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Combination drug hope for some breast cancer patients

Friday November 15th, 2019

Some patients with HER2-positive breast cancer have responded well to the combination drug T-DM1, new research reveals today (15 November 2019).

Dr Benedetta Conte, from the University of Genova, Italy, will tell the Advanced Breast Cancer Fifth International Consensus Conference (ABC5) in Lisbon, Portugal, today that it is the first time that the efficacy of T-DM1, which combines trastuzumab with DM1, as a second-line treatment has been demonstrated among patients who had previously received pertuzumab and whose breast cancer had started to metastasise.

This research, which is published in the latest edition of Clinical Breast Cancer, used information from the largest group of patients to be treated this way in a real-world setting.

The study team found that T-DM1 treatment resulted in the cancer shrinking or disappearing in one third of patients and nearly 40% of patients continued on the treatment for at least six months with their disease under control.

Dr Conte said: “Our study showed T-DM1 had a meaningful clinical effect after first-line pertuzumab. The length of time that patients lived on T-DM1 treatment without their disease getting worse was an average of over six months. The results from our study are real-world data, which improve the available evidence for recommendations for treatment of metastatic breast cancer after it has failed to respond or has returned after initial therapy and show that T-DM1 is a good option for these patients.”

Dr Conte and her colleagues identified 77 out of 2034 patients who were enrolled in the multi-centre, Gruppo Italiano Mammella (GIM) 14/BIOMETA study, which looked at treatment patterns and outcomes in patients with metastatic breast cancer.

The 77 patients had metastatic, HER2-positive breast cancer and had received second-line treatment with T-DM1 between November 2013 and May 2018 after initial treatment with pertuzumab, trastuzumab and a taxane.

The study comprised a prospective part – patients who had been diagnosed with metastatic breast cancer after the beginning of the study in April 2016 and whose data were collected prospectively – and a retrospective part for patients who were diagnosed between January 2000 to March 2016.

After a median follow-up of seven months, the median progression-free survival was 6.3 months and time to treatment failure was seven months.

Twenty-nine (37.6%) patients experienced prolonged control of their disease for at least six months, with an objective response rate of 27%.

By April 2016, the overall survival rate one year after T-DM1 treatment began was 82%. When the disease progressed, metastases occurred or increased in the central nervous system (CNS) in 18 patients, 13 of whom had CNS metastases at the start of the study.

Dr Conte said although its efficacy is reduced in pertuzumab-resistant disease, T-DM1 is still associated with a clinically significant response rate and disease control.

Conte B. T-DM1 efficacy and activity in HER2-positive metastatic breast cancer patients progressing after frontline taxane plus pertuzumab and trastuzumab: an Italian multicentre observational study of the Gruppo Italiano Mammella (GIM) study group.

Tags: Cancer | Europe | Pharmaceuticals | Women's Health & Gynaecology

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