ArticleAdvances in therapy2026
Treatment Patterns and Clinical Outcomes in Metastatic HR+/HER2- and Triple-Negative Breast Cancer in Canada: The HER2- TRENDS Study.
Article in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe treatment landscape for human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (mBC) in Canada is rapidly evolving. This retrospective cohort study described real-world historical treatment patterns and clinical outcomes for patients with HER2- mBC.
methodsAdults enrolled in the pan-Canadian 'Personalize My Treatment' cancer registry and diagnosed with stage IV HER2- mBC (01/01/2015-03/01/2022) were eligible and followed until 03/01/2023. Hormone receptor-positive (HR+)/HER2- mBC and triple-negative mBC (mTNBC) were analyzed separately and further stratified by line of therapy. Main study outcomes included treatment patterns, PIK3CA/AKT1/PTEN alteration testing/positivity rates, and overall survival (OS), all analyzed descriptively.
resultsA total of 507 patients with HER2- mBC were included (HR+/HER2- mBC: 387; mTNBC: 120; median follow-up: 54.1 months). The most common HR+/HER2- mBC treatments were cyclin‑dependent kinase 4/6 inhibitors (CDK4/6is) plus endocrine therapy (ET) in first line (1L; 55.0%), targeted therapies (22.9%) and CDK4/6i + ET (22.0%) in second line (2L), and chemotherapy (CT) monotherapy (42.7%) in third line (3L). CT monotherapy was the most common mTNBC treatment in 1L (35.1%), 2L (50.6%), and 3L (54.8%). Attrition was similar for HR+/HER2- mBC and mTNBC from 1L-2L (16.9% and 16.3%, respectively) but was lower for HR+/HER2- mBC from 2L-3L (33.2% and 38.6%) and 3L-4L (48.1% and 62.1%). PIK3CA/AKT1/PTEN alteration testing was performed in 31.8% of patients with HR+/HER2- mBC and 50.0% with mTNBC, with alterations identified in 15.4% and 20.0% of patients, respectively. Median OS (65.9 and 31.4 months, respectively), OS rates (1 year: 94.8% and 79.8%; 5 years: 56.0% and 21.7%), and time to next treatment (1L-2L: 24.5 and 8.1 months; 2L-3L: 10.1 and 5.1 months) were greater for HR+/HER2- mBC than mTNBC.
conclusionsThese findings describe historical HER2- mBC treatment patterns and associated outcomes in Canada. Ongoing research is needed to optimize therapeutic strategies, expand novel treatment access, and improve patient outcomes.
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