HER2+ metastatic breast cancer: pyrotinib yields benefits in real-world analysis

  • Chen Q & al.
  • Front Oncol
  • 1 Jan 2020

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Pyrotinib, a pan inhibitor of Erb-B2 receptor tyrosine kinase, is safe and effective as second-line or higher-line therapy in patients with HER2+ metastatic breast cancer, according to a real-world cohort study from China.
  • Patients with brain metastases do as well as other patients.

Why this matters

  • Data have been scarce regarding the benefits of pyrotinib in real-world use.
  • Pyrotinib appears to be a feasible approach in combination with chemotherapy or as a replacement for lapatinib.

Study design

  • Multicenter cohort of 168 patients with HER2+ metastatic breast cancer.
  • PFS was the primary outcome.
  • Tumor mutation burden (TMB) was assayed in 28 patients, using a panel of 1021 genes as mutations per megabase.
  • Funding: None disclosed.

Key results

  • Median PFS among all participants was 8.07 (95% CI, 7.041-9.009) months.
  • Median PFS with second-line therapy was 8.17 months (n=65).
  • Median PFS was 7.60 months with third-line or higher use (n=94).
  • Median PFS in patients with brain metastases was 8.80 months.
  • Median PFS in patients previously treated with lapatinib was shorter (6.43 months) than in those without previous lapatinib (8.37 months).
  • High TMB was associated with poor PFS (P=.0176).
  • Diarrhea was the most common adverse event (AE), occurring in 98.2% (across all grades) and in 19.6% of participants with grade 3-4 AEs.

Limitations

  • Observational.