T-DM1 and brain metastases: Clinical outcome in HER2-positive metastatic breast cancer. (October 2018)

• Record Type: Journal Article
• Authors: Fabi, Alessandra; Alesini, Daniele; Valle, Enrichetta; Moscetti, Luca; Caputo, Roberta; Caruso, Michele; Carbognin, Luisa; Ciccarese, Mariangela; La Verde, Nicla; Arpino, Grazia; Cannita, Katia; Paris, Ida; Santini, Daniele; Montemurro, Filippo; Russillo, Michelangelo; Ferretti, Gianluigi; Filippelli, Gianfranco; Rossello, Rosalba; Fabbri, Agnese; Zambelli, Alberto; Leonardi, Vita; D'Ottavio, Anna Maria; Nisticò, Cecilia; Stani, Simonetta; Giampaglia, Marianna; Scandurra, Giusy; Catania, Giovanna; Malaguti, Paola; Giannarelli, Diana; Cognetti, Francesco
• Is Part Of: Breast. Volume 41(2018)
• Page Start: 137
• Page End: 143
• Publication Date: 2018-10
• Subjects: Brain metastases -- Metastatic breast cancer -- T-DM1 -- Trastuzumab-emtansine; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2018.07.004
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Background: We reported the results of an Italian large retrospective analysis that evaluated the effectiveness and safety of T-DM1 in 'field-practice' breast cancer patients. We performed a sub-analysis to investigate the clinical activity of T-DM1 in patients with brain metastases (BMs). Methods: The records of 87 adult women with HER2-positive breast cancer and BMs treated with T-DM1 were reviewed. Their clinical outcomes were compared with those of 216 patients without central nervous system (CNS) involvement. Results: Response to T-DM1 treatment in BMs was available for 53 patients in the BM group (60.9%): two patients reported a complete response (3.8%), 11 patients obtained partial response (20.7%; overall response rate: 24.5%), 16 patients had a stable disease (30.1%). Regarding extracranial disease, a total of 77 and 191 patients were evaluable for response in BM group and non-BM group, respectively. The overall response rate was 35.1% in the BM group and 38.3% in the non-BM group; disease control rate was 53.3% and 66.6%, respectively. At a median follow-up of 16 months (range: 1–55), median cumulative progression-free survival (PFS) was 7 months (95% CI: 5.4–8.6) in the BM group and 8 months (95% CI: 5.7–10.3) in the non-BM group. In the second-line setting, PFS was 5 (95% CI: 3.1–6.9) versus 11 (95% CI: 7.1–14.9) months (p = 0.01). Overall survival was 14 months (95% CI: 12.2–15.8) in the BM group and 32 months (95% CI: 24.4–39.6) in the non-BM group (p < 0.0001). Conclusions: T-DM1 is active in breast cancer patients with BMs. Highlights: We evaluated T-DM1 in 87 breast cancer patients with brain metastases (BMs). ORR was 24.5% and SD rate was 30.1%. Median PFS was 7 months and median OS was 14 months. T-DM1 is active in breast cancer patients with BMs.