Pertuzumab as second‑ or later‑line therapy for human epidermal growth factor receptor 2‑positive metastatic breast cancer: A clinical experience

Biskup,Ewelina; Sartorius,Céline Montavon; Müller,Andreas; Leo,Cornelia; Nussbaum,Catrina Uhlmann; Georgescu Margarint,Elena Laura; Koychev,Daniel; Schreiber,Alexander; Taverna,Christian; Thorn,David; Vetter,Marcus

doi:10.3892/mco.2023.2648

Pertuzumab as second‑ or later‑line therapy for human epidermal growth factor receptor 2‑positive metastatic breast cancer: A clinical experience

Authors:
- Ewelina Biskup
- Céline Montavon Sartorius
- Andreas Müller
- Cornelia Leo
- Catrina Uhlmann Nussbaum
- Elena Laura Georgescu Margarint
- Daniel Koychev
- Alexander Schreiber
- Christian Taverna
- David Thorn
- Marcus Vetter
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Affiliations: Department of Basic and Clinical Medicine, Shanghai University of Medicine and Health Sciences, Shanghai 201318, P.R. China, Department of Medical Oncology and Breast Cancer Center, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland, Canton Hospital Winterthur (Med. Oncology), 8400 Winterthur, Switzerland, Department of Gynecology, Canton Hospital Baden, 5404 Baden, Switzerland, Department of Internal Medicine, Canton Hospital Olten, 4600 Olten, Switzerland, Shanghai East International Medical Center, Shanghai 200120, P.R. China, Tumor Center ZeTuP, 8640 Rapperswil, Switzerland, Canton Hospital Aarau, 5001 Aarau, Switzerland, Canton Hospital Muensterlingen, 8596 Münsterlingen, Switzerland, Oncology Private Practice Basel, Department of Medical Oncology, University Hospital Basel, 4052 Basel, Switzerland, Medical University Clinic, Canton Hospital Baselland, University of Basel, 4410 Liestal, Switzerland
Published online on: May 18, 2023 https://doi.org/10.3892/mco.2023.2648
Article Number: 52
Copyright: © Biskup et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Trastuzumab and pertuzumab with taxane‑based chemotherapy are considered the first‑line standard therapy for human epidermal growth factor receptor 2 (HER2)‑positive metastatic breast cancer (mBC). Pertuzumab is also a later‑line therapy for mBC in Switzerland, although limited safety and efficacy data are available. The present study assessed the therapeutic regimens, toxicities and clinical outcomes after second‑ or later‑line pertuzumab therapy in patients with mBC who did not receive pertuzumab as a first‑line therapy. Physicians from nine major Swiss oncology centers retrospectively completed a questionnaire for each pertuzumab‑naive patient who was treated with pertuzumab as a second‑ or later‑line therapy. Of 35 patients with HER2‑positive mBC (median age, 49 years; range, 35‑87 years), 14 received pertuzumab as a second‑line therapy, 6 as a third‑line therapy, and 15 as a fourth‑ or later‑line therapy. A total of 20 patients (57%) died during the study period. The median overall survival was 74.2 months (95% confidence interval, 47.6‑139.8 months). Grade (G) 3/4 adverse events (AEs) were reported in 14% of patients, with only 1 patient discontinuing therapy due to pertuzumab‑related toxicities. The most common AE was fatigue (overall, 46%; G3, 11%). Overall, congestive heart disease occurred in 14% of patients (G3, 6%), nausea in 14% of patients (all G1), and myelosuppression in 12% of patients (G3, 6%). In conclusion, the median overall survival of patients who underwent second‑ or later‑line pertuzumab treatment was similar to that reported for patients who underwent first‑line pertuzumab treatment, and the safety profile was acceptable. These data support the use of pertuzumab for second‑ or later‑line therapy when it was not administered as first‑line therapy.

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