Lazaratos Anna-Maria, Dankner Matthew, Hamouda Aalya, Labidi Soumaya, Cohen Victor, Panasci Lawrence, Friedmann Jennifer E, Patenaude François, Ferrario Cristiano, Basik Mark, Rose April A N, Fallah Parvaneh
Rosalind and Morris Goodman Cancer Institute, Montreal, QC H3A 1A3, Canada.
Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada.
Curr Oncol. 2024 Dec 24;32(1):1. doi: 10.3390/curroncol32010001.
Trastuzumab deruxtecan (TDXd) is an antibody-drug conjugate that has demonstrated impressive activity in randomized controlled clinical trials in the context of patients with HER2-amplified and HER2-low metastatic breast cancer. We aimed to review the activity and adverse event profile of TDXd in heavily pretreated breast cancer patients in real practice.
We describe a single-center retrospective case series of metastatic breast cancer patients who were treated with TDXd. The outcomes of interest were the overall response rate, overall survival, progression-free survival and grade 4-5 adverse events. Objective responses and PFS were assessed in accordance with RECIST 1.1 criteria.
We identified 38 patients treated with TDXd. Of these, 15 patients had classically defined HER2-positive (HER2+) breast cancer, 4 of whom had active central nervous system (CNS) metastases. A total of 23 patients had HER2-low breast cancer, 2 of whom had active CNS disease. Of the 33 patients evaluable for response, 21 (63%) patients had a response to treatment, including three (9%) complete responses. Outcomes were similar between patients with a HER2+ and HER2-low status, as well as in patients with or without CNS metastases. No patients experienced grade 4 or 5 toxicities, and four of thirty-eight patients (10.5%) experienced pneumonitis (two patients with grade 3 pneumonitis, one patient with grade 2 and one patient with grade 1), resulting in TDXd discontinuation for three patients (with steroid administration in two patients).
TDXd demonstrates impressive activity with manageable adverse event profiles in this heavily pretreated population that includes patients with active CNS metastases.
曲妥珠单抗德鲁昔单抗（TDXd）是一种抗体药物偶联物，在HER2扩增和HER2低表达转移性乳腺癌患者的随机对照临床试验中显示出令人印象深刻的活性。我们旨在回顾TDXd在实际临床中对经过大量治疗的乳腺癌患者的活性和不良事件情况。
我们描述了一组接受TDXd治疗的转移性乳腺癌患者的单中心回顾性病例系列。关注的结果包括总缓解率、总生存期、无进展生存期和4-5级不良事件。客观缓解和无进展生存期根据RECIST 1.1标准进行评估。
我们确定了38例接受TDXd治疗的患者。其中，15例患者为经典定义的HER2阳性（HER2+）乳腺癌，4例有活跃的中枢神经系统（CNS）转移。共有23例患者为HER2低表达乳腺癌，2例有活跃的CNS疾病。在33例可评估缓解的患者中，21例（63%）患者对治疗有反应，包括3例（9%）完全缓解。HER2+和HER2低表达状态的患者之间，以及有或无CNS转移的患者之间，结果相似。没有患者发生4级或5级毒性反应，38例患者中有4例（10.5%）发生肺炎（2例3级肺炎患者，1例2级患者和1例1级患者），导致3例患者停用TDXd（2例患者接受了类固醇治疗）。
在这个包括有活跃CNS转移患者的经过大量治疗的人群中，TDXd显示出令人印象深刻的活性，不良事件情况可控。
