Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study
Background: Trastuzumab emtansine (T-DM1) has demonstrated improvements in survival and neurological symptoms in patients with breast cancer with brain metastases (BCBM). This real-world study investigated the effectiveness of T-DM1 versus lapatinib plus capecitabine (LC) in patients with BCBM. Meth...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Breast |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977623000073 |
| _version_ | 1827926665020309504 |
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| author | Thibaut Sanglier Jinjoo Shim Neil Lamarre Claudia Peña-Murillo Vincent Antao Filippo Montemurro |
| author_facet | Thibaut Sanglier Jinjoo Shim Neil Lamarre Claudia Peña-Murillo Vincent Antao Filippo Montemurro |
| author_sort | Thibaut Sanglier |
| collection | DOAJ |
| description | Background: Trastuzumab emtansine (T-DM1) has demonstrated improvements in survival and neurological symptoms in patients with breast cancer with brain metastases (BCBM). This real-world study investigated the effectiveness of T-DM1 versus lapatinib plus capecitabine (LC) in patients with BCBM. Methods: This retrospective, observational study evaluated patients with HER2–positive BCBM using a real-world database. Eligible patients had initiated T-DM1 or LC with a prior diagnosis of brain metastasis and ≥1 prior metastatic breast cancer treatment. The primary endpoint was overall survival (OS); secondary endpoints were time to next relevant treatment or death (TTNT) and real-world progression-free survival (rwPFS). An inverse probability of treatment weighting (IPTW) approach was used to account for differences in potential baseline characteristics between treatment groups. Outcomes were described using the Kaplan-Meier method, and the average treatment effect of initiating T-DM1 versus LC was estimated using weighted Cox proportional hazard models and hazard ratio (HR). Results: A total of 214 patients were available for analysis (T-DM1, n = 161; LC, n = 53). Demographics and baseline characteristics were generally well-balanced between treatment groups after weighting. After weighting, median OS was 17.7 (T-DM1) versus 9.6 (LC) months (HR, 0.55 [95% CI, 0.34–0.89]; P=0.013). Median TTNT was 9.0 (T-DM1) versus 6.0 (LC) months (HR, 0.55 [95% CI, 0.36–0.85]; P = 0.005). After weighting, median rwPFS was 6.0 (T-DM1) versus 4.0 (LC) months (HR, 0.50 [95% CI, 0.36–0.69]; P < 0.001). Conclusions: These results support the superior effectiveness and clinical relevance of T-DM1 versus LC in patients with HER2-positive BCBM in the real world. |
| first_indexed | 2024-03-13T05:41:08Z |
| format | Article |
| id | doaj.art-dc6441ba5eec4f8093e6c924597ba37f |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-03-13T05:41:08Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-dc6441ba5eec4f8093e6c924597ba37f2023-06-14T04:32:37ZengElsevierBreast1532-30802023-06-0169441450Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world studyThibaut Sanglier0Jinjoo Shim1Neil Lamarre2Claudia Peña-Murillo3Vincent Antao4Filippo Montemurro5F. Hoffmann-La Roche, Basel, Switzerland; Corresponding author. F. Hoffmann-La Roche, Grenzacherstrasse 124, 4070 Basel, Switzerland.F. Hoffmann-La Roche, Basel, SwitzerlandGenesis Research, Hoboken, NJ, USAF. Hoffmann-La Roche, Basel, SwitzerlandGenentech Inc., South San Francisco, CA, USACandiolo Cancer Institute, FPO-IRCCS, ItalyBackground: Trastuzumab emtansine (T-DM1) has demonstrated improvements in survival and neurological symptoms in patients with breast cancer with brain metastases (BCBM). This real-world study investigated the effectiveness of T-DM1 versus lapatinib plus capecitabine (LC) in patients with BCBM. Methods: This retrospective, observational study evaluated patients with HER2–positive BCBM using a real-world database. Eligible patients had initiated T-DM1 or LC with a prior diagnosis of brain metastasis and ≥1 prior metastatic breast cancer treatment. The primary endpoint was overall survival (OS); secondary endpoints were time to next relevant treatment or death (TTNT) and real-world progression-free survival (rwPFS). An inverse probability of treatment weighting (IPTW) approach was used to account for differences in potential baseline characteristics between treatment groups. Outcomes were described using the Kaplan-Meier method, and the average treatment effect of initiating T-DM1 versus LC was estimated using weighted Cox proportional hazard models and hazard ratio (HR). Results: A total of 214 patients were available for analysis (T-DM1, n = 161; LC, n = 53). Demographics and baseline characteristics were generally well-balanced between treatment groups after weighting. After weighting, median OS was 17.7 (T-DM1) versus 9.6 (LC) months (HR, 0.55 [95% CI, 0.34–0.89]; P=0.013). Median TTNT was 9.0 (T-DM1) versus 6.0 (LC) months (HR, 0.55 [95% CI, 0.36–0.85]; P = 0.005). After weighting, median rwPFS was 6.0 (T-DM1) versus 4.0 (LC) months (HR, 0.50 [95% CI, 0.36–0.69]; P < 0.001). Conclusions: These results support the superior effectiveness and clinical relevance of T-DM1 versus LC in patients with HER2-positive BCBM in the real world.http://www.sciencedirect.com/science/article/pii/S0960977623000073Trastuzumab emtansineHER2-Positive metastatic breast cancerBrain metastasesLapatinib plus capecitabineReal-world |
| spellingShingle | Thibaut Sanglier Jinjoo Shim Neil Lamarre Claudia Peña-Murillo Vincent Antao Filippo Montemurro Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study Breast Trastuzumab emtansine HER2-Positive metastatic breast cancer Brain metastases Lapatinib plus capecitabine Real-world |
| title | Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study |
| title_full | Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study |
| title_fullStr | Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study |
| title_full_unstemmed | Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study |
| title_short | Trastuzumab emtansine vs lapatinib and capecitabine in HER2-positive metastatic breast cancer brain metastases: A real-world study |
| title_sort | trastuzumab emtansine vs lapatinib and capecitabine in her2 positive metastatic breast cancer brain metastases a real world study |
| topic | Trastuzumab emtansine HER2-Positive metastatic breast cancer Brain metastases Lapatinib plus capecitabine Real-world |
| url | http://www.sciencedirect.com/science/article/pii/S0960977623000073 |
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