Hear ye, Hear Ye: "real-world data shows dual targeting in HER2+ER+MBC patients

[Lani]

MBC (=Stage IVs)... with or without chemotherapy, dual targeting of HRs and HER2 receptors is associated with significantly prolonged PFS and OS time". This would imply that dual targeting with or without chemo would improve the effectiveness of adjuvant treatment (preventing Stage IV)
Triple targeting would be even better one might think!


Oncologist. 2013 May 7. [Epub ahead of print]
First-Line Treatment Patterns and Clinical Outcomes in Patients With HER2-Positive and Hormone Receptor-Positive Metastatic Breast Cancer From registHER.
Tripathy D, Kaufman PA, Brufsky AM, Mayer M, Yood MU, Yoo B, Quah C, Yardley D, Rugo HS.
Source
University of Southern California, Norris Comprehensive Cancer Center, Department of Medicine, Los Angeles, California, USA;
Abstract
BACKGROUND:
Limited data are available describing the natural history of patients with HER2-positive and hormone receptor (HR)-positive metastatic breast cancer (MBC). We examined first-line treatment patterns and clinical outcomes in patients with HER2-positive, HR-positive MBC in a real-world setting.
METHODS:
registHER is a prospective, observational cohort of 1,023 patients with HER2-positive MBC diagnosed within 6 months of enrollment and followed until death, disenrollment, or June 2009 (median follow-up time: 27 months). Demographics, first-line treatment patterns, and clinical outcomes were examined for 530 HER2-positive, HR-positive patients. Progression-free survival (PFS) and overall survival (OS) times were examined. Multivariate analyses adjusted for baseline demographic and prognostic factors.
RESULTS:
HER2-positive, HR-positive patients receiving first-line trastuzumab plus hormonal therapy had significantly longer PFS times than patients who received hormonal therapy only (13.8 vs. 4.8 months; adjusted hazard ratio [HR]: 0.37, 95% confidence interval [CI]: 0.22-0.60); a nonsignificant reduction in OS time was observed (adjusted HR: 0.55, 95% CI: 0.27-1.14). Compared with patients who received first-line trastuzumab plus chemotherapy, patients who received first-line trastuzumab plus chemotherapy and hormonal therapy had longer median PFS times (20.4 months vs. 9.5 months; adjusted HR: 0.53, 95% CI: 0.42-0.68); a statistically significant reduction in risk of death was observed (adjusted HR: 0.50, 95% CI: 0.36-0.70). Sequential use of chemotherapy and hormonal therapy was associated with improved OS times when compared with concurrent use (adjusted PFS HR: 0.81, 95% CI: 0.54-1.21; adjusted OS HR: 0.48, 95% CI: 0.26-0.89).
CONCLUSIONS:
These real-world data in patients with HER2-positive/HR-positive MBC provide evidence that, with or without chemotherapy, dual targeting of HRs and HER2 receptors is associated with significantly prolonged PFS and OS times.
KEYWORDS:
Breast cancer, HER2, Hormone receptor, Metastatic, Trastuzumab, Treatment

PMID: 23652380 [PubMed - as supplied by publisher]