PMID- 33569405
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220420
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 9
IP  - 2
DP  - 2021 Jan
TI  - Pyrotinib versus trastuzumab emtansine for HER2-positive metastatic breast cancer 
      after previous trastuzumab and lapatinib treatment: a real-world study.
PG  - 103
LID - 10.21037/atm-20-4054 [doi]
LID - 103
AB  - BACKGROUND: To compare the efficacy and safety of pyrotinib and trastuzumab 
      emtansine (T-DM1) in patients who experienced disease progression on trastuzumab 
      and lapatinib treatment. METHODS: This was a real-world study that included cases 
      of metastatic breast cancer (MBC) with trastuzumab and lapatinib failure. One 
      group of patients received pyrotinib monotherapy or combination therapy, whereas 
      the other group received T-DM1 monotherapy. The primary study endpoint was 
      progression-free survival (PFS); secondary endpoints were the objective response 
      rate (ORR), clinical benefit rate (CBR) and safety. RESULTS: Between January 2013 
      and November 2019, 105 patients were enrolled in the pyrotinib group (n=55) or 
      T-DM1 group (n=50). The median PFS was 6.0 months (95% CI, 4.7 to 7.3 months) 
      with pyrotinib and 4.2 months (95% CI, 3.6 to 4.8 months) with T-DM1 (P=0.044). 
      ORR values were 16.3% and 20.0% in the pyrotinib and T-DM1 groups, respectively 
      (P=0.629); CBR values were 45.5% and 40.0% in the pyrotinib and T-DM1 groups, 
      respectively (P=0.573). Subgroup analysis of those benefitting from lapatinib 
      revealed a median PFS of 8.1 months (95% CI, 4.8 to 11.4 months) in the pyrotinib 
      group, whereas that of the T-DM1 group was 4.4 months (95% CI, 3.8 to 5.0 months, 
      P=0.013). Moreover, the median PFS of patients without liver metastases was 6.9 
      months (95% CI, 3.7 to 10.1 months) in the pyrotinib group and 4.1 months (95% 
      CI, 3.1 to 5.1 months) in the T-DM1 group (P=0.010). The main common adverse 
      events (AEs) were diarrhea (98.2%) and nausea (49.1%) in the pyrotinib group and 
      thrombocytopenia (42.0%) and nausea (40.0%) in the T-DM1 group. The percentages 
      of grade 3 to 4 AEs in the pyrotinib and T-DM1 groups were 34.5% and 40.0%, 
      respectively. CONCLUSIONS: The results of this study suggest that patients with 
      HER2-positive MBC with trastuzumab and lapatinib failure can benefit from 
      subsequent pyrotinib treatment and tolerate this treatment well, especially those 
      who have benefited from previous lapatinib treatment or those who have no liver 
      metastasis.
CI  - 2021 Annals of Translational Medicine. All rights reserved.
FAU - Li, Feng
AU  - Li F
AD  - Department of Breast Oncology, Academy of Military Medical Sciences, Beijing, 
      China.
AD  - Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
FAU - Xu, Fengrui
AU  - Xu F
AD  - Department of Breast Oncology, Academy of Military Medical Sciences, Beijing, 
      China.
AD  - PLA Rocket Force Characteristic Medical Center, Beijing, China.
FAU - Li, Jianbin
AU  - Li J
AD  - Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
AD  - Department of Medical Molecular Biology, Beijing Institute of Biotechnology, 
      Academy of Military Medical Sciences, Beijing, China.
FAU - Wang, Tao
AU  - Wang T
AD  - Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
FAU - Bian, Li
AU  - Bian L
AD  - Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
FAU - Zhang, Shaohua
AU  - Zhang S
AD  - Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
FAU - Jiang, Zefei
AU  - Jiang Z
AD  - Department of Breast Oncology, the Fifth Medical Center of Chinese PLA General 
      Hospital, Beijing, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC7867920
OTO - NOTNLM
OT  - HER2
OT  - Metastatic breast cancer (MBC)
OT  - T-DM1
OT  - pyrotinib
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/atm-20-4054). The authors have no 
      conflicts of interest to declare.
EDAT- 2021/02/12 06:00
MHDA- 2021/02/12 06:01
PMCR- 2021/01/01
CRDT- 2021/02/11 05:55
PHST- 2021/02/11 05:55 [entrez]
PHST- 2021/02/12 06:00 [pubmed]
PHST- 2021/02/12 06:01 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - atm-09-02-103 [pii]
AID - 10.21037/atm-20-4054 [doi]
PST - ppublish
SO  - Ann Transl Med. 2021 Jan;9(2):103. doi: 10.21037/atm-20-4054.