Efficacy of trastuzumab emtansine (T-DM1) in patients (pts) with HER2+ metastatic breast cancer (MBC) previously treated with pertuzumab (P).

Authors

null

Ander Urruticoechea

Onkologikoa Foundation, San Sebastian, Spain

Ander Urruticoechea , Seock-Ah Im , Montserrat Munoz , Jose Baselga , Denise A. Yardley , Sarah Heeson , Sarah Jones , Adam Knott , Hannah Douthwaite , Tanja Badovinac Crnjevic , Sandra M. Swain

Organizations

Onkologikoa Foundation, San Sebastian, Spain, Seoul National University, Seoul, Republic of Korea, Hospital Clínic de Barcelona, Barcelona, Spain, Memorial Sloan-Kettering Cancer Center, New York, NY, Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN, Roche Products, Ltd., Welwyn, United Kingdom, F. Hoffmann-La Roche Ltd., Basel, Switzerland, Georgetown University Medical Center, Washington, DC

Research Funding

Pharmaceutical/Biotech Company

Background: T-DM1 was approved for pts with HER2+ MBC previously treated with trastuzumab (H) and a taxane based on the phase III EMILIA study. P in combination with H + docetaxel (T) later became the first-line standard of care for HER2+ MBC, but there are limited data on T-DM1 efficacy in pts who previously received P. We present exploratory efficacy results from pts treated with T-DM1 any time after P from 2 phase III studies: CLEOPATRA and PHEREXA. Methods: CLEOPATRA (NCT00567190) and PHEREXA (NCT01026142) are randomized, 2-arm trials evaluating P-based regimens for HER2+ MBC. CLEOPATRA studies H + T + P vs HT + placebo in pts with no prior anti-HER2 treatment (tx) or chemotherapy for MBC, while PHEREXA studies H + capecitabine (C) +/− P in pts who progressed during/after previous H tx for MBC. We assessed overall survival (OS) in an exploratory analysis of pts who either received or did not receive T-DM1 at any time after discontinuing study-assigned tx in CLEOPATRA or PHEREXA. Results: Of 408 pts who received HTP in CLEOPATRA and 228 pts who received HCP in PHEREXA, 32 and 43 pts received subsequent T-DM1, respectively (Table). Median duration of T-DM1 tx was 7.1 mo (range 0−44) and 4.2 mo (range 0−22), respectively, and median time from discontinuation of P to start of T-DM1 was 3.5 mo (range 1−47) and 10.6 mo (range 1−28). Conclusions: Although data are limited in these exploratory analyses, our results provide additional evidence of T-DM1 clinical activity in pts with HER2+ MBC who progressed on prior P + H, a finding with real-world implications. Clinical trial information: NCT00567190, NCT01026142

No T-DM1T-DM1
CLEOPATRA
HT + placebo, n36234
Pts with event, n (%)198 (54.7)20 (58.8)
Median OS, mo (95% CI)39.6 (35–47)46.2 (34–57)
HRa(95% CI)0.93 (0.58–1.49)
P=0.7538b
HTP, n37632
Pts with event, n (%)158 (42.0)11 (34.4)
Median OS, mo (95% CI)61.4 (49–NR)NR (49–NR)
HRa(95% CI)0.62 (0.33–1.14)
P=0.1196b
PHEREXA
HC, n17939
Pts with event, n (%)98 (54.7)16 (41.0)
Median OS, mo (95% CI)23.7 (20–29)40.1 (31–57)
HRa(95% CI)0.45 (0.26–0.81)
P=0.0061b
HCP, n18543
Pts with event, n (%)82 (44.3)16 (37.2)
Median OS, mo (95% CI)32.8 (28–39)38.3 (34–NR)
HRa(95% CI)0.53 (0.30–0.94)
P=0.0283b

avs no T-DM1. bLog-rank P-value. HR, hazard ratio; NR, not reached.

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer—Metastatic

Track

Breast Cancer

Sub Track

HER2-Positive

Clinical Trial Registration Number

NCT00567190, NCT01026142

Citation

J Clin Oncol 35, 2017 (suppl; abstr 1023)

DOI

10.1200/JCO.2017.35.15_suppl.1023

Abstract #

1023

Poster Bd #

15

Abstract Disclosures