Evidence map›Paper›PMID 34238257›Full record

Observational studyBMC cancer2021

Real-world effectiveness of post-trastuzumab emtansine treatment in patients with HER2-positive, unresectable and/or metastatic breast cancer: a retrospective observational study (KBCSG-TR 1917).

Takahiro Nakayama, Tetsuhiro Yoshinami, Hiroyuki Yasojima, Nobuyoshi Kittaka, Masato Takahashi, Shoichiro Ohtani, Seung Jin Kim, Hiroyuki Kurakami, Naoko Yamamoto, Tomomi Yamada and 2 more

Open access · goldAbstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMC cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 2 countries.

Takahiro NakayamaDepartment of Breast and Endocrine Surgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan. taqnakayama@gmail.com.ORCID https://orcid.org/0000-0002-3713-1624
Tetsuhiro YoshinamiDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, 2-2-E-10 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
Hiroyuki YasojimaDepartment of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
Nobuyoshi KittakaDepartment of Breast and Endocrine Surgery, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan.
Masato TakahashiDepartment of Breast Surgery, National Hospital Organization Hokkaido Cancer Center, 2-3-54, Kikusui 4-jo Shiroishi-ku, Sapporo, Hokkaido, 003-0804, Japan.
Shoichiro OhtaniDepartment of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan.
Seung Jin KimDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, 2-2-E-10 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
Hiroyuki KurakamiDepartment of Medical Innovation, Osaka University Hospital, 2-15, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Naoko YamamotoDepartment of Medical Innovation, Osaka University Hospital, 2-15, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Tomomi YamadaDepartment of Medical Innovation, Osaka University Hospital, 2-15, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Takehiko TakataOncology Medical Science Department, Daiichi Sankyo Co., Ltd., 3-5-1, Nihonbashi-honcho, Chuo-ku, Tokyo, 103-8426, Japan.
Norikazu MasudaDepartment of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.ORCID https://orcid.org/0000-0002-7302-0278
Osaka University Hospital · JPOsaka National Hospital · JPThe University of Osaka · JPDaiichi-Sankyo (Japan) · JPHiroshima City Asa Citizens Hospital · JPNational Hospital Organization Hokkaido Medical Center · JPOsaka International Cancer Institute · JPOsaka International Cancer Institute · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTrastuzumab emtansine (T-DM1) is a second-line standard therapy for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. Evidence regarding post-T-DM1 treatments is currently lacking. We evaluated the effectiveness of post-T-DM1 drug therapy in patients with HER2-positive, unresectable and/or metastatic breast cancer.

methodsIn this multicenter, retrospective, observational study, real-world clinical data of female patients with HER2-positive breast cancer who had a history of T-DM1 treatment were consecutively collected from five sites in Japan. We investigated the effectiveness of post-T-DM1 therapy by evaluating the real-world progression-free survival (rwPFS), time to treatment failure (TTF), overall survival (OS), objective response rate (ORR), and clinical benefit rate (CBR). Tumor response was assessed by investigators according to Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) guidelines. Subgroup and exploratory analyses according to background factors were also undertaken.

resultsOf the 205 patients who received T-DM1 treatment between 1 January 2014 and 31 December 2018, 128 were included in this study. Among the 128 patients analyzed, 105 (82%) patients received anti-HER2 therapy and 23 (18%) patients received regimens without anti-HER2 therapy. Median (95% confidence interval [CI]) rwPFS, TTF, and OS were 5.7 (4.8-6.9) months, 5.6 (4.6-6.4) months, and 22.8 (18.2-32.4) months, respectively. CBR and ORR (95% CI) were 48% (38.8-56.7) and 23% (15.1-31.4), respectively. Cox-regression analysis showed that an ECOG PS score of 0, a HER2 immunohistochemistry score of 3+, recurrent type, ≥12 month duration of T-DM1 therapy, and anti-HER2 therapy were independent variables for rwPFS. An exploratory subgroup analysis of regimens after T-DM1 showed that those with anti-HER2 therapy had a median rwPFS of 6.3 and those without anti-HER2 therapy had a median rwPFS of 4.8 months.

conclusionsIn the real-world setting in Japan, several post-T-DM1 regimens for patients with unresectable and/or metastatic HER2-positive breast cancer, including continuation of anti-HER2 therapy, showed some effectiveness; however, this effectiveness was insufficient. Novel therapeutic options are still needed for further improvement of PFS and OS in later treatment settings.

trial registrationUMIN000038296 ; registered on 15 October 2019.

Indexed as

Ado-Trastuzumab EmtansineAdultAgedAged, 80 and overBreast NeoplasmsFemaleHumansMiddle AgedNeoplasm MetastasisRetrospective StudiesAdo-Trastuzumab EmtansineHER2-positiveKBCSG-TR 1917Retrospective observational studyT-DM1/trastuzumab emtansineUnresectable and/or metastatic breast cancer

Identifiers

PMID34238257
PMCPMC8268506
OpenAlexW3181496601

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.