Abstract
Real-world treatment patterns in patients with HER2+ unresectable or metastatic breast cancer: Interim results from HER2 REAL Asia cohort.
Author
person
Soo-Chin Lee
National University Hospital, Singapore, Singapore
info_outline
Soo-Chin Lee, Wei-Pang Chung, Roger Kai-Cheong Ngan, Seock-Ah Im, Rina Hui, Carlos Barrios, Teresa Tung
Full text
Authors
person
Soo-Chin Lee
National University Hospital, Singapore, Singapore
info_outline
Soo-Chin Lee, Wei-Pang Chung, Roger Kai-Cheong Ngan, Seock-Ah Im, Rina Hui, Carlos Barrios, Teresa Tung
Organizations
National University Hospital, Singapore, Singapore, National Cheng Kung University Hospital, Tainan, Taiwan, Queen Elizabeth Hospital, Hong Kong, Hong Kong, Seoul National University Hospital, Seoul, South Korea, Westmead Hospital, Westmead, NSW, Australia, Hospital Moinhos de ventos, Porto Alegre, Brazil, AstraZeneca, Taipei, Taiwan
Abstract Disclosures
Research Funding
Pharmaceutical/Biotech Company
AstraZeneca
Background:
HER2 REAL (NCT04857619) is the first multi-country, retrospective study exploring the treatment practices and outcomes in patients (pts) with HER2+ locally advanced, unresectable (u)/metastatic (m) breast cancer (BC) from routine clinical care in the APAC and LATAM.
Methods:
Adult HER2+ u/mBC pts diagnosed since reimbursement or wider access of trastuzumab emtansine (T-DM1) or 01 Jan 2017, whichever was earlier with ≥12 months (mo) of follow-up data from index date (u/mBC diagnosis) and treated with ≥1-line of therapy (LOT) were enrolled per medical chart review from 6 countries. Here we present interim descriptive analyses (cut-off 30 June 2022) on demographics, clinical characteristics, and treatment patterns.
Results:
Of the 763 enrolled pts, 370 with median (range) age of 55 (20–81) yrs from Hong Kong, Korea, Singapore, and Taiwan were eligible for interim analyses; 368 (99.5%) were female with 210 (57.1%) postmenopausal. A total of 210 (57.1%) pts with reported data had a median time of 2 (0–18) yrs from initial BC diagnosis to u/mBC relapse. At index date, majority had ductal carcinoma (227/254 [89.4%]), visceral (255/355 [71.8%]), and non-visceral (258/355 [72.3%]) metastases; 80/355 (22.5%) had CNS metastases. Family history of BC was reported by 45/370 (12.2%) pts completing the questionnaire; 209/370 (56.5%) had hormone receptor-positive BC. Treatments reported in the first to fifth line were quite variable. HER2-directed therapy was received by 323/367 (88.0%) in LOT1 (mainly trastuzumab [TRA] and pertuzumab [PTZ]-based) and 298/343 (86.9%) in LOT2 (mainly T-DM1). Median duration of LOT1 and LOT2 were 7.8 (0–130) and 5.0 (0–100) mo, respectively, that decreased to 2.3 (0–30) mo in LOT5. The prime reason for treatment discontinuation was disease progression (LOT1: 294 [80.1%]; LOT2: 273 [79.6%]; LOT3: 187 [68.5%]). Serious adverse effects from treatments were rare (LOT1: 7 [1.9%]; LOT2: 10 [2.9%]; LOT3: 5 [1.8%]).
Conclusions:
The interim analyses show heterogeneous treatment patterns in real-world among pts with HER2+ u/mBC progressing on HER2-directed therapies possibly due to access disparity in these 4 Asian countries. Clinical trial information: NCT04857619.
Real-world treatment patterns.
LOT
a
,
n (%)
Median duration of LOT
(range), mo
TRA + PTZ + CT
T-DM1
TRA + CT
Lapatinib + CT
CT alone
HT alone
Anti-HER2
b
+ HT
Anti-HER2
b
+ CT + HT
LOT1 (N=367)
7.9 (0–130)
(n=361)
163 (44.4)
17 (4.6)
51 (13.9)
-
54 (14.7)
16 (4.4)
-
63 (17.2)
LOT2 (N=343)
5.0 (0–100)
(n=314)
22 (6.4)
155 (45.2)
24 (7.0)
30 (8.7)
45 (13.1)
-
19 (5.5)
21 (6.1)
LOT3 (N=273)
4.2 (0–57)
(n=221)
13 (4.8)
40 (14.7)
42 (15.4)
35 (12.8)
89 (32.6)
16 (5.9)
18 (6.6)
-
LOT4 (N=167)
2.7 (0–33)
(n=145)
8 (4.8)
-
29 (17.4)
29 (17.4)
85 (50.9)
11 (7.8)
-
-
LOT5 (N=114)
2.3 (0–30)
(n=99)
10 (8.8)
7 (6.1)
17 (14.9)
14 (12.3)
55 (48.3)
7 (6.1)
-
-
a
Reported in ≥4.0% pts.
b
Mainly includes TRA, PTZ, and Lapatinib. Abbreviations: CT, chemotherapy; HT, hormone therapy.
Clinical status
Clinical
7 organizations
4 drugs
1 target
Organization
National University HospitalOrganization
National Cheng Kung University HospitalOrganization
Queen Elizabeth HospitalOrganization
Seoul National University HospitalOrganization
Westmead HospitalOrganization
Hospital Moinhos de ventosOrganization
AstraZenecaDrug
TrastuzumabDrug
pertuzumabDrug
lapatinibTarget
HER2 (ERBB2)