Second-Line Gemcitabine With Dual Antibody Therapy for ERBB2-Positive Metastatic Breast Cancer
Posted: Monday, March 2, 2020
Treatment with gemcitabine, trastuzumab, and pertuzumab was associated with a 3-month progression-free survival of 73% after previous pertuzumab-based therapy in patients with ERBB2-positive metastatic breast cancer. The results of the phase II clinical trial also demonstrated that continuing pertuzumab beyond disease progression appeared to be of clinical benefit. These findings were published in JAMA Network Open by Neil M. Iyengar, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues.
“Dual anti-ERBB2 therapy with trastuzumab and pertuzumab after prior pertuzumab exposure was active and well tolerated,” the authors wrote.
The single-center phase II clinical trial included 45 patients with ERBB2-positive metastatic breast cancer. Patients had previously been treated with three or fewer chemotherapy regimens, including at least one pertuzumab-based regimen. Patients ranged from 31 to 77 years old, with a median age of 57. Treatment consisted of gemcitabine on days 1 and 8 every 3 weeks, and trastuzumab and pertuzumab once every 3 weeks.
After a median follow-up of 28 months, 3-month progression-free survival was 73%. The authors had specified before the study began that they defined success as a 3-month progression-free survival of at least 70%. The median progression-free survival was 5.5 months.
According to the investigators, treatment was well tolerated. No cases of febrile neutropenia nor symptomatic left ventricular systolic dysfunction were reported.
“To our knowledge, this is the first study to show promising efficacy of a pertuzumab-containing regimen after prior exposure to pertuzumab,” the authors concluded. “Our findings support the advancement of phase 3 trials comparing the efficacy of regimens containing trastuzumab and pertuzumab with standard and novel ERBB2-directed treatment in patients previously treated with this dual-antibody combination.”
Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.