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

• Published in: Molecular and clinical oncology 2023-07, Vol.19 (1), Article 52
• Main Authors: Biskup, Ewelina, Sartorius, Celine Montavon, Muller, Andreas, Leo, Cornelia, Nussbaum, Catrina Uhlmann, Margarint, Elena Laura Georgescu, Koychev, Daniel, Schreiber, Alexander, Taverna, Christian, Thorn, David, Vetter, Marcus
• Format: Article
• Language: English
• Subjects: Breast cancer; Cancer; Cancer therapies; Care and treatment; Chemotherapy; Epidermal growth factor; Health aspects; Hospitals; Immunotherapy; Medical prognosis; Medical records; Metastasis; Oncology; Patients; Pertuzumab; Pharmaceutical industry; Physicians; Questionnaires; Survival analysis; Toxicity
• ISSN: 2049-9450; 2049-9469
• DOI: 10.3892/mco.2023.2648

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.