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APHINITY 研究:帕妥珠单抗联合曲妥珠单抗和化疗用于 HER2 阳性早期乳腺癌患者的报告功能、健康相关生活质量和症状。

Patient-reported function, health-related quality of life, and symptoms in APHINITY: pertuzumab plus trastuzumab and chemotherapy in HER2-positive early breast cancer.

机构信息

Department of Medical Oncology, Instituto Nacional de Câncer, Rio de Janeiro, Brazil.

Roche Products Limited, Welwyn Garden City, UK.

出版信息

Br J Cancer. 2021 Jul;125(1):38-47. doi: 10.1038/s41416-021-01323-y. Epub 2021 Apr 7.

Abstract

BACKGROUND

We assessed health-related quality of life (symptoms of therapy/patient functioning/global health status), in APHINITY (pertuzumab/placebo, trastuzumab, and chemotherapy as adjuvant HER2-positive early breast cancer therapy).

METHODS

Patients received 1 year/18 cycles of pertuzumab/placebo with trastuzumab and chemotherapy and completed EORTC QLQ-C30 and BR23 questionnaires until 36 months post-randomisation/disease recurrence. Changes ≥10 points from baseline were considered clinically meaningful.

RESULTS

87-97% of patients completed questionnaires. In the pertuzumab versus placebo arms, mean decrease in physical function scores (baseline → end of taxane) was -10.7 (95% CI -11.4, -10.0) versus -10.6 (-11.4, -9.9), mean decrease in global health status was -11.2 (-12.2, -10.2) versus -10.2 (-11.1, -9.2), and mean increase in diarrhoea scores (baseline → end of taxane) was +22.3 (21.0, 23.6) versus +9.2 (8.2, 10.2). Diarrhoea scores remained elevated versus baseline in the pertuzumab arm throughout HER2-targeted treatment (week 25: +13.2; end of treatment: +12.2). Role functioning was maintained in both arms.

CONCLUSIONS

Improved invasive disease-free survival achieved by adding pertuzumab to trastuzumab and chemotherapy did not adversely affect the ability to conduct activities of daily living versus trastuzumab and chemotherapy alone. Patient-reported diarrhoea worsened during taxane therapy in both arms, persisting during HER2-targeted treatment in the pertuzumab arm. CLINICALTRIALS.GOV: NCT01358877.

摘要

背景

我们评估了与健康相关的生活质量(治疗相关症状/患者功能/总体健康状况),在 APHINITY(曲妥珠单抗/安慰剂、帕妥珠单抗、曲妥珠单抗和化疗作为辅助 HER2 阳性早期乳腺癌治疗)中。

方法

患者接受了 1 年/18 个周期的曲妥珠单抗/安慰剂联合帕妥珠单抗和化疗,并在随机分组/疾病复发后 36 个月内完成了 EORTC QLQ-C30 和 BR23 问卷。与基线相比变化≥10 分被认为具有临床意义。

结果

87-97%的患者完成了问卷。在曲妥珠单抗组与安慰剂组中,体力功能评分的平均下降(从基线到紫杉醇结束)分别为-10.7(95%CI-11.4,-10.0)和-10.6(-11.4,-9.9),总体健康状况的平均下降为-11.2(-12.2,-10.2)和-10.2(-11.1,-9.2),腹泻评分的平均增加(从基线到紫杉醇结束)分别为+22.3(21.0,23.6)和+9.2(8.2,10.2)。在曲妥珠单抗组中,腹泻评分在整个曲妥珠单抗靶向治疗期间仍高于基线(第 25 周:+13.2;治疗结束时:+12.2)。在两个臂中,角色功能均得以维持。

结论

与单独使用曲妥珠单抗和化疗相比,加入帕妥珠单抗可提高浸润性无病生存率,但不会对单独使用曲妥珠单抗和化疗的日常生活活动能力产生不利影响。在两个臂中,紫杉烷治疗期间患者报告的腹泻均恶化,在曲妥珠单抗靶向治疗期间在曲妥珠单抗组中持续存在。CLINICALTRIALS.GOV:NCT01358877。

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