: Pre-treatment prognostic groups with significant differences in OS and PFS for HER2-positive ABC patients initiating second-line and later T-DM1 were identified. For HER2-positive ABC patients considering initiating second-line and later T-DM1, the prognostic groups enable more personalized expectations of disease control, survival and absolute treatment benefit. Highlights: A prognostic tool for HER2-positive ABC patients initiating T-DM1 therapy. Prognostic groups were significantly associated with PFS and OS. Median PFS ranged from 6 to 12 months across the prognostic groups. Median OS ranged from 16 to 40 months across the prognostic groups. Provide personalized expectations of disease control and survival.