International journal of clinical oncology · 2025
Anti-HER2 plus endocrine therapy versus anti-HER2 plus chemotherapy in hormone receptor-positive and HER2-positive metastatic breast cancer: a retrospective study.
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Fan Zhenhua, Yuan Yang, Chen Xiaoyan, Wang Tao, Zhang Shaohua, Bian Li, Mo Xueli
Аннотация
BACKGROUND: No clinical trials demonstrated anti-HER2 plus chemotherapy (anti-HER2 + ChT) was superior to anti-HER2 plus endocrine therapy (anti-HER2 + ET) in HR + /HER2 + MBC. This study aims to compare efficacy of anti-HER2 + ET with anti-HER2 + ChT in real-world clinical practice, and analyze clinical outcome of anti-HER2 + ET as maintenance therapy after benefiting from anti-HER2 + ChT.
METHODS: This study retrospectively compared two regimens: anti-HER2 + ChT vs anti-HER2 + ET, utilizing chi-square tests for response rate comparisons and Kaplan-Meier approach for survival analysis.
RESULTS: Totally, 241 eligible patients were included in this study. In first-line setting, 197 patients (81.7%) received anti-HER2 + ChT and 44 (18.3%) received anti-HER2 + ET. Objective response rate (54.3% vs 11.4%, P < 0.001) and clinical benefit rate (82.7% vs 68.2%, P = 0.029) of anti-HER2 + ChT group were higher than those of anti-HER2 + ET. PFS analysis showed there was no significant difference between anti-HER2 + ChT and anti-HER2 + ET in first-line (mPFS, 15.0 m [95%CI 12.1-17.9] vs 9.0 m [95%CI 0.5-17.5]; HR 1.32 [0.88-1.98]; P = 0.162) and the front two lines of treatment (PFS-2, 26.0 m [95%CI 23.0-29.0] vs 24.0 m [95%CI 15.9-32.1]; HR 1.03 [0.64-1.64]; P = 0.919). Notably, PFS of patients with anti-HER2 + ChT maintained by anti-HER2 + ET was superior to anti-HER2 + ET (24.0 m [95%CI 18.0-30.0] vs 17.0 m [95%CI 9.5-24.5]; HR 0.53 [0.32-0.89]; P = 0.005) and other anti-HER2 + ChT group (24.0 m vs 12.0 m [95%CI 9.1-15.0]; HR 0.52 [0.36-0.76]; P < 0.001).
CONCLUSION: While anti-HER2 + ChT showed superior disease control over anti-HER2 + ET, it didn't confer a survival advantage, possibly due to small sample size or retrospective design constraints. For patients deriving benefit from anti-HER2 + ChT, transitioning to maintenance therapy with anti-HER2 + ET may represent an optional strategy.
METHODS: This study retrospectively compared two regimens: anti-HER2 + ChT vs anti-HER2 + ET, utilizing chi-square tests for response rate comparisons and Kaplan-Meier approach for survival analysis.
RESULTS: Totally, 241 eligible patients were included in this study. In first-line setting, 197 patients (81.7%) received anti-HER2 + ChT and 44 (18.3%) received anti-HER2 + ET. Objective response rate (54.3% vs 11.4%, P < 0.001) and clinical benefit rate (82.7% vs 68.2%, P = 0.029) of anti-HER2 + ChT group were higher than those of anti-HER2 + ET. PFS analysis showed there was no significant difference between anti-HER2 + ChT and anti-HER2 + ET in first-line (mPFS, 15.0 m [95%CI 12.1-17.9] vs 9.0 m [95%CI 0.5-17.5]; HR 1.32 [0.88-1.98]; P = 0.162) and the front two lines of treatment (PFS-2, 26.0 m [95%CI 23.0-29.0] vs 24.0 m [95%CI 15.9-32.1]; HR 1.03 [0.64-1.64]; P = 0.919). Notably, PFS of patients with anti-HER2 + ChT maintained by anti-HER2 + ET was superior to anti-HER2 + ET (24.0 m [95%CI 18.0-30.0] vs 17.0 m [95%CI 9.5-24.5]; HR 0.53 [0.32-0.89]; P = 0.005) and other anti-HER2 + ChT group (24.0 m vs 12.0 m [95%CI 9.1-15.0]; HR 0.52 [0.36-0.76]; P < 0.001).
CONCLUSION: While anti-HER2 + ChT showed superior disease control over anti-HER2 + ET, it didn't confer a survival advantage, possibly due to small sample size or retrospective design constraints. For patients deriving benefit from anti-HER2 + ChT, transitioning to maintenance therapy with anti-HER2 + ET may represent an optional strategy.
Предметные рубрики MeSH
Retrospective StudiesErb-b2 Receptor Tyrosine KinasesAntineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsKaplan-Meier EstimateAntineoplastic Agents, HormonalProgression-Free SurvivalMaintenance ChemotherapyReceptors, EstrogenReceptors, ProgesteroneDisease ProgressionAromatase InhibitorsSelective Estrogen Receptor ModulatorsTyrosine Kinase InhibitorsImmunoconjugatesHumansFemaleYoung AdultAdultMiddle AgedAgedAnthracyclinesTaxoids