Evolving treatments and outcomes in HER2-Positive metastatic breast cancer: Data from the GIM14/BIOMETA study
Massimo Di Maio,
Claudia Bighin,
Francesco Schettini,
Tommaso Ruelle,
Laura Marandino,
Alessandra Fabi,
Carmine De Angelis,
Mario Giuliano,
Pietro De Placido,
Michelino De Laurentiis,
Ferdinando Riccardi,
Caterina Picotto,
Fabio Puglisi,
Lucia Del Mastro,
Grazia Arpino
Affiliations
Massimo Di Maio
Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
Claudia Bighin
Department of Medical Oncology, U.O. Oncologia Medica 2, Ospedale Policlinico San Martino, Genoa, Italy
Francesco Schettini
Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
Tommaso Ruelle
Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
Laura Marandino
Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
Alessandra Fabi
Precision Medicine in Senology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
Carmine De Angelis
Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy
Mario Giuliano
Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy
Pietro De Placido
Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy
Michelino De Laurentiis
Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, Italy
Ferdinando Riccardi
Oncology Unit, Antonio Cardarelli Hospital, Naples, Italy
Caterina Picotto
Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy
Fabio Puglisi
Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy; Department of Medicine (DAME), University of Udine, Udine, Italy
Lucia Del Mastro
Department of Medical Oncology, U.O. Oncologia Medica 2, Ospedale Policlinico San Martino, Genoa, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
Grazia Arpino
Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy; Corresponding author: , Oncology Division, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini 5, 80100, Naples, Italy. +39 081 7463772
Background: Treatment for HER2-positive (+) metastatic breast cancer has improved in the last decade. We analyzed treatment changes over time and their impact on patients outcomes in a real-world dataset. Methods: Data from 637 HER2+ patients with metastatic breast cancer enrolled in the multicenter Italian GIM14/BIOMETA study were retrieved. Progression-free survival (PFS) over time was evaluated according to the type of anti-HER2 therapy, disease onset (de novo vs. relapsing), metastatic site, and year of treatment (2000–2013 vs. 2014–2020). Results: Median follow-up was 64.4 months. Overall, for first-line therapies, mPFS was 16.5 vs 19.5 months for patients treated in 2000–2013 vs 2014–2020 (HR: 0.78, 95% CI:0.65–0.94, P = 0.008). mPFS improved over time in all patients except for those with brain metastasis. Interestingly mPFS was 17.4 vs13.4 months (HR, 1.49; 95% CI, 1.13–1.98, P = 0.005) in 2000–2013 and 24.4 vs 20.9 months (HR 1.04; 95% CI 0.78–1.40 p = 0.77) in 2014–2020 in pts without vs with liver metastases. For second line therapies, the overall median PFS was 9.6 months (95% CI, 8.31–10.97) and did not change over time. Conclusion: Median first-line PFS improved since 2014, mainly due to the introduction of pertuzumab. The outcome of patients with liver metastases appears to have improved in recent years. Patients with brain metastases had the worst PFS, which also did not improve over time.
