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Pertuzumab Added to Trastuzumab and Chemotherapy Improves Outcomes in Metastatic Breast Cancer
Findings from a real-world study suggest the addition of pertuzumab to trastuzumab and chemotherapy improves safety and overall survival (OS) for patients with metastatic breast cancer (JAMA Netw Open. 2022;5[2]:e2145460. doi:10.1001/jamanetworkopen.2021.45460.).
“To date, limited studies have examined the comparative outcomes of pertuzumab treatment in the real-world setting,” wrote Wei Fang Dai, MPH, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, and colleagues.
“End-of-study analyses of the CLEOPATRA trial found median OS of 57.1 months in patients receiving pertuzumab compared with 40.8 months in control patients, a benefit of 16.3 months. However, studies examining the real-world use of pertuzumab have found conflicting results,” they continued.
This study aimed to assess the real-world comparative effectiveness and safety of pertuzumab, trastuzumab, and chemotherapy for metastatic breast cancer.
Researchers identifies patients receiving first-line treatment for metastatic breast cancer between January 2008 and March 2018. Data analysis was performed between November 13, 2019, and August 1, 2021.
A total of 1823 patients were identified and included in the study; 912 received pertuzumab with trastuzumab and chemotherapy and 911 received trastuzumab and chemotherapy alone (control group). A total of 579 patients receiving pertuzumab were matched to 579 patients in the control group using propensity score matching.
The main outcomes were OS and hazard ratios (HRs) calculated using Kaplan-Meier and Cox proportional hazards regression methods. Secondary outcomes included safety end points.
Follow-up duration was up to 5 years from the start of therapy with a maximum follow-up to March 31, 2019. The median OS was 40.2 months in patients receiving pertuzumab vs 25.3 months in this control group. Pertuzumab was associated with reduces mortality (HR, 0.66). The cumulative incidence of direct hospitalization at 1 year was 11.7% among those receiving pertuzumab vs 19% among those in the control group (P <.001).
“Although the median OS in both the pertuzumab and control groups were shorter in this study than those observed in the CLEOPATRA trial, there appears to be a similar significant OS benefit with pertuzumab in the real-world setting,” concluded Dai and colleagues.
