Trastuzumab emtansine versus trastuzumab plus pertuzumab for HER2-positive breast cancer with residual disease after neoadjuvant therapy: a real-world study - Report - MDSpire
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Trastuzumab emtansine versus trastuzumab plus pertuzumab for HER2-positive breast cancer with residual disease after neoadjuvant therapy: a real-world study
Clinical Report: Comparison of T-DM1 and Dual-Target Therapy in HER2+ Breast Cancer
Overview
Revise to specify that the 38% reduction in recurrence risk is not statistically significant.
Background
HER2-positive breast cancer patients with residual invasive disease after neoadjuvant therapy face increased recurrence and mortality risks. The KATHERINE trial established T-DM1 as a beneficial adjuvant treatment for non-pathological complete response (non-pCR) patients, yet the comparative efficacy of T-DM1 versus dual-target therapy remains unclear. This study aims to address this gap in knowledge.
Data Highlights
Group
Disease Progression (%)
Recurrence Risk Reduction
Grade ≥3 Thrombocytopenia (%)
Dual-Target Treatment
20.3
-
0.88
T-DM1 Treatment
12.6
38%
8.45
Key Findings
Disease progression was observed in 20.3% of the dual-target group and 12.6% of the T-DM1 group.
T-DM1 was associated with a 38% reduction in recurrence risk, though not statistically significant (HR: 0.62, P = 0.19).
Subgroup analyses indicated improved disease-free survival with T-DM1 in patients with initially unresectable disease or poor pathological response.
Grade ≥3 thrombocytopenia occurred significantly more often in the T-DM1 group (8.45% vs 0.88%, P = 0.01).
No treatment-related deaths were reported in either group.
Clinical Implications
Clinicians should consider T-DM1 for HER2-positive patients with residual disease after neoadjuvant therapy, especially those with poor pathological responses. However, the increased risk of thrombocytopenia with T-DM1 necessitates careful monitoring and management.
Conclusion
The findings suggest that T-DM1 may offer improved disease-free survival in specific subgroups of HER2-positive breast cancer patients, although the safety profile requires attention. Further studies are warranted to confirm these results.
