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Research Article
Ewelina Biskup
Shanghai University of Medicine and Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9871-927X
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Background: Trastuzumab and pertuzumab with taxane-based chemotherapy are considered the first-line standard therapy for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (mBC). Pertuzumab is also a later-line therapy for mBC in Switzerland, although limited safety and efficacy data are available. This study assesses the therapeutic regimens, toxicities, and clinical outcomes after second- or later-line pertuzumab therapy in patients with mBC who did not receive pertuzumab as a first-line therapy.
Materials and Methods: Physicians from major Swiss oncology centers retrospectively completed a questionnaire for each pertuzumab-naive patient who was treated with pertuzumab as a second- or later-line therapy.
Results: Of 35 patients with HER2-positive mBC (median age: 49 years; range: 35-87 years), 14 received pertuzumab as a second-line therapy, six as a third-line therapy, and 15 as a fourth- or later-line therapy. Twenty patients (57%) died during the study period. The median overall survival was 74.2 months (95% confidence interval: 47.6-139.8 months). Grade (G) 3/4 adverse events (AEs) were reported in 14% of patients, with only one patient discontinuing therapy due to pertuzumab-related toxicities. The most common AE was fatigue (overall: 46%; G3: 11%). Overall, congestive heart disease occurred in 14% of patients (G3: 6%), nausea in 14% (all G1), and myelosuppression in 12% (G3: 6%).
Conclusion: The median overall survival of second- or later-line pertuzumab is similar to that reported for first-line pertuzumab, and the safety profile was acceptable. These data support using pertuzumab for second- or later-line therapy when it was not administered as first-line therapy.
Keywords
metastatic breast cancer, pertuzumab, trastuzumab, human epidermal growth factor receptor 2, second-line therapy, overall survival
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This preprint is under consideration at Breast Cancer Research and Treatment. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Ewelina Biskup
Shanghai University of Medicine and Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9871-927X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 10 Nov, 2021
No community comments so far
Reviews received
Received 15 Nov, 2021
Reviewers invited
Invitations sent on 04 Nov, 2021
First submitted
On 11 Oct, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Trastuzumab and pertuzumab with taxane-based chemotherapy are considered the first-line standard therapy for human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (mBC). Pertuzumab is also a later-line therapy for mBC in Switzerland, although limited safety and efficacy data are available. This study assesses the therapeutic regimens, toxicities, and clinical outcomes after second- or later-line pertuzumab therapy in patients with mBC who did not receive pertuzumab as a first-line therapy.
Materials and Methods: Physicians from major Swiss oncology centers retrospectively completed a questionnaire for each pertuzumab-naive patient who was treated with pertuzumab as a second- or later-line therapy.
Results: Of 35 patients with HER2-positive mBC (median age: 49 years; range: 35-87 years), 14 received pertuzumab as a second-line therapy, six as a third-line therapy, and 15 as a fourth- or later-line therapy. Twenty patients (57%) died during the study period. The median overall survival was 74.2 months (95% confidence interval: 47.6-139.8 months). Grade (G) 3/4 adverse events (AEs) were reported in 14% of patients, with only one patient discontinuing therapy due to pertuzumab-related toxicities. The most common AE was fatigue (overall: 46%; G3: 11%). Overall, congestive heart disease occurred in 14% of patients (G3: 6%), nausea in 14% (all G1), and myelosuppression in 12% (G3: 6%).
Conclusion: The median overall survival of second- or later-line pertuzumab is similar to that reported for first-line pertuzumab, and the safety profile was acceptable. These data support using pertuzumab for second- or later-line therapy when it was not administered as first-line therapy.
Figure 1
Figure 2
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