Valencia Guillermo, Rioja Patricia, Peralta Olenka, Chirito Miguel, Mantilla Raúl, Castañeda Carlos, Morante Zaida, Fuentes Hugo, Vidaurre Tatiana, Calderón Mónica, Neciosup Silvia, Gómez Henry L
Medical Oncology Department, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru.
Grupo de Estudios Clínicos Oncológicos del Perú (GECOPERU), Lima, Peru.
Breast Cancer (Auckl). 2025 May 22;19:11782234251342477. doi: 10.1177/11782234251342477. eCollection 2025.
Advanced breast cancer (ABC) is an incurable disease, with a median overall survival (OS) of 3 years, even in high-income countries. Oncological treatment has improved survival rates, particularly for hormone receptor-positive and HER2-positive subtypes; however, access to new therapies in Latin American (LATAM) countries is limited.
The impact of sequencing 2 lines of therapy in Peruvian patients with HER2-positive ABC in a single public institution was evaluated. First-line (1L) treatment consisted of trastuzumab and chemotherapy (CT, with taxanes), followed by second-line (2L) treatment with lapatinib plus capecitabine.
In this retrospective study, we analyze clínico-pathological features (including blood biomarkers) collected from medical records of patients with HER2-positive ABC treated in a public Peruvian oncologic institution and its association with survival between 2020 and 2022.
Efficacy was measured using OS and progression-free survival (PFS). A discussion was added on the impact of OS based on clinicopathological characteristics, including outcomes in 2L "long-term responder" patients (who achieved response to 2L therapy ⩾6 months) and the evaluation of blood biomarkers.
Treatment sequencing has been demonstrated to enhance OS in patients with HER2-positive ABC, with a median OS of 34 months. This effect is more pronounced among long-term responders (37 months), particularly those without central nervous system (CNS) involvement, as compared with those with CNS metastases (51 vs 34 months). Blood biomarkers were not found to be prognostic indicators for either PFS or OS.
Treatment sequencing has been demonstrated to enhance OS in LATAM patients with HER2-positive ABC. This study did not identify any prognostic blood biomarkers. These outcomes could influence the selection criteria for patients to receive treatment sequencing in countries without full access to innovative oncological therapies.
晚期乳腺癌（ABC）是一种无法治愈的疾病，即使在高收入国家，其总体中位生存期（OS）也仅为3年。肿瘤治疗提高了生存率，特别是对于激素受体阳性和HER2阳性亚型；然而，拉丁美洲（LATAM）国家获得新疗法的机会有限。
评估在一家单一的公共机构中，对秘鲁HER2阳性ABC患者进行二线治疗测序的影响。一线（1L）治疗包括曲妥珠单抗和化疗（CT，使用紫杉烷），随后二线（2L）治疗为拉帕替尼加卡培他滨。
在这项回顾性研究中，我们分析了2020年至2022年期间在秘鲁一家公共肿瘤机构接受治疗的HER2阳性ABC患者病历中收集的临床病理特征（包括血液生物标志物）及其与生存的相关性。
使用总生存期（OS）和无进展生存期（PFS）来衡量疗效。基于临床病理特征，包括二线“长期缓解者”（对二线治疗有反应≥6个月）的结果和血液生物标志物的评估，对OS的影响进行了讨论。
已证明治疗测序可提高HER2阳性ABC患者的OS，中位OS为34个月。与有中枢神经系统（CNS）转移的患者（51个月对34个月）相比，这种效果在长期缓解者中更为明显（37个月），特别是那些没有CNS受累的患者。未发现血液生物标志物是PFS或OS的预后指标。
已证明治疗测序可提高拉丁美洲HER2阳性ABC患者的OS。本研究未发现任何预后血液生物标志物。这些结果可能会影响在无法完全获得创新肿瘤治疗的国家中患者接受治疗测序的选择标准。
