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Background <p>In the realm of HER2-positive (HER2+) metastatic breast cancer (MBC), the advent of targeted therapies, notably trastuzumab and pertuzumab, represents a substantial advancement in enhancing patient outcomes. However, the intricacies of treatment escalate when patients encounter progression or resistance during first-line (1L) therapy. The togetHER study aimed to elucidate real-world insights into the profile, management strategies, and outcomes for HER2+ MBC patients initiating second-line treatment (2LT) in Greece, predating recent international guideline changes incorporating trastuzumab deruxtecan and tucatinib in the second line and beyond lines of treatments.</p> Methods <p>Data from adult female patients with HER2+ MBC who had initiated 2LT between 01-Jan-2015 and 31-Dec-2018 in 18 oncology departments across Greece were retrospectively abstracted through medical chart review.</p> Results <p>The eligible population comprised 122 patients, 68.0% of whom presented with recurrent MBC. Among the latter, 26.5% were tested for HER2 both in early and metastatic settings with 27.3% of them changing HER2 status from negative to positive. Retesting of HER2 expression following 2LT initiation was recorded in 8 cases. At 2LT initiation, patients’ median age was 57.0&#xa0;years and 63.6% were hormone receptor-positive. The most common metastatic sites were bone (56.6%), lung (44.3%), liver (41.0%), and brain (29.5%). Anti-HER2 agent usage in 1L and 2L stood at 91.8% and 92.6%, respectively, with rates slightly diminishing in third (3L) (85.9%) and fourth line (4L) (82.4%). Endocrine therapy administration was generally low across treatment lines (12.3%, 9.9%, and 5.9%, in 2L, 3L, and 4L respectively), while chemotherapy use increased from 30.3% in 2L to 47.9% and 47.1% to 3L and 4L, correspondingly. Median progression-free survival (PFS) for 2L, 3L, and 4L was 7.7 [95% confidence interval (CI) 6.0–14.4], 6.4 (95% CI 5.4–7.1), and 5.6 (95% CI 2.6–9.0) months, respectively, while median overall survival was 25.0 (95% CI 20.5–34.4) months.</p> Conclusions <p>Although the 2LT pattern in Greece generally aligned with guidelines, persistently poor treatment outcomes underscore a significant unmet medical need for these patients.</p>

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Real-world management strategies and clinical outcomes of metastatic HER2-positive breast cancer in Greece in the second-line setting and beyond (the togetHER study)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月1日

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  • Ippokratis Korantzis,
  • Anna Koumarianou,
  • Vassiliki Rapti,
  • Eleni Timotheadou,
  • Christos Christodoulou,
  • Dimitrios Tryfonopoulos,
  • Sofia Karageorgopoulou,
  • Ioannis Boukovinas,
  • Flora Zagouri,
  • Adamantia Nikolaidi,
  • Konstantinos Papazisis,
  • Evangelia Razis,
  • Vasileios Barbounis,
  • Athina Christopoulou,
  • Dimitrios Mavroudis,
  • Vassilios Georgoulias,
  • Georgios Kesisis,
  • Emmanuel I. Papadopoulos,
  • Rozalia Michalea,
  • Alexandros Ardavanis

摘要

Background

In the realm of HER2-positive (HER2+) metastatic breast cancer (MBC), the advent of targeted therapies, notably trastuzumab and pertuzumab, represents a substantial advancement in enhancing patient outcomes. However, the intricacies of treatment escalate when patients encounter progression or resistance during first-line (1L) therapy. The togetHER study aimed to elucidate real-world insights into the profile, management strategies, and outcomes for HER2+ MBC patients initiating second-line treatment (2LT) in Greece, predating recent international guideline changes incorporating trastuzumab deruxtecan and tucatinib in the second line and beyond lines of treatments.

Methods

Data from adult female patients with HER2+ MBC who had initiated 2LT between 01-Jan-2015 and 31-Dec-2018 in 18 oncology departments across Greece were retrospectively abstracted through medical chart review.

Results

The eligible population comprised 122 patients, 68.0% of whom presented with recurrent MBC. Among the latter, 26.5% were tested for HER2 both in early and metastatic settings with 27.3% of them changing HER2 status from negative to positive. Retesting of HER2 expression following 2LT initiation was recorded in 8 cases. At 2LT initiation, patients’ median age was 57.0 years and 63.6% were hormone receptor-positive. The most common metastatic sites were bone (56.6%), lung (44.3%), liver (41.0%), and brain (29.5%). Anti-HER2 agent usage in 1L and 2L stood at 91.8% and 92.6%, respectively, with rates slightly diminishing in third (3L) (85.9%) and fourth line (4L) (82.4%). Endocrine therapy administration was generally low across treatment lines (12.3%, 9.9%, and 5.9%, in 2L, 3L, and 4L respectively), while chemotherapy use increased from 30.3% in 2L to 47.9% and 47.1% to 3L and 4L, correspondingly. Median progression-free survival (PFS) for 2L, 3L, and 4L was 7.7 [95% confidence interval (CI) 6.0–14.4], 6.4 (95% CI 5.4–7.1), and 5.6 (95% CI 2.6–9.0) months, respectively, while median overall survival was 25.0 (95% CI 20.5–34.4) months.

Conclusions

Although the 2LT pattern in Greece generally aligned with guidelines, persistently poor treatment outcomes underscore a significant unmet medical need for these patients.