Frontiers in Oncology (May 2020)
Effectiveness and Safety of Pyrotinib, and Association of Biomarker With Progression-Free Survival in Patients With HER2-Positive Metastatic Breast Cancer: A Real-World, Multicentre Analysis
- Qitong Chen,
- Dengjie Ouyang,
- Dengjie Ouyang,
- Munawar Anwar,
- Ning Xie,
- Shouman Wang,
- Peizhi Fan,
- Liyuan Qian,
- Gannong Chen,
- Enxiang Zhou,
- Lei Guo,
- Xiaowen Gu,
- Boni Ding,
- Xiaohong Yang,
- Liping Liu,
- Chao Deng,
- Zhi Xiao,
- Jing Li,
- Yunqi Wang,
- Shan Zeng,
- Jinhui Hu,
- Wei Zhou,
- Bo Qiu,
- Zhongming Wang,
- Jie Weng,
- Mingwen Liu,
- Yi Li,
- Tiegang Tang,
- Jianguo Wang,
- Hui Zhang,
- Bin Dai,
- Wuping Tang,
- Tao Wu,
- Maoliang Xiao,
- Xiantao Li,
- Hailong Liu,
- Lai Li,
- Wenjun Yi,
- Quchang Ouyang
Affiliations
- Qitong Chen
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Dengjie Ouyang
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Dengjie Ouyang
- Department of General Surgery, Xiangya Hospital Central South University, Changsha, China
- Munawar Anwar
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Ning Xie
- Department of Breast Internal Medicine, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- Shouman Wang
- Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
- Peizhi Fan
- Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital, Changsha, China
- Liyuan Qian
- Department of Breast and Thyroid Surgery, Central South University Third Xiangya Hospital, Changsha, China
- Gannong Chen
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Enxiang Zhou
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Lei Guo
- Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China
- Xiaowen Gu
- Department of Breast and Thyroid Surgery, Hunan Provincial People's Hospital, Changsha, China
- Boni Ding
- Department of Breast and Thyroid Surgery, Central South University Third Xiangya Hospital, Changsha, China
- Xiaohong Yang
- Department of Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Cental South University, Changsha, China
- Liping Liu
- Department of Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Cental South University, Changsha, China
- Chao Deng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Zhi Xiao
- Department of Breast Internal Medicine, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- Jing Li
- Department of Breast Medical Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Cental South University, Changsha, China
- Yunqi Wang
- 0Department of Traditional Chinese Medicine, The Affiliated Cancer Hospital of Xiangya School of Medicine, Cental South University, Changsha, China
- Shan Zeng
- 1Department of Internal Medicine – Oncology, Xiangya Hospital Central South University, Changsha, China
- Jinhui Hu
- 2Department of Breast Surgery, The First Hospital Hunan University of Chinese Medicine, Changsha, China
- Wei Zhou
- 3Department of Breast and Thyroid Surgery, The Affiliated ZhuZhou Hospital of Xiangya School of Medicine Central South University, Zhuzhou, China
- Bo Qiu
- 4Department of Oncology, The Affiliated ZhuZhou Hospital of Xiangya School of Medicine Central South University, Zhuzhou, China
- Zhongming Wang
- 5Department of Breast Surgery, The Third People's Hospital of Yongzhou, Yongzhou, China
- Jie Weng
- 6Department of Oncology, The First People's Hospital of Yueyang, Yueyang, China
- Mingwen Liu
- 7Department of Breast and Thyroid Surgery, The First People's Hospital of Xiangtan City, Xiangtan, China
- Yi Li
- 8Department of Oncology, The Third People's Hospital of Changde, Changde, China
- Tiegang Tang
- 9Department of Oncology, Xiangtan Central Hospital, Xiangtan, China
- Jianguo Wang
- 0Department of General Surgery, Xiangtan Central Hospital, Xiangtan, China
- Hui Zhang
- 1Department of Oncology, Central Hospital of Shaoyang, Shaoyang, China
- Bin Dai
- 2Department of Breast and Thyroid Surgery, Central Hospital of Shaoyang, Shaoyang, China
- Wuping Tang
- 3Department of Breast Surgery, Shaoyang Hospital of Traditional Chinese Medicine, Shaoyang, China
- Tao Wu
- 4Department of Oncology, The First People's Hospital of Changde, Changde, China
- Maoliang Xiao
- 5Department of Oncology, The Third Hospital of Hunan University of Chinese Medicine, Zhuzhou, China
- Xiantao Li
- 6Department of Oncology, The Central Hospital of Yiyang, Yiyang, China
- Hailong Liu
- 7Department of Internal Medicine – Oncology, The First People's Hospital of Chenzhou, Chenzhou, China
- Lai Li
- 8Department of Breast and Thyroid Surgery, The People's Hospital of Xiangtan County, Xiangtan, China
- Wenjun Yi
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Quchang Ouyang
- Department of Breast Internal Medicine, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
- DOI
- https://doi.org/10.3389/fonc.2020.00811
- Journal volume & issue
-
Vol. 10
Abstract
Background: Pyrotinib, an irreversible pan-ERBB inhibitor, has shown promising antitumour activity, and acceptable tolerability. This research was conducted to evaluate the actual use and effectiveness of pyrotinib in China, therefore, contributed to solve the problem of real-world data scarcity.Methods: In this retrospective study, 168 patients who received pyrotinib treatment for HER2-positive metastatic breast cancer (MBC) in Hunan Province from June 2018 to August 2019 were included. Progression-free survival (PFS), tumor mutation burden (TMB), and drug-related adverse events (AEs) after pyrotinib administration were analyzed.Results: The median PFS (mPFS) time in the 168 participants was 8.07 months. The mPFS times in patients with pyrotinib in second-line therapy (n = 65) and third-or-higher-line therapy (n = 94) were 8.10 months and 7.60 months, respectively. Patients with brain metastases achieved 8.80 months mPFS time. In patients with pyrotinib in third-or-higher-line therapy, patients who had previously used lapatinib still got efficacy but showed a shorter mPFS time (6.43 months) than patients who had not (8.37 months). TMB was measured in 28 patients, K-M curve (P = 0.0024) and Multivariate Cox analysis (P = 0.0176) showed a significant negative association between TMB and PFS. Diarrhea occurred in 98.2% of participants (in any grade) and 19.6% in grade 3–4 AEs.Conclusion: Pyrotinib is highly beneficial to second-or-higher-line patients or HER2-positive MBC patients with brain metastases. Pyrotinib seems to be a feasible strategy both in combination of chemotherapeutic drugs or as a replacement of lapatinib if diseases progressed. TMB could be a potential predictor for evaluating pyrotinib's effectiveness in HER2-positive MBC.
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