The Efficacy of Pyrotinib as a Third- or Higher-Line Treatment in HER2-Positive Metastatic Breast Cancer Patients Exposed to Lapatinib Compared to Lapatinib-Naive Patients: A Real-World Study

D. J Ouyang; D. J Ouyang; Q. T Chen; M. Anwar; N. Xie; Q. C. Ouyang; P. Z. Fan; L. Y. Qian; G. N. Chen; E. X. Zhou; L. Guo; X. W. Gu; B. N. Ding; X. H. Yang; L. P. Liu; C. Deng; Z. Xiao; J. Li; Y. Q. Wang; S. Zeng; Shouman Wang; Wenjun Yi

doi:10.3389/fphar.2021.682568

Frontiers in Pharmacology (Aug 2021)

The Efficacy of Pyrotinib as a Third- or Higher-Line Treatment in HER2-Positive Metastatic Breast Cancer Patients Exposed to Lapatinib Compared to Lapatinib-Naive Patients: A Real-World Study

D. J Ouyang,
D. J Ouyang,
Q. T Chen,
M. Anwar,
N. Xie,
Q. C. Ouyang,
P. Z. Fan,
L. Y. Qian,
G. N. Chen,
E. X. Zhou,
L. Guo,
X. W. Gu,
B. N. Ding,
X. H. Yang,
L. P. Liu,
C. Deng,
Z. Xiao,
J. Li,
Y. Q. Wang,
S. Zeng,
Shouman Wang,
Wenjun Yi

Affiliations

D. J Ouyang: Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
D. J Ouyang: Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China
Q. T Chen: Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
M. Anwar: Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
N. Xie: Department of Internal Medicine of Breast, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
Q. C. Ouyang: Department of Internal Medicine of Breast, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
P. Z. Fan: Department of Breast and Thyroid Surgery, Hunan Provincial People’s Hospital, Changsha, China
L. Y. Qian: Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China
G. N. Chen: Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
E. X. Zhou: Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
L. Guo: Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
X. W. Gu: Department of Breast and Thyroid Surgery, Hunan Provincial People’s Hospital, Changsha, China
B. N. Ding: Department of Breast and Thyroid Surgery, Third Xiangya Hospital, Central South University, Changsha, China
X. H. Yang: Department of Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
L. P. Liu: Department of Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
C. Deng: Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
Z. Xiao: Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
J. Li: Department of Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
Y. Q. Wang: Department of Traditional Chinese Medicine, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
S. Zeng: 0Department of Internal Medicine–Oncology, Xiangya Hospital, Central South University, Changsha, China
Shouman Wang: Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
Wenjun Yi: Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China

DOI: https://doi.org/10.3389/fphar.2021.682568
Journal volume & issue: Vol. 12

Abstract

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Background: Pyrotinib is a novel irreversible pan-ErbB receptor tyrosine kinase inhibitor. Evidence of the efficacy of pyrotinib-based treatments for HER2-positive metastatic breast cancer (MBC) in patients exposed to lapatinib is limited.Methods: Ninety-four patients who received pyrotinib as a third- or higher-line treatment for HER2-positive MBC were included in this retrospective study. The primary and secondary endpoints were overall survival (OS) and progression‐free survival (PFS). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were implemented to balance important patient characteristics between groups.Results: Thirty (31.9%) patients were pretreated with lapatinib and subsequently received pyrotinib as an anti-HER2 treatment, and 64 (68.1%) patients did not receive this treatment. The OS and PFS indicated a beneficial trend in lapatinib-naive group compared to lapatinib-treated group in either the original cohort (PFS: 9.02 vs 6.36 months, p = 0.05; OS: 20.73 vs 14.35 months, p = 0.08) or the PSM (PFS: 9.02 vs 6.08 months, p = 0.07; OS: 19.07 vs 18.00 months, p = 0.61) or IPTW (PFS: 9.90 vs 6.17 months, p = 0.05; OS: 19.53 vs 15.10 months, p = 0.08) cohorts. Subgroup analyses demonstrated lapatinib treatment-related differences in PFS in the premenopausal subgroup and the no prior trastuzumab treatment subgroup, but no significant differences were observed in OS.Conclusion: Pyrotinib-based therapy demonstrated promising effects in HER2-positive MBC patients in a real-world study, especially in lapatinib-naive patients, and also some activity in lapatinib-treated patients.

Published in Frontiers in Pharmacology

ISSN: 1663-9812 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Therapeutics. Pharmacology
Website: http://journal.frontiersin.org/journals/pharmacology

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