Endometrial cancer: add-on trastuzumab extends survival in rare type

  • Fader AN & al.
  • Clin Cancer Res
  • 29 Jun 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In women with stage III-IV or recurrent, HER2/neu-positive uterine serous carcinoma, the addition of trastuzumab to carboplatin+paclitaxel yielded a significant improvement in survival.

Why this matters

  • The National Comprehensive Cancer Network recommended the chemotherapy/trastuzumab combination as the preferred treatment in this setting based on preliminary PFS data.

Study design

  • Updated analysis of phase 2 randomized trial.
  • 61 patients who had stage III-IV or recurrent uterine serous carcinoma were randomly assigned to receive carboplatin+paclitaxel with or without trastuzumab followed by maintenance trastuzumab until progression or toxicity.
  • Funding: None disclosed.

Key results

  • The median follow-up was 25.9 months.
  • 43 progressions and 38 deaths were reported in 58 evaluable patients.
  • Trastuzumab significantly prolonged median PFS:
    • Overall: 12.9 vs 8.0 months (HR, 0.46; P=.005).
    • Stage III-IV disease: 17.7 vs 9.3 months (HR, 0.44; P =.015).
    • Recurrent disease: 9.2 vs 7.0 months (HR =0.12; P =.004).
  • OS significantly improved in the add-on trastuzumab group:
    • Overall: 29.6 vs 24.4 months (HR, 0.58; P=.046).
    • Stage III-IV disease: not reached vs 24.4 months (HR, 0.49; P=.041).
    • No significant OS benefit from trastuzumab was observed in patients with recurrent disease.
  • Toxicity was not significantly different between the 2 groups (P=.49).

Limitations

  • Small size.