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Blanter J, Baldwin E, Patel R, Sheng T, Tiersten A. Patterns in use and tolerance of adjuvant neratinib in patients with hormone receptor (HR)-positive, HER2-positive early-stage breast cancer. Breast Cancer Res Treat 2024:10.1007/s10549-024-07461-0. [PMID: 39153126 DOI: 10.1007/s10549-024-07461-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE One year of neratinib therapy is known to derive a significant invasive disease-free survival (iDFS) benefit in early-stage, hormone receptor-positive (HR +), HER2 + , node-positive breast cancer after trastuzumab-based adjuvant therapy. Limitations to neratinib use include significant gastrointestinal side effects, which often result in treatment discontinuation. In this study, we aimed to identify clinicopathologic features associated with adjuvant neratinib use and factors impacting treatment completion. METHODS We performed a retrospective review of patients with early-stage HR + HER2 + breast cancer who were prescribed neratinib from 2017 to 2023 at our institution. We used the electronic medical record to extract information on patient characteristics, clinical features, and treatment information. Patients were identified as high risk based on definitions adapted from the standard high-risk definition in HR + HER2- breast cancer combined with studies correlating high Ki67 or high tumor grade with lower recurrence-free survival. Statistical analysis was performed using two-sided T-tests and chi-square tests. RESULTS We identified 62 eligible patients of whom 55% completed 1 year of neratinib and 45% did not. Sixty percent (N = 37) of patients offered neratinib were considered high risk at diagnosis. The most common reason for neratinib discontinuation was inability to tolerate side effects (54%) followed by pill burden (18%). The most common side effect experienced by patients was diarrhea despite anti-diarrheal prophylaxis (56%), followed by rash (8%). Patients who received an up-titration of neratinib were more likely to complete the full course of neratinib when compared to those who did not (76% vs. 40.5% p = 0.013). The median starting dose of those who completed neratinib treatment was 140 vs. 240 mg in those who did not (p = 0.016). Neither group experienced a statistically significant greater likelihood of treatment holds or dose reductions. In terms of outcomes, 10 patients had progression of disease of whom 7 did not complete neratinib treatment (p = 0.169). Interestingly, those 7 patients developed metastatic disease and 57% (N = 4) had central nervous system metastases. CONCLUSION Patients are more likely to complete 1 year of adjuvant neratinib with dose up-titration. Dose reductions and interruptions did not affect neratinib adherence in our patient population. Seven patients (11%) in our study developed metastatic disease, all of whom did not complete adjuvant neratinib treatment.
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Affiliation(s)
- Julia Blanter
- Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA.
| | - Elena Baldwin
- Division of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rima Patel
- Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA
| | - Tianxiang Sheng
- Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA
| | - Amy Tiersten
- Division of Hematology and Oncology, Icahn School of Medicine at Mount Sinai, The Tisch Cancer Institute, New York, NY, USA
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Guo L, Shao W, Zhou C, Yang H, Yang L, Cai Q, Wang J, Shi Y, Huang L, Zhang J. Neratinib for HER2-positive breast cancer with an overlooked option. Mol Med 2023; 29:134. [PMID: 37803271 PMCID: PMC10559443 DOI: 10.1186/s10020-023-00736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023] Open
Abstract
Positive human epidermal growth factor receptor 2 (HER2) expression is associated with an increased risk of metastases especially those to the brain in patients with advanced breast cancer (BC). Neratinib as a tyrosine kinase inhibitor can prevent the transduction of HER1, HER2 and HER4 signaling pathways thus playing an anticancer effect. Moreover, neratinib has a certain efficacy to reverse drug resistance in patients with BC with previous HER2 monoclonal antibody or targeted drug resistance. Neratinib, as monotherapy and in combination with other therapies, has been tested in the neoadjuvant, adjuvant, and metastatic settings. Neratinib with high anticancer activity is indicated for the prolonged adjuvant treatment of HER2-positive early BC, or in combination with other drugs including trastuzumab, capecitabine, and paclitaxel for the treatment of advanced HER2-positive BC especially cancers with central nervous system (CNS) metastasis to reduce the risk of BC recurrence. This article reviewed the pharmacological profiles, efficacy, safety, tolerability, and current clinical trials pertaining to neratinib, with a particular focus on the use of neratinib in patients with metastatic breast cancer (MBC) involving the CNS. We further discussed the use of neratinib for HER2-negative and HER2-mutant breast cancers, and mechanisms of resistance to neratinib. The current evidence suggests that neratinib has promising efficacy in patients with BC which is at least non-inferior compared to previous therapeutic regimens. The most common AE was diarrhea, and the incidence, severity and duration of neratinib-related grade 3 diarrhea can be reduced with loperamide. Of note, neratinib has the potential to effectively control and prevent brain metastasis in patients with advanced BC, providing a therapeutic strategy for HER2-positive BC.
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Affiliation(s)
- Liting Guo
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China.
| | - Weiwei Shao
- Department of Pathology, The First People's Hospital of Yancheng City, Yancheng, China
| | - Chenfei Zhou
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Hui Yang
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Liu Yang
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Qu Cai
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Junqing Wang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China.
| | - Yan Shi
- Department of General Surgery, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, 358 Datong Road, Gaoqiao Town, Shanghai, 200137, China.
| | - Lei Huang
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China.
- Medical Center on Aging of Ruijin Hospital, MCARJH, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Jun Zhang
- Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
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Dhiwar PS, Matada GSP, Raghavendra NM, Ghara A, Singh E, Abbas N, Andhale GS, Shenoy GP, Sasmal P. Current updates on EGFR and HER2 tyrosine kinase inhibitors for the breast cancer. Med Chem Res 2022. [DOI: 10.1007/s00044-022-02934-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Lu YS, Yeo W, Yap YS, Park YH, Tamura K, Li H, Cheng R. An Overview of the Treatment Efficacy and Side Effect Profile of Pharmacological Therapies in Asian Patients with Breast Cancer. Target Oncol 2021; 16:701-741. [PMID: 34582007 PMCID: PMC8613101 DOI: 10.1007/s11523-021-00838-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 11/05/2022]
Abstract
Breast cancer (BC) among Asians accounts for ~ 40% of the global BC burden. Differences in BC risk, presentation, tumor biology, and response to treatment exist between Asian and non-Asian patients; however, Asian patients are often under-represented in clinical trials. This narrative review summarizes the efficacy and safety of pharmacological therapies for BC in Asian populations, with a focus on outcomes in Asian versus non-Asian patients treated with chemotherapy, hormone therapy, anti-human epidermal growth factor receptor-2 targeted therapies, cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, mammalian target of rapamycin inhibitors, bone-targeted therapies, poly-ADP ribose polymerase, phosphoinositide 3-kinase, and checkpoint inhibitors. While most therapies have demonstrated comparable efficacy and safety in Asian and non-Asian patients with BC, differences that are largely attributed to pharmacogenetic variations between populations exist. Pharmacogenetic differences may contribute to a reduced clinical benefit of tamoxifen, whereas improved clinical outcomes have been reported with tyrosine kinase inhibitors and CDK4/6 inhibitors in Asian versus non-Asian patients with BC. In particular, Asian patients have an increased incidence of hematological toxicities, including neutropenia, although adverse events can be effectively managed using dose adjustments. Recent trials with CDK4/6 inhibitors have increased efforts to include Asians within study subsets. Future clinical trials enrolling higher numbers of Asian patients, and an increased understanding of differences in patient and tumor genetics between Asians and non-Asians, have the potential to incrementally improve the management of BC in Asian patients.
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Affiliation(s)
- Yen-Shen Lu
- Department of Oncology, National Taiwan University Hospital, No. 7, Chung Shan South Road, Taipei, 100, Taiwan.
| | - Winnie Yeo
- Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yoon-Sim Yap
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Yeon Hee Park
- Sungkyunkwan University, SKKU-Samsung Medical Centre, Seoul, South Korea
| | - Kenji Tamura
- Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Huiping Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing, China
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5
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Dai MS, Feng YH, Chen SW, Masuda N, Yau T, Chen ST, Lu YS, Yap YS, Ang PCS, Chu SC, Kwong A, Lee KS, Ow S, Kim SB, Lin J, Chung HC, Ngan R, Kok VC, Rau KM, Sangai T, Ng TY, Tseng LM, Bryce R, Bebchuk J, Chen MC, Hou MF. Analysis of the pan-Asian subgroup of patients in the NALA Trial: a randomized phase III NALA Trial comparing neratinib+capecitabine (N+C) vs lapatinib+capecitabine (L+C) in patients with HER2+metastatic breast cancer (mBC) previously treated with two or more HER2-directed regimens. Breast Cancer Res Treat 2021; 189:665-676. [PMID: 34553296 PMCID: PMC8505315 DOI: 10.1007/s10549-021-06313-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE Neratinib, an irreversible pan-HER tyrosine kinase inhibitor, has demonstrated systemic efficacy and intracranial activity in various stages of HER2+breast cancer. NALA was a phase III randomized trial that assessed the efficacy and safety of neratinib+capecitabine (N+C) against lapatinib+capecitabine (L+C) in HER2+ metastatic breast cancer (mBC) patients who had received ≥ 2 HER2-directed regimens. Descriptive analysis results of the Asian subgroup in the NALA study are reported herein. METHODS 621 centrally assessed HER2+ mBC patients were enrolled, 202 of whom were Asian. Those with stable, asymptomatic brain metastases (BM) were eligible for study entry. Patients were randomized 1:1 to N (240 mg qd) + C (750 mg/m2 bid, day 1-14) with loperamide prophylaxis or to L (1250 mg qd) + C (1000 mg/m2 bid, day 1-14) in 21-day cycles. Co-primary endpoints were centrally assessed progression-free survival (PFS) and overall survival (OS). Secondary endpoints included time to intervention for central nervous system (CNS) disease, objective response rate, duration of response (DoR), clinical benefit rate, and safety. RESULTS 104 and 98 Asian patients were randomly assigned to receive N+C or L+C, respectively. Median PFS of N+C and L+C was 7.0 and 5.4 months (P = 0.0011), respectively. Overall cumulative incidence of intervention for CNS disease was lower with N+C (27.9 versus 33.8%; P = 0.039). Both median OS (23.8 versus 18.7 months; P = 0.185) and DoR (11.1 versus 4.2 months; P < 0.0001) were extended with N+C, compared to L+C. The incidences of grade 3/4 treatment emergent adverse events (TEAEs) and TEAEs leading to treatment discontinuation were mostly comparable between the two arms. Diarrhea and palmar-plantar erythrodysesthesia were the most frequent TEAEs in both arms, similar to the overall population in incidence and severity. CONCLUSION Consistent with the efficacy profile observed in the overall study population, Asian patients with HER2+ mBC, who had received ≥ 2 HER2-directed regimens, may also benefit from N+C. No new safety signals were noted. CLINICAL TRIAL REGISTRATION NCT01808573.
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Affiliation(s)
- Ming Shen Dai
- Department of Hematology-Oncology, Tri-Service General Hospital, Taipei, Taiwan
| | - Yin Hsun Feng
- Department of Hematology-Oncology, Chi Mei Medical Center-Yongkang Branch, Tainan, Taiwan
| | - Shang Wen Chen
- Department of Hematology-Oncology, Chi Mei Medical Center-LiouYing Branch, Tainan, Taiwan
| | - Norikazu Masuda
- Department of Surgery and Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Thomas Yau
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Shou Tung Chen
- Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Yen Shen Lu
- Division of Medical Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yoon Sim Yap
- Department of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Peter C S Ang
- Department of Medical Oncology, OncoCare Cancer Centre, Singapore, Singapore
| | - Sung Chao Chu
- Department of Hematology-Oncology, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, Hong Kong
| | - Keun Seok Lee
- Center for Breast Cancer, National Cancer Center, Goyang-si, South Korea
| | - Samuel Ow
- Department of Haematology and Oncology, National University Cancer Institute, Singapore, Singapore
| | - Sung Bae Kim
- Department of Oncology, Asan Medical Center, Seoul, South Korea
| | - Johnson Lin
- Department of Hematology-Oncology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Hyun Cheol Chung
- Department of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Roger Ngan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, Hong Kong
| | - Victor C Kok
- Division of Medical Oncology, Kuang Tien General Hospital Cancer Center, Taichung, Taiwan
| | - Kun Ming Rau
- Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung, Taiwan
| | - Takafumi Sangai
- Department of Breast and Thyroid Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Ting Ying Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong, Hong Kong
| | - Ling Ming Tseng
- Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Judith Bebchuk
- Department of Biostatistics, Puma Biotechnology Inc., Los Angeles, USA
| | - Mei Chieh Chen
- Clinical Development and Medical Affairs, CANbridge Pharmaceuticals Inc., Taipei, Taiwan
| | - Ming Feng Hou
- Division of Breast Oncology and Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, No.100, Tzyou 1st Road, Kaohsiung, 807, Taiwan.
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Yang X, Wu D, Yuan S. Tyrosine Kinase Inhibitors in the Combination Therapy of HER2 Positive Breast Cancer. Technol Cancer Res Treat 2020; 19:1533033820962140. [PMID: 33034269 PMCID: PMC7592330 DOI: 10.1177/1533033820962140] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC)
accounts for about 20% to 30% of all BC subtypes and is characterized by
invasive disease and poor prognosis. With the emergence of anti-HER2 target
drugs, HER2-positive BC patient outcomes have changed dramatically. However,
treatment failure is mostly due to drug resistance and the special treatment
needs of different subgroups. Small molecule tyrosine kinase inhibitors can
inhibit multiple targets of the human epidermal growth factor receptor family
and activate PI3K/AKT, MAPK, PLC γ, ERK1/2, JAK/STAT, and other pathways
affecting the expression of MDM2, mTOR, p27, and other transcription factors.
This can help regulate the differentiation, apoptosis, migration, growth, and
adhesion of normal cells and reverse drug resistance to a certain extent. These
inhibitors can cross the blood-brain barrier and be administered orally. They
have a good synergistic effect with effective drugs such as trastuzumab,
pertuzumab, t-dm1, and cyclin-dependent kinase 4 and 6 inhibitors. These
advantages have resulted in small-molecule tyrosine kinase inhibitors attracting
attention. The new small-molecule tyrosine kinase inhibitor was investigated in
multi-target anti-HER2 therapy, showed a good effect in preclinical and clinical
trials, and to some extent, improved the prognosis of HER2-positive BC patients.
Its use could lead to a de-escalation of treatment in some patients, possibly
preventing unnecessary procedures along with the associated side effects and
costs.
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Affiliation(s)
- Xue Yang
- Department of Oncology, Qingdao Municipal Hospital, Qingdao, China
| | - Dapeng Wu
- Department of Oncology, Qingdao Municipal Hospital, Qingdao, China
| | - Shengli Yuan
- Department of Oncology, Qingdao Municipal Hospital, Qingdao, China
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Park YH, Senkus-Konefka E, Im SA, Pentheroudakis G, Saji S, Gupta S, Iwata H, Mastura MY, Dent R, Lu YS, Yin Y, Smruti BK, Toyama T, Malwinder S, Lee SC, Tseng LM, Kim JH, Kim TY, Suh KJ, Cardoso F, Yoshino T, Douillard JY. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with early breast cancer: a KSMO-ESMO initiative endorsed by CSCO, ISMPO, JSMO, MOS, SSO and TOS. Ann Oncol 2020; 31:451-469. [PMID: 32081575 DOI: 10.1016/j.annonc.2020.01.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/20/2019] [Accepted: 01/04/2020] [Indexed: 12/27/2022] Open
Abstract
In view of the planned new edition of the most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of primary breast cancer published in 2015, it was decided at the ESMO Asia Meeting in November 2018, by both the ESMO and the Korean Society of Medical Oncology (KSMO), to convene a special face-to-face guidelines meeting in 2019 in Seoul. The aim was to adapt the latest ESMO 2019 guidelines to take into account the ethnic and geographical differences associated with the treatment of early breast cancer in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with early breast cancer representing the oncology societies of Korea (KSMO), China (CSCO), India (ISMPO) Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and was independent of both the current treatment practices, and the drug availability and reimbursement situations, in the individual participating Asian countries.
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Affiliation(s)
- Y H Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - E Senkus-Konefka
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - S-A Im
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - S Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - S Gupta
- Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - M Y Mastura
- Pantai Cancer Institute, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - R Dent
- Medical Oncology, National Cancer Center Singapore, Singapore, Singapore
| | - Y-S Lu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Y Yin
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - B K Smruti
- Medical Oncology, Lilavati Hospital and Research Centre and Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - T Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - S Malwinder
- Sri Kota Specialist Medical Centre, Selangor, Malaysia
| | - S C Lee
- Department of Haematology-Oncology, National University, Cancer Institute, Singapore, (NCIS) National University Health System, Singapore, Singapore
| | - L-M Tseng
- Department of Surgery, Taipei-Veterans General Hospital, Taipei, Taiwan
| | - J H Kim
- Division of Hematology/Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - T-Y Kim
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - K J Suh
- Division of Hematology-Medical Oncology, Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Xu B, Kim SB, Inoue K, Lee J, Zhang B, Bryce R, Chow LWC. Neratinib-based therapy in patients with metastatic HER2-positive breast cancer from Asia. Future Oncol 2019; 15:3243-3253. [DOI: 10.2217/fon-2019-0222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate the safety and efficacy of neratinib-based therapy in Asian patients with HER2-positive metastatic breast cancer (MBC). Patients & methods: We performed a pooled analysis of seven early-phase studies of neratinib given either as monotherapy or in combination with chemotherapeutic agents or trastuzumab in patients with advanced solid tumors. Results: A total of 793 patients with HER2-positive MBC were included in the efficacy analysis (Asia: 271 patients; other regions: 522 patients). The overall response rate in patients from Asia was 66.4% (180/271) and the median progression-free survival was 55.6 weeks. The most common adverse event in patients from Asia was diarrhea (all-grade: 96.3%; grade 3: 27.4%). Conclusion: Neratinib-based therapy is safe and effective in patients with HER2-positive MBC from Asia.
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Affiliation(s)
- Binghe Xu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, PR China
| | - Sung-Bae Kim
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, Korea
| | - Kenichi Inoue
- Division of Breast Oncology, Saitama Cancer Center, Saitama 362 0806, Japan
| | | | - Bo Zhang
- Puma Biotechnology Inc., Los Angeles, CA 90024, USA
| | | | - Louis W-C Chow
- Comprehensive Centre for Breast Diseases, Unimed Medical Institute, Wan Chai, Hong Kong
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