Department of Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, via A. Manzoni 56 20089, Rozzano, Milano, Italy.
Oncologia Medica, IRCCS ICS Maugeri, Pavia, Italy.
Breast Cancer Res Treat. 2021 Nov;190(1):103-109. doi: 10.1007/s10549-021-06371-9. Epub 2021 Aug 27.
The most appropriate therapy for HR + /HER2-positive (HER2 +) advanced breast cancer (ABC) is a matter of debate. Co-targeting of both receptors represents an attractive strategy to overcome the cross-talk between them.
The HERMIONE 9 is an observational retrospective multicentric study which aimed to describe the clinical outcome of patients with HR + /HER2 + ABC who received the combination of Fulvestrant (F) and Trastuzumab (T) as part of their routine treatment at 10 Italian Institutions.
Eighty-seven patients were included. Median age was 63 (range, 35-87) years. The median number of previous treatments was 3 (range, 0-10) and F and T were administered as ≥ 3rd line in 67 patients. Among the 86 evaluable patients, 6 (6.9%) achieved CR, 18 (20.7%) PR, and 44 (50.6%) had SD ≥ 24 weeks with an overall CBR of 78.2%. At a median follow-up of 33.6 months, mPFS of the entire cohort was 12.9 months (range, 2.47-128.67). No difference was observed in mPFS between patients treated after progression or as maintenance therapy (mPFS 12.9 and 13.9 months in 64 and 23 patients, respectively), neither considering the number of previous treatment lines (≤ 3 or < 3).
The combination of F and T was active in this cohort at poor prognosis and deserves further investigations possibly in combination with pertuzumab in patients with high ER expression.
HR+/HER2+（HER2+）晚期乳腺癌（ABC）的最佳治疗方法存在争议。同时靶向这两个受体是克服它们之间交叉对话的一种有吸引力的策略。
HERMIONE9 是一项观察性回顾性多中心研究，旨在描述在意大利 10 个机构中，作为常规治疗的一部分，接受氟维司群（F）和曲妥珠单抗（T）联合治疗的 HR+/HER2+ABC 患者的临床结果。
共纳入 87 例患者。中位年龄为 63 岁（范围，35-87 岁）。中位治疗线数为 3 条（范围，0-10 条），67 例患者接受了 F 和 T 的治疗≥3 线。在 86 例可评估患者中，6 例（6.9%）达到了 CR，18 例（20.7%）达到了 PR，44 例（50.6%）有≥24 周的 SD，总体 CBR 为 78.2%。在中位随访 33.6 个月时，整个队列的 mPFS 为 12.9 个月（范围，2.47-128.67）。在进展后治疗或维持治疗的患者之间，mPFS 无差异（64 例和 23 例患者的 mPFS 分别为 12.9 和 13.9 个月），也与之前的治疗线数无关（≤3 或<3）。
在这个预后较差的患者队列中，F 和 T 的联合治疗是有效的，值得进一步研究，可能与高 ER 表达的患者联合使用 pertuzumab。
