Trastuzumab-based Retreatment after Lapatinib in Heavily Pretreated HER2 Positive Metastatic Breast Cancer: an Anatolian Society of Medical Oncology Study

Uncu, Doğan; Bayoğlu, İbrahim Vedat; Arslan, Ulku Yalcintas; Küçüköner, Mehmet; Artaç, Mehmet; Koca, Doğan; Oğuz, Arzu; Demırcı, Umut; Arpaci, Erkan; Doğan, Mutlu; Küçükzeybek, Yüksel; Türker, İbrahim; Işıkdoğan, Abdurrahman; Güler, Tunç; Zengi̇n, Nurullah

doi:10.7314/apjcp.2015.16.9.4127

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…The first-choice pharmacological treatment for patients with HER2 protein overexpression is based on the combination of trastuzumab (TRA) (Herceptin®, Roche) with other chemotherapy agents. Although TRA may be used for retreatment of refractory cases, to date, there is no consensus on its indication for this specific scenario [10].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Trastuzumab Emtansine in the Treatment of Metastatic Breast Cancer

Mosegui

Vianna

Rodrigues

et al. 2017

Int J Pharm Pharm Sci

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Objective: To investigate the cost-effectiveness of second-line pharmacological treatments for metastatic breast cancer (MBC) by comparing trastuzumab emtansine (T-DM1) versus a combination of lapatinib and capecitabine (LAP+CAP) from the perspective of the Brazilian health system, the Unified Health System (Sistema Único de Saúde–SUS).Methods: The results of each treatment were simulated based on a three-state Markov decision model applied to a hypothetical cohort of 1,000 women, aged 50 y old or older, with MBC and HER2 (human epidermal growth factor receptor 2) overexpression. The data on the effectiveness of treatments were taken from reports in the literature. The period considered for simulation was three years subdivided into monthly cycles of transition between health states. A discount rate of 5% per year was applied to costs and outcomes. Possible uncertainty was assessed by means of a sensitivity analysis.Results: Chemotherapy for women with refractory MBC using T-DM1 monotherapy was ruled out by extended dominance. Treatment with LAP+CAP proved to be the most efficient strategy because the cost in relation to the overall survival (BRL 72,035.43/quality-adjusted life year–QALY) was the lowest and fell within the acceptability threshold, BRL 86,628.00.Conclusion: T-DM1 demonstrated pharmacological superiority over other agents used for the treatment of MBC in clinical studies. However, the price set for T-DM1 in Brazil is the determinant variable that contraindicates its inclusion in the SUS, in agreement with other international assessments.

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Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Trastuzumab Emtansine in the Treatment of Metastatic Breast Cancer

Mosegui

Vianna

Rodrigues

et al. 2017

Int J Pharm Pharm Sci

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Outcome of eribulin as a late treatment line for Thai metastatic breast cancer patients

Ditsatham

Chitapanarux

Somwangprasert

et al. 2018

OTT

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BackgroundWe report the safety and efficacy of eribulin as a late treatment line in Thai metastatic breast cancer (MBC) patients.Patients and methodsA total of 30 MBC patients treated with eribulin between January 2014 and January 2017 were retrospectively analyzed. The patients were scheduled to receive 1.4 mg/m2 of eribulin on day 1, day 8 and subsequently every 21 days. All patients had previously received at least three chemotherapy regimens including anthracycline and taxane. Response rate and progression-free survival (PFS) were analyzed.ResultsThe median age was 56 years (range, 40–74 years), with a median follow-up time of 5.7 months (range, 0.2–25 months). The overall response rate was 30% (nine patients): four patients had triple-negative breast cancer, three patients had luminal B breast cancer and two patients had luminal A breast cancer. The median PFS was 2.9 months (range, 0.2–14 months). The median number of previous chemotherapy regimens was 4 (range, 3–9). Univariate analysis showed that the number of regimens (four or fewer) prior to eribulin was statistically associated with superior PFS (P = 0.009). Multivariate analysis also showed similar statistical association between number of prior regimens (four or fewer) and better PFS adjusted by age group (≥50 years; hazard ratio = 1.29; 95% CI: 1.0–1.65; P = 0.046). There were no toxic deaths or grade 4 toxicities. Nine (30%) patients had grade 3 anemia toxicities, and the other common toxicities were leukopenia and neutropenia. Four (13%) patients required dose reduction and 16 (53%) patients required dose delay because of toxicities.ConclusionEribulin is an effective drug for heavily pretreated MBC patients with tolerable toxicities. The benefit was superior in patients who received fewer than four previous chemotherapy regimens.

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The potential of using eribulin in patients with breast cancer, associated with brain metastasis: the scientific background and the Russian clinical experience

Kolyadina¹,

Владимировна²,

Bulavina³

et al. 2019

J. Mod. Onco.

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Aim. Eribulin is an active cytostatic, associated with a wide range of mechanisms of antitumor effects, but eribulin efficiency and safety in patients with breast cancer (BC), associated with cerebral metastases are still poorly understood. Materials and methods. We analyzed the combined Russian experience of eribulin application in BC patients associated with brain metastases; the analysis included 459 Russian women with advanced BC who had received at least 2 course of eribulin during the period from 2014 to 2018; 35 of 459 patients had brain metastases (40.0% - luminal HER2-negative subtype, 31.4% - triple negative subtype and 28.6%h - HER2-positive BC). The median age was 52 years (39 - 80 years of age). In most cases, the patient had two or more metastatic brain lesions (68.6%; the median was - 3); brain radiotherapy was used in 62.8% of patients before eribulin treatment and in 5.8% of patients was held stereotactic radiation therapy during eribulin chemotherapy. We analyzed the efficiency of eribulin application (the therapy continued until disease progression, the development of unacceptable toxicity, or impossibility to apply the drug for any other reason). Results. The results showed that clinical efficacy (objective response rate + stabilization of disease lasting for more than 6 months) was 48.6%: partial response - in 20% of patients and stabilization of disease - 62.9%; tumor growth control was in 82.9%. Median PFS in all group of patients with brain metastases was 4.1 months and was similar to median PFS in patients who received radiotherapy before eribulin treatment or without eribulin - 4.1 vs 3.47 months; p=0.798. Conclusions. The application of eribulin in BC patients with brain metastasis are absolutely justified, the drug demonstrates the efficiency in a retrospective analysis in a Russian population. The determination of the optimal algorithm for the treatment of patients with metastatic BC associated with brain metastasis requires a multidisciplinary approach and further research.

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Trastuzumab-based Retreatment after Lapatinib in Heavily Pretreated HER2 Positive Metastatic Breast Cancer: an Anatolian Society of Medical Oncology Study

Cited by 3 publications

References 27 publications

Cost-Effectiveness Analysis of Trastuzumab Emtansine in the Treatment of Metastatic Breast Cancer

Cost-Effectiveness Analysis of Trastuzumab Emtansine in the Treatment of Metastatic Breast Cancer

Outcome of eribulin as a late treatment line for Thai metastatic breast cancer patients

The potential of using eribulin in patients with breast cancer, associated with brain metastasis: the scientific background and the Russian clinical experience

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