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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

3906 - Pertuzumab, Trastuzumab and Taxane combination for Visceral Organ Metastatic Patients: Real Life Practice Results

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Immunotherapy;  Breast Cancer

Presenters

Ece Esin

Citation

Annals of Oncology (2018) 29 (suppl_8): viii90-viii121. 10.1093/annonc/mdy272

Authors

E. Esin1, O.B. Cakmak Oksuzoglu2, A. Bilici3, I. Cicin4, S. Aksoy5, A. Alacacioglu6, M.A. Kaplan7, D. Cabuk8, A.T. Sumbul9, S. Paydas10, A. Sakin11, Ö. Er12, T. Korkmaz13, N. Yildirim14, M. Artac15, H. Harputluoglu16, P.F. Yumuk17, G. Basaran13, B. Oyan Uluc18, U. Demirci19

Author affiliations

  • 1 Medical Oncology, University of Health Sciences, Ankara Oncology Education and Research Hospital, 06510 - Ankara/TR
  • 2 Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital, 6200 - Ankara/TR
  • 3 Department Of Medical Oncology, Medipol Mega Hospitals Complex (University Hospital), 34214 - Istanbul/TR
  • 4 Department Of Medical Oncology, Trakya University Faculty of Medicine, Edirne/TR
  • 5 Medical Oncology, Hacettepe University Faculty of Medicine, 6100 - Ankara/TR
  • 6 Medical Oncology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, 35360 - Izmir/TR
  • 7 Medical Oncology, Dicle University, 21280 - Diyarbakir/TR
  • 8 Medical Oncology, Kocaeli University, 41380 - Kocaeli/TR
  • 9 Medical Oncology, Baskent University Faculty of Medicine Adana Uygulama Ve Arastirma Mer., 1120 - Adana/TR
  • 10 Department Of Medical Oncology, Faculty Of Medicine, Cukurova University, Adana/TR
  • 11 Department Of Medical Oncology, Okmeydanı Education and Research Hospital, Istanbul/TR
  • 12 Medical Oncology, Ac?badem Maslak Hastanesi, 34457 - Istanbul/TR
  • 13 Medical Oncology, Istanbul Acibadem University, 34600 - Istanbul/TR
  • 14 Oncology, Gaziantep Dr. Ersin Arslan Goverment Hospital, 27060 - Gaziantep/TR
  • 15 Medical Oncology, Necmettin Erbakan University, Konya/TR
  • 16 Medical Oncology, Inonu University Turgut Ozal Institute, Diyarbakir/TR
  • 17 Medical Oncology, Marmara University, Istanbul/TR
  • 18 Medical Oncology, Acibadem Antunizade Hospital, Istanbul/TR
  • 19 Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital, 06200 - Ankara/TR
More

Resources

Abstract 3906

Background

Anti-HER2 agents were a breakthrough in the treatment of HER2-enriched breast cancer (BC). In this study, we aimed to describe the real-life efficacy and safety of pertuzumab-trastuzumab-taxane (PTT) combination in BC patients.

Methods

This study was conducted by the Turkish Oncology Group and reached 35 centers nationwide. 309 visceral metastatic, and trastuzumab naive patients who received first line PTT were included.

Results

Patients' characteristics and treatment details are summarized in the table. Median progression-free survival (PFS) was 28.5 months (95% CI:15.6-41.4), while median overall survival (OS) was 40.3 months (95%CI: 26.9-53.7). Brain metastatic patients (n = 13, 4.2%) had worse PFS (16.8m vs. 28.5m; HR:3.9, 95% CI:1.7-9.2, p = 0.002) and OS (26.7m vs. 40.3m; HR:3.2, 95% CI:1.3-7.6, p = 0.009). Elderly patients (>65y) had significantly lower OS results (19.8m vs. 40.3m; HR:0.4, %95 CI:0.2-0.8, p = 0.01). Docetaxel was the choice in 268 patients (86.7%), while 41 patients (13.3%) received paclitaxel. There was no statistically significant difference in PFS (28.5 m vs. 24.1 m; p = 0.61) and OS (40.3 m vs. NR; p = 0.17) between taxane groups. Additionally, ≥10 cycles of docetaxel were not associated with improvement in outcomes compared with 6-10 cycles. One treatment-related death due to sepsis was noted. In 8 patients (2.6%), 5-40% ejection fraction decrease from baseline was detected without any sign of heart failure.Table: 325P

Demographic characteristics and treatment details

N = 309%
Median age (year, range)51 (22-82)
>65 years-old patients3912.6
De-novo metastatic patients25883.5
Histopathology
IDC29093.9
ILC31
Mixt51.6
Others113.5
Hormone receptor status
ER and/or PR positive17055.2
ER/PR negative13844.8
Unknown10.3
Metastatic site distribution
Liver ± LN/skeletal11236.3
Lung ± LN/skeletal12038.8
Brain only61.9
Brain + liver + lung72.3
Liver + lung165.2
Other4815.5
Only skeletal or only LN--
Prior therapies
Prior anthracyclines5116.5
Prior trastuzumabNANA
Treatment details
Median number of cycle (range)
Pertuzumab-trastuzumab10 (1-75)
Docetaxel6 (1-23)
Paclitaxel3 (1- 26)

IDC: Invasive Ductal Carcinoma ILC: Invasive lobular carcinoma LN: Lymph Node

Conclusions

This real-life practice population differs from the CLEOPATRA study in terms of visceral only metastatic disease, and inclusion of brain metastatic patients. Regardless of these negative prognostic characteristics, results are concordant with the pivotal study. Elderly patients had overall lower PFS, which necessitates further investigation of pertuzumab-trastuzumab combination with cytotoxic/antihormonal therapies. To our knowledge, this is the largest scale real-life clinical practice study of PTT to date.

Clinical trial identification

Legal entity responsible for the study

Ece ESIN, on behalf of Turkish Oncology Group.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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