Pertuzumab monotherapy after trastuzumab-based treatment and subsequent reintroduction of trastuzumab: Activity and tolerability in patients with advanced human epidermal growth factor receptor 2-positive breast cancer

Javier Corteś, Pierre Fumoleau, GiuliaValeria Bianchi, Teresa M. Petrella, Karen Gelmon, Xavier Pivot, Shailendra Verma, Joan Albanell, Pierfranco Conte, Ana Lluch, Stefania Salvagni, Veronique Servent, Luca Gianni, Maurizio Scaltriti, Graham A. Ross, Joanna Dixon, Tania Szado, Jose Baselga

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The combination of pertuzumab and trastuzumab resulted in a clinical benefit rate (CBR) of 50% in patients with human epidermal growth factor receptor 2 (HER2) -positive breast cancer whose disease progressed during prior trastuzumab-based therapy. To define whether this previously observed encouraging activity was a result of the combination of pertuzumab and trastuzumab or of pertuzumab alone, we recruited a third cohort of patients who received pertuzumab without trastuzumab. We then investigated the impact of reintroducing trastuzumab to patients whose disease progressed on pertuzumab monotherapy. Patients and Methods: Twenty-nine patients with HER2-positive breast cancer whose disease progressed during prior trastuzumab-based therapy received pertuzumab (840 mg loading dose, then 420 mg every 3 weeks) until progressive disease or unacceptable toxicity. Seventeen patients with disease progression continued to receive pertuzumab (at the same dose), with the addition of trastuzumab (4 mg/kg loading dose and then 2 mg/kg weekly or 8 mg/kg loading dose and then 6 mg/kg every 3 weeks). Results: All 29 patients enrolled for pertuzumab monotherapy experienced disease progression. The objective response rate (ORR) and CBR were 3.4% and 10.3%, respectively, during pertuzumab monotherapy. With the addition of trastuzumab, the ORR and CBR were 17.6% and 41.2%, respectively. Progression-free survival was longer with combination therapy than pertuzumab monotherapy (17.4 v 7.1 weeks, respectively). Treatment was well tolerated with minimal cardiac dysfunction. Conclusion: Although pertuzumab has some activity in patients with HER2-positive breast cancer that progressed during therapy with trastuzumab, the combination of pertuzumab and trastuzumab seems to be more active than monotherapy.

Original languageEnglish
Pages (from-to)1594-1600
Number of pages7
JournalJournal of Clinical Oncology
Volume30
Issue number14
DOIs
Publication statusPublished - May 10 2012

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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