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Phase II Randomized Study of Trastuzumab Emtansine Versus Trastuzumab Plus Docetaxel in Patients With Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer
Abstract
Purpose: Trastuzumab emtansine (T-DM1), an antibody-drug conjugate composed of the cytotoxic agent DM1 conjugated to trastuzumab via a stable thioether linker, has shown clinical activity in single-arm studies enrolling patients with human epidermal growth factor receptor 2 (HER2) –positive metastatic breast cancer (MBC) whose disease had progressed on HER2-targeted therapy in the metastatic setting. Patients and Methods: Patients (N = 137) with HER2-positive MBC or recurrent locally advanced breast cancer were randomly assigned to trastuzumab plus docetaxel (HT; n = 70) or T-DM1 (n = 67) as first-line treatment until disease progression or unacceptable toxicity. Primary end points were investigator-assessed progression-free survival (PFS) and safety. Key secondary end points included overall survival (OS), objective response rate (ORR), duration of objective response, clinical benefit rate, and quality of life. Results: Median PFS was 9.2 months with HT and 14.2 months with T-DM1 (hazard ratio, 0.59; 95% CI, 0.36 to 0.97); median follow-up was approximately 14 months in both arms. ORR was 58.0% (95% CI, 45.5% to 69.2%) with HT and 64.2% (95% CI, 51.8% to 74.8%) with T-DM1. T-DM1 had a favorable safety profile versus HT, with fewer grade ≥ 3 adverse events (AEs; 46.4% v 90.9%), AEs leading to treatment discontinuations (7.2% v 40.9%), and serious AEs (20.3% v 25.8%). Preliminary OS results were similar between treatment arms; median follow-up was approximately 23 months in both arms. Conclusion: In this randomized phase II study, first-line treatment with T-DM1 for patients with HER2-positive MBC provided a significant improvement in PFS, with a favorable safety profile, versus HT.
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Trastuzumab emtansine for HER2-positive advanced breast cancer
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Antibody–Drug Conjugates: An Emerging Concept in Cancer Therapy
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Phase I Study of 68Ga-HER2-Nanobody for PET/CT Assessment of HER2 Expression in Breast Carcinoma
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Antibody–Drug Conjugates (ADCs) for Personalized Treatment of Solid Tumors: A Review
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A review of the clinical efficacy of FDA-approved antibody‒drug conjugates in human cancers
Liu, K., Li, M., Li, Y., Li, Y., Chen, Z., Tang, Y., Yang, M., Deng, G., & Liu, H. (2024) · Molecular Cancer · doi:10.1186/s12943-024-01963-7 · Cited by 196
Metadata
- Authors
- Hurvitz, S. A., Dirix, L., Kocsis, J., Bianchi, G. V., Lu, J., Vinholes, J., Guardino, E., Song, C., Tong, B., Ng, V., Chu, Y.-W., & Perez, E. A.
- Venue
- Journal of Clinical Oncology
- Published
- 2013-03-20
- Volume
- 31
- Issue
- 9
- Pages
- 1157-1163
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2136527721
- Cited by
- 392
- References
- 6
- FWCI
- 31.15
- Type
- journal article
- Language
- en
- Open access
- closed
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- Hurvitz, S. A., Dirix, L., Kocsis, J., Bianchi, G. V., Lu, J., Vinholes, J., Guardino, E., Song, C., Tong, B., Ng, V., Chu, Y.-W., & Perez, E. A. (2013). Phase II Randomized Study of Trastuzumab Emtansine Versus Trastuzumab Plus Docetaxel in Patients With Human Epidermal Growth Factor Receptor 2–Positive Metastatic Breast Cancer. Journal of Clinical Oncology. https://doi.org/10.1200/jco.2012.44.9694
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