Rush University Cancer Center, Rush University Medical Center, Chicago, Illinois.
Breast Cancer Research Program, Sarah Cannon Research Institute and Tennessee Oncology, Nashville, Tennessee.
Clin Cancer Res. 2020 Mar 1;26(5):1105-1113. doi: 10.1158/1078-0432.CCR-19-2350. Epub 2019 Nov 26.
We report treatments and outcomes in a contemporary patient population with HER2-positive metastatic breast cancer (MBC) by hormone receptor (HR) status from the Systemic Therapies for HER2-positive Metastatic Breast Cancer Study (SystHERs).
SystHERs (NCT01615068) was an observational, prospective registry study of U.S.-based patients with newly diagnosed HER2-positive MBC. Endpoints included treatment patterns and clinical outcomes.
Of 977 eligible patients (enrolled from 2012 to 2016), 70.1% ( = 685) had HR-positive and 29.9% ( = 292) had HR-negative disease. Overall, 59.1% (405/685) of patients with HR-positive disease received any first-line endocrine therapy (with or without HER2-targeted therapy or chemotherapy); 34.9% (239/685) received HER2-targeted therapy + chemotherapy + sequential endocrine therapy. Patients with HR-positive versus HR-negative disease had longer median overall survival (OS; 53.0 vs 43.4 months; hazard ratio, 0.70; 95% confidence interval, 0.56-0.87). Compared with patients with high HR-positive staining (10%-100%, = 550), those with low HR-positive staining (1%-9%, = 60) received endocrine therapy less commonly (64.2% vs 33.3%) and had shorter median OS (53.8 vs 40.1 months). Similar median OS (43.4 vs 40.1 months) was observed in patients with HR-negative versus low HR-positive tumors (1%-9%).
Despite evidence that first-line HER2-targeted therapy, chemotherapy, and sequential endocrine therapy improves survival in patients with HR-positive, HER2-positive disease, only 34.9% of patients in this real-world setting received such treatment. Patients with low tumor HR positivity (1%-9%) had lower endocrine therapy use and worse survival than those with high tumor HR positivity (10%-100%).
我们报告了一项当代人 HER2 阳性转移性乳腺癌（MBC）患者人群中，按激素受体（HR）状态进行的治疗和结果，这些患者来自 HER2 阳性转移性乳腺癌的系统治疗研究（SystHERs）。
SystHERs（NCT01615068）是一项观察性、前瞻性注册研究，纳入了美国新诊断为 HER2 阳性 MBC 的患者。终点包括治疗模式和临床结局。
在 977 例合格患者中（2012 年至 2016 年入组），70.1%（=685）为 HR 阳性，29.9%（=292）为 HR 阴性。总体而言，685 例 HR 阳性疾病患者中，59.1%（405/685）接受了任何一线内分泌治疗（联合或不联合 HER2 靶向治疗或化疗）；34.9%（239/685）接受了 HER2 靶向治疗+化疗+序贯内分泌治疗。HR 阳性与 HR 阴性疾病患者的中位总生存期（OS）更长（53.0 与 43.4 个月；风险比，0.70；95%置信区间，0.56-0.87）。与高 HR 阳性染色（10%-100%，=550）患者相比，低 HR 阳性染色（1%-9%，=60）患者较少接受内分泌治疗（64.2%与 33.3%），中位 OS 更短（53.8 与 40.1 个月）。HR 阴性与低 HR 阳性肿瘤（1%-9%）患者的中位 OS 相似（43.4 与 40.1 个月）。
尽管有证据表明一线 HER2 靶向治疗、化疗和序贯内分泌治疗可改善 HR 阳性、HER2 阳性疾病患者的生存，但在这一真实世界环境中，只有 34.9%的患者接受了此类治疗。肿瘤 HR 阳性率较低（1%-9%）的患者接受内分泌治疗的比例较低，生存较差，而肿瘤 HR 阳性率较高（10%-100%）的患者则不然。
