A real world study on the relationship between drug resistance of targeted therapy and prognosis of HER-2-positive advanced breast cancer.
10.3760/cma.j.cn112152-20200409-00325
- Author:
Zi Jing WANG
1
;
Yi Qun HAN
1
;
Qiao LI
1
;
Hong Nan MO
1
;
Yi Qun LI
1
;
Xiu Wen GUAN
1
;
Yi Meng CHEN
1
;
Shao Yan LIN
1
;
Bing He XU
1
;
Qing LI
1
;
Pin ZHANG
1
;
Fei MA
1
Author Information
1. Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021, China.
- Publication Type:Journal Article
- Keywords:
Acquired drug resistance;
Anti-HER-2 drugs;
Breast neoplasms;
Primary drug resistance
- MeSH:
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Breast Neoplasms/pathology*;
Drug Resistance;
Female;
Humans;
Middle Aged;
Neoadjuvant Therapy;
Prognosis;
Receptor, ErbB-2/metabolism*;
Trastuzumab/therapeutic use*;
Treatment Outcome
- From:
Chinese Journal of Oncology
2022;44(4):360-363
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the effect of primary and acquired resistance to anti-human epidermal growth factor receptor 2 (HER-2) on the overall survival of patients with HER-2 positive advanced breast cancer. Methods: The clinical characteristics of HER-2 positive patients with advanced breast cancer admitted to Cancer Hospital of Chinese Academy of Medical Sciences from January 1998 to December 2018 were collected, and their neoadjuvant/adjuvant and advanced three-line chemotherapy were summarized. Among them, targeted drugs for HER-2 included trastuzumab, pertuzumab, T-DM1, RC48-ADC, lapatinib, pyrotinib, allitinib, sipatinib, seratinib. Based on the duration of benefit from anti HER-2 treatment, the patients were divided into two groups: primary anti HER-2 resistance group and acquired anti HER-2 resistance group. In this study, the overall survival (OS) was used as the main end point. Kaplan-Meier analysis and Cox proportional risk regression model were used to analyze the effects of different drug resistance mechanisms on the overall survival. Results: The whole group of 284 patients were included. The median age of recurrence and metastasis was 48 years old, 155 (54.6%) were hormone receptor (HR) positive and 129 (45.4%) were HR negative, 128 cases (45.1%) were premenopausal and 156 cases (54.9%) were postmenopausal, 277 cases (97.5%) had a score of 0-1 in ECoG PS and 7 cases (2.5%) had a score of more than 2 in the first diagnosis of relapse and metastasis. There were 103 cases (36.3%) in the primary drug resistance group and 181 cases (63.7%) in the secondary drug resistance group. The median overall survival time of the two groups was 24.9 months and 40.4 months, respectively, with statistical significance (P<0.001). Conclusion: Primary resistance to HER-2 is one of the factors of poor prognosis in HER-2 positive breast cancer, and its mechanism needs to be further explored.
