LR/mBCa: dual HER2-blockade plus taxane does well in PERUSE

  • Bachelot T & al.
  • Ann Oncol
  • 23 Feb 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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  • Preliminary results from the PERUSE trial find that front-line dual blockade with pertuzumab and trastuzumab plus a taxane is safe and effective for human epidermal growth factor receptor 2 (HER2)-positive locally recurrent (LR) or metastatic breast cancer (mBCa).
  • Docetaxel, paclitaxel, and nab-paclitaxel were similarly effective with different safety profiles.

Why this matters

  • Findings consistent with the CLEOPATRA trial, supporting paclitaxel as a safe and effective alternative to docetaxel, with a different safety profile.

Study design

  • Multicenter, single-group phase 3b PERUSE trial of 1436 patients with HER2+ LR/mBCa receiving investigator-selected taxanes until disease progression or unacceptable toxicity.
  • Primary outcome was safety.
  • Funding: F. Hoffmann LaRoche Ltd.

Key results

  • Paclitaxel-containing therapy (vs docetaxel-containing) was associated with more all-grade peripheral neuropathy (31% vs 16%) but less febrile neutropenia (1% vs 11%) and mucositis (14% vs 25%).
  • At median 52.2 months, median overall PFS was 20.6 (95% CI, 18.9-22.7) months, with similar duration among individual taxanes:
    • Docetaxel 19.6; 95% CI, 16.9-21.8 months.
    • Paclitaxel 23.0; 95% CI, 19.8-25.8 months.
    • Nab-paclitaxel 18.1; 95% CI, 12.2-32.3 months.
  • Overall objective response rate was 80% (95% CI, 78%-82%), with similar rates among individual taxanes:
    • Docetaxel 79%; 95% CI, 75%-82%.
    • Paclitaxel 83%; 95% CI, 79%-86%.
    • Nab-paclitaxel 77%; 95% CI, 64%-88%.


  • Nonrandomized design.

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