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Background <p>No clinical trials demonstrated anti-HER2 plus chemotherapy (anti-HER2 + ChT) was superior to anti-HER2 plus endocrine therapy (anti-HER2 + ET) in HR + /HER2 + MBC. This study aims to compare efficacy of anti-HER2 + ET with anti-HER2 + ChT in real-world clinical practice, and analyze clinical outcome of anti-HER2 + ET as maintenance therapy after benefiting from anti-HER2 + ChT.</p> Methods <p>This study retrospectively compared two regimens: anti-HER2 + ChT vs anti-HER2 + ET, utilizing chi-square tests for response rate comparisons and Kaplan–Meier approach for survival analysis.</p> Results <p>Totally, 241 eligible patients were included in this study. In first-line setting, 197 patients (81.7%) received anti-HER2 + ChT and 44 (18.3%) received anti-HER2 + ET. Objective response rate (54.3% vs 11.4%, <i>P</i> &lt; 0.001) and clinical benefit rate (82.7% vs 68.2%, <i>P</i> = 0.029) of anti-HER2 + ChT group were higher than those of anti-HER2 + ET. PFS analysis showed there was no significant difference between anti-HER2 + ChT and anti-HER2 + ET in first-line (mPFS, 15.0&#xa0;m [95%CI 12.1–17.9] vs 9.0&#xa0;m [95%CI 0.5–17.5]; HR 1.32 [0.88–1.98]; <i>P</i> = 0.162) and the front two lines of treatment (PFS-2, 26.0&#xa0;m [95%CI 23.0–29.0] vs 24.0&#xa0;m [95%CI 15.9–32.1]; HR 1.03 [0.64–1.64]; <i>P</i> = 0.919). Notably, PFS of patients with anti-HER2 + ChT maintained by anti-HER2 + ET was superior to anti-HER2 + ET (24.0&#xa0;m [95%CI 18.0–30.0] vs 17.0&#xa0;m [95%CI 9.5–24.5]; HR 0.53 [0.32–0.89]; <i>P</i> = 0.005) and other anti-HER2 + ChT group (24.0&#xa0;m vs 12.0&#xa0;m [95%CI 9.1–15.0]; HR 0.52 [0.36–0.76]; <i>P</i> &lt; 0.001).</p> Conclusion <p>While anti-HER2 + ChT showed superior disease control over anti-HER2 + ET, it didn’t confer a survival advantage, possibly due to small sample size or retrospective design constraints. For patients deriving benefit from anti-HER2 + ChT, transitioning to&#xa0;maintenance therapy with anti-HER2 + ET may represent an optional strategy.</p>

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Anti-HER2 plus endocrine therapy versus anti-HER2 plus chemotherapy in hormone receptor-positive and HER2-positive metastatic breast cancer: a retrospective study

  • 期刊论文

  • 发表日期：

    2025年10月9日

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  • Zhenhua Fan,
  • Yang Yuan,
  • Xiaoyan Chen,
  • Tao Wang,
  • Shaohua Zhang,
  • Li Bian,
  • Xueli Mo

摘要

Background

No clinical trials demonstrated anti-HER2 plus chemotherapy (anti-HER2 + ChT) was superior to anti-HER2 plus endocrine therapy (anti-HER2 + ET) in HR + /HER2 + MBC. This study aims to compare efficacy of anti-HER2 + ET with anti-HER2 + ChT in real-world clinical practice, and analyze clinical outcome of anti-HER2 + ET as maintenance therapy after benefiting from anti-HER2 + ChT.

Methods

This study retrospectively compared two regimens: anti-HER2 + ChT vs anti-HER2 + ET, utilizing chi-square tests for response rate comparisons and Kaplan–Meier approach for survival analysis.

Results

Totally, 241 eligible patients were included in this study. In first-line setting, 197 patients (81.7%) received anti-HER2 + ChT and 44 (18.3%) received anti-HER2 + ET. Objective response rate (54.3% vs 11.4%, P < 0.001) and clinical benefit rate (82.7% vs 68.2%, P = 0.029) of anti-HER2 + ChT group were higher than those of anti-HER2 + ET. PFS analysis showed there was no significant difference between anti-HER2 + ChT and anti-HER2 + ET in first-line (mPFS, 15.0 m [95%CI 12.1–17.9] vs 9.0 m [95%CI 0.5–17.5]; HR 1.32 [0.88–1.98]; P = 0.162) and the front two lines of treatment (PFS-2, 26.0 m [95%CI 23.0–29.0] vs 24.0 m [95%CI 15.9–32.1]; HR 1.03 [0.64–1.64]; P = 0.919). Notably, PFS of patients with anti-HER2 + ChT maintained by anti-HER2 + ET was superior to anti-HER2 + ET (24.0 m [95%CI 18.0–30.0] vs 17.0 m [95%CI 9.5–24.5]; HR 0.53 [0.32–0.89]; P = 0.005) and other anti-HER2 + ChT group (24.0 m vs 12.0 m [95%CI 9.1–15.0]; HR 0.52 [0.36–0.76]; P < 0.001).

Conclusion

While anti-HER2 + ChT showed superior disease control over anti-HER2 + ET, it didn’t confer a survival advantage, possibly due to small sample size or retrospective design constraints. For patients deriving benefit from anti-HER2 + ChT, transitioning to maintenance therapy with anti-HER2 + ET may represent an optional strategy.