Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: a phase 3b/4 trial: a phase 3b/4 trial

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Název: Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: a phase 3b/4 trial: a phase 3b/4 trial
Autoři: Harbeck, Nadia, Ciruelos, Eva, Jerusalem, Guy, Mueller, Volkmar, Niikura, Naoki, Viale, Giuseppe, Bartsch, Rupert, Kurzeder, Christian, Higgins, Michaela J., Connolly, Roisin M., Baron-Hay, Sally, Gion, Maria, Guarneri, Valentina, Bianchini, Giampaolo, Wildiers, Hans, Escriva-de-Romani, Santiago, Prahladan, Manoj, Bridge, Helen, Kuptsova-Clarkson, Nataliya, Scotto, Nana, Verma, Sunil, Lin, Nancy U., Yeo, Belinda, Mccarthy, Nicole, Mccartney, Amelia, Clay, Timothy, Murray, Nicholas, Gombos, Andrea, Collignon, Joelle, De Cuypere, Eveline, Jerzak, Katarzyna, Chia, Stephen, Maraldo, Maja, Ronlev, Jeanette, Brix, Eva, Tanner, Minna, Mattson, Johanna, Huovinen, Riikka, Wimberger, Pauline, Reinisch, Mattea, Tesch, Hans, Untch, Michael, Fasching, Peter, Park-Simon, Tjoung-Won, Tio, Joke, Braun, Michael, Grischke, Eva Maria, Marme, Frederik, van Mackelenbergh, Marion, Mccaffrey, John, De Laurentiis, Michelino, Caruso, Michele, Berardi, Rossana, Biganzoli, Laura, Fotia, Vittoria, Yamashita, Toshinari, Tsurutani, Junji, Tsugawa, Koichiro, Tomioka, Nobumoto, de Boer, Maaike, Houtsma, Daniel, Pilskog, Martin, Engebraten, Olav, Saetersdal, Anna, Wysocki, Piotr, Nowecki, Zbigniew, Radecka, Barbara, Jassem, Jacek, Duchnowska, Renata, Simoes, Joana, Cardoso, Fatima, Sousa, Ana Rita, Losada, Maria Jesus Vidal, Manich, Cristina Saura, Gregori, Joaquin Gavila, Marti, Maria Pilar Lopez, Borrego, Manuel Ruiz, Castan, Javier Cortes, Lopez, Rafael Lopez, Sanchez, Cesar Rodriguez, Flores, Encarnacion Gonzalez, Gonzalez, Carmen Hinojo, del Prado, Purificacion Martinez, Schiza, Aglaia, Killander, Fredrika, Klint, Leif, Rossi, Lorenzo, Aebi, Stefan, Zaman, Khalil, Hall, Peter, Anders, Carey
Přispěvatelé: Institut Català de la Salut, [Harbeck N] Breast Center, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Munich, LMU University Hospital, Munich, Germany. [Ciruelos E] Hospital Universitario 12 de Octubre, Madrid, Spain. [Jerusalem G] CHU Liège and Liège University, Liège, Belgium. [Müller V] University Medical Center Hamburg-Eppendorf, Hamburg, Germany. [Niikura N] Tokai University School of Medicine, Kanagawa, Japan. [Viale G] Department of Pathology and Laboratory Medicine, IEO European Institute of Oncology IRCCS, Milan, Italy. [Escrivá-de-Romaní S] Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus
Zdroj: Nat Med
Scientia
Scientia. Dipòsit d'Informació Digital del Departament de Salut
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Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Immunoconjugates, Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia, Receptor, ErbB-2, Oncologie, Medicaments antineoplàstics - Ús terapèutic, Research & Experimental Medicine, DESTINY-Breast12 study group, Antineoplastic Agents, Immunological, COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antineoplásicos::inmunoterapia antineoplásica, Immunoconjugates/adverse effects, Prospective Studies, Human health sciences, 11 Medical and Health Sciences, EXPLORATORY ANALYSIS, CLINICAL-PRACTICE GUIDELINE, Other subheadings::Other subheadings::Other subheadings::/drug therapy, Anticossos monoclonals - Ús terapèutic, Brain Neoplasms, CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Monoclonal, Middle Aged, Progression-Free Survival, trastuzumab deruxtecan, EMTANSINE T-DM1, Oncology, Medicine, Research & Experimental, ErbB-2/metabolism, Female, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento::supervivencia libre de progresión, Life Sciences & Biomedicine, Receptor, RADIOTHERAPY, RADIOSURGERY, Adult, Biochemistry & Molecular Biology, Receptor, erbB-2, Immunology, SOCIETY, Antineoplastic Agents, Brain Neoplasms/drug therapy, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome::Progression-Free Survival, Breast Neoplasms, CAPECITABINE, Sciences de la santé humaine, Article, Immunological/therapeutic use, Breast Neoplasms/drug therapy, COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::anticuerpos monoclonales, CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents::Antineoplastic Agents, Immunological, Humans, Immunoconjugates/therapeutic use, Aged, Trastuzumab/therapeutic use, Science & Technology, 42 Health sciences, ERBB2 protein, human, Cell Biology, 32 Biomedical and clinical sciences, Trastuzumab, EFFICACY, DS-8201A, Mama - Càncer - Tractament, Avaluació de resultats (Assistència sanitària), Brain Neoplasms/secondary, Camptothecin/analogs & derivatives, Camptothecin, ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias de la mama, DISEASES::Neoplasms::Neoplasms by Site::Breast Neoplasms
Popis: Trastuzumab deruxtecan (T-DXd) intracranial activity has been observed in small or retrospective patient cohorts with human epidermal growth factor receptor 2–positive (HER2+) advanced/metastatic breast cancer (mBC) and stable or active (untreated/previously treated and progressing) brain metastases (BMs). The phase 3b/4 DESTINY-Breast12 study investigated T-DXd in patients with HER2+ mBC and is, to our knowledge, the largest prospective study of T-DXd in patients with BMs in this setting. Patients (stable/active BMs (n = 263) and no BMs (n = 241)) treated with one or more prior anti-HER2–based regimens received T-DXd (5.4 mg per kg). Primary endpoints were progression-free survival (PFS; BMs cohort) and objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (non-BMs cohort). Additional endpoints included central nervous system (CNS) PFS, ORR, time to second progression, CNS ORR (BMs cohort), incidence of new symptomatic CNS metastases (non-BMs cohort), time to progression, duration of response, overall survival and safety (both cohorts). No formal hypothesis testing was conducted for this single-arm, open-label study. In the BMs cohort, 12-month PFS was 61.6% (95% confidence interval (CI): 54.9–67.6), and 12-month CNS PFS was 58.9% (95% CI: 51.9–65.3). In the non-BMs cohort, ORR was 62.7% (95% CI: 56.5–68.8). Grade 3 or higher adverse events occurred in 51% (BMs cohort) and 49% (non-BMs cohort) of patients. Investigator-reported interstitial lung disease/pneumonitis occurred in 16% (grade ≥3: 3%) of patients with BMs and 13% (grade ≥3: 1%) of patients without BMs. These data show substantial and durable overall and intracranial activity for T-DXd, supporting its use in previously treated patients with HER2+ mBC irrespective of stable/active baseline BMs. ClinicalTrials.gov identifier: NCT04739761.
Druh dokumentu: Article
Other literature type
Popis souboru: application/pdf
Jazyk: English
ISSN: 1546-170X
1078-8956
DOI: 10.1038/s41591-024-03261-7
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/39271844
https://hdl.handle.net/11351/12359
https://cris.maastrichtuniversity.nl/en/publications/5907550f-729b-40c9-900e-d22721072849
https://doi.org/10.1038/s41591-024-03261-7
https://www.nature.com/articles/s41591-024-03261-7#article-info
https://doi.org/10.1038/s41591-024-03261-7
https://hdl.handle.net/20.500.11768/172577
https://www.nature.com/articles/s41591-024-03261-7
https://doi.org/10.1038/s41591-024-03261-7
https://lirias.kuleuven.be/handle/20.500.12942/750006
https://doi.org/10.1038/s41591-024-03261-7
https://hdl.handle.net/2268/328027
https://doi.org/10.1038/s41591-024-03261-7
https://portal.findresearcher.sdu.dk/da/publications/06812573-f19e-46ad-8295-e6fc0b9f1d28
https://doi.org/10.1038/s41591-024-03261-7
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....5de4b3269c6eb2ecbb1a71103f15df3a
Databáze: OpenAIRE
Popis
Abstrakt:Trastuzumab deruxtecan (T-DXd) intracranial activity has been observed in small or retrospective patient cohorts with human epidermal growth factor receptor 2–positive (HER2+) advanced/metastatic breast cancer (mBC) and stable or active (untreated/previously treated and progressing) brain metastases (BMs). The phase 3b/4 DESTINY-Breast12 study investigated T-DXd in patients with HER2+ mBC and is, to our knowledge, the largest prospective study of T-DXd in patients with BMs in this setting. Patients (stable/active BMs (n = 263) and no BMs (n = 241)) treated with one or more prior anti-HER2–based regimens received T-DXd (5.4 mg per kg). Primary endpoints were progression-free survival (PFS; BMs cohort) and objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1 (non-BMs cohort). Additional endpoints included central nervous system (CNS) PFS, ORR, time to second progression, CNS ORR (BMs cohort), incidence of new symptomatic CNS metastases (non-BMs cohort), time to progression, duration of response, overall survival and safety (both cohorts). No formal hypothesis testing was conducted for this single-arm, open-label study. In the BMs cohort, 12-month PFS was 61.6% (95% confidence interval (CI): 54.9–67.6), and 12-month CNS PFS was 58.9% (95% CI: 51.9–65.3). In the non-BMs cohort, ORR was 62.7% (95% CI: 56.5–68.8). Grade 3 or higher adverse events occurred in 51% (BMs cohort) and 49% (non-BMs cohort) of patients. Investigator-reported interstitial lung disease/pneumonitis occurred in 16% (grade ≥3: 3%) of patients with BMs and 13% (grade ≥3: 1%) of patients without BMs. These data show substantial and durable overall and intracranial activity for T-DXd, supporting its use in previously treated patients with HER2+ mBC irrespective of stable/active baseline BMs. ClinicalTrials.gov identifier: NCT04739761.
ISSN:1546170X
10788956
DOI:10.1038/s41591-024-03261-7