Clinico-pathological predictors of radiologic complete response to first-line anti-HER2 therapy in metastatic breast cancer
Year: 2024
Type: article
Abstract: Background: Up to 6-8% of patients with HER2 positive metastatic breast cancer (MBC) experience a radiologic complete response (rCR) to a first line of therapy, but these results mostly derive from dated and/or limited cohorts. Currently, there is limited data regarding which variables could predictive of a rCR to anti-HER2 therapies. Methods: Patients were selected from the database of the GIM14 study (NCT02284581) and classified according to the best radiologic response obtained to the first line anti-HER2 therapy and upon time-to-treatment-discontinuation (TTD). rCR was defined as complete response (CR) with a TTD > 3 months. The association across variables was tested through logistic regression and their prognostic impact in terms of overall survival (OS) was estimated using the Kaplan-Meier method and compared using the log-rank test. Results: Of the 3,423 patients included in the GIM14 study, 814 had HER2 positive MBC and data about best radiological response were available for 545 patients. Eighty patients (14.7%) experienced a rCR to first line anti-HER2 therapy with a TTD > 3 months. At multivariable analysis, HER2 Immunohistochemistry score 3+ (OR 2.03, p-value=0.01), presence of non visceral metastases (OR 1.51, p-value=0.01) and 1 metastatic site (OR 2.49, p-value= 0.01) were significantly associated with higher odds of obtaining a CR. Furthermore, amongst the 80 patients achieving a rCR, 56 (73%) experienced a durable and sustained CR with a TTD > 18 months. At multivariable analysis, only type of anti-HER2 therapy (OR 0.13 p-value<0.01 for trastuzumab-based therapy and OR 0.08, p-value=0.04 for other anti-HER2 therapy) was associated with a higher probability of achieving a CR with a TTD > 18 months. A median OS of 10.22 years was observed for patients that had achieved a CR to a first line anti-HER2 therapy and a TTD > 3 months. For patients with a CR and TTD > 18 months, a median OS of 12.73 years was observed. Conclusions: This study characterized a real-world cohort of HER2 positive MBC patients experiencing radiologic complete response to a first line treatment. Higher odds of achieving a complete response to a first-line anti-HER2 therapy with a TTD > 3 months were observed for HER2 Immunohistochemistry score 3+, presence of visceral metastases and presence of a single metastatic site. Additionally, a sustained complete response with a TTD > 18 months, was described in a subset of patients that had been exposed to a trastuzumab-based therapy.
Source: npj Breast Cancer
Authors: Linda Cucciniello, Eva Blondeaux, Claudia Bighin, Simona Gasparro, Stefania Russo, Arianna Dri, Palma Pugliese, Andrea Fontana, Enrico Cortesi, Antonella Ferzi, Ferdinando Riccardi, Valentina Sini, Luca Boni, Alessandra Fabi, Filippo Montemurro, Michelino De Laurentiis, Grazia Arpino, Lucia Del Mastro, Lorenzo Gerratana, Fabio Puglisi
Institutions: University of Udine, Centro di Riferimento Oncologico, Ospedale Policlinico San Martino, University of Genoa, Instituto Nazionale Tumori Regina Elena, Ospedale Santa Maria della Misericordia di Udine, Azienda sanitaria universitaria Friuli Centrale, Azienda Socio Sanitaria Territoriale Lariana, Azienda Ospedaliera Universitaria Pisana, Sapienza University of Rome, Azienda Ospedaliera Ospedale Civile di Legnano, Aziende Socio Sanitarie Territoriale Ovest Milanese, Ospedale Antonio Cardarelli, ASL Roma, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, Candiolo Cancer Institute, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Federico II University Hospital, University of Naples Federico II
Language: English
Topic: HER2/EGFR in Cancer Research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,490
Funder: Ministero della Salute
OpenAlex ID: W4405516129