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05-03-2018 | Breast cancer | News | Article

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Adding metronomic chemotherapy to dual HER2-blockade may benefit older breast cancer patients

medwireNews: Older women with metastatic, HER2-positive breast cancer derive a progression-free survival (PFS) benefit from the addition of metronomic chemotherapy to the anti-HER2 agents pertuzumab and trastuzumab, indicate results from the EORTC 75111-10114 trial.

Median PFS in the phase II study was 12.7 months for the 41 patients (≥70 years or 60–69 years with functional restrictions) who were randomly allocated to receive cyclophosphamide 50 mg/day alongside trastuzumab plus pertuzumab and 5.6 months for their 39 counterparts given just the HER2 inhibitors.

The estimated 6-month PFS rates were 73.4% and 46.2%, respectively, with the between-group difference of 27.2% exceeding the protocol-specified difference threshold of 10.0%.

Grade 3 lymphopenia occurred more often in the chemotherapy than in the dual HER2-blockade group, at 37% versus 3%, but on the whole both regimens had a favorable adverse event profile, which Hans Wildiers (KU Leuven in Belgium) and co-investigators believe is “a major asset” for this population of older and frail patients.

Writing in The Lancet Oncology, they conclude: “The results of this study indicate that the benefit of avoiding the side-effects of chemotherapy with the use of dual anti-HER2 blockade alone does not compensate for the substantial loss of activity in the metastatic breast cancer setting.”

By Shreeya Nanda

medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group

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