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ESMO 2024: Survival Maintained With Chemotherapy-Free Tx for Metastatic Breast Cancer
Addition of ribociclib to trastuzumab and pertuzumab may further improve survival in HER2-positive and hormone receptor-positive breast cancer
MONDAY, Sept. 16, 2024 (HealthDay News) -- Chemotherapy-free treatment appears to be effective for patients with HER2-positive and hormone receptor-positive metastatic breast cancer, according to a study presented at the annual meeting of the European Society for Medical Oncology, held from Sept. 13 to 17 in Barcelona, Spain.
Wolfgang Janni, from Ulm University Hospital in Germany, and colleagues randomly assigned 271 patients with HER2-positive and hormone receptor-positive metastatic breast cancer participating in the phase 3 DETECT V trial to receive trastuzumab and pertuzumab combined with either physicians’ choice endocrine therapy or chemotherapy followed by maintenance therapy with trastuzumab, pertuzumab, and endocrine therapy. The study was amended after enrollment of 124 patients with the addition of the CDK4/6 inhibitor ribociclib to endocrine therapy in both arms. The efficacy and tolerability between the chemotherapy-free and chemotherapy-containing treatment arms were compared as part of a second interim analysis, with a cutoff of April 3, 2024.
The researchers found that overall survival (OS) and progression-free survival (PFS) did not differ between patients receiving chemotherapy-free and chemotherapy-containing treatment (median OS: not reached versus 46.1 months; hazard ratio [HR], 1.07; 95% confidence interval [CI], 0.65 to 1.77; P = 0.79; median PFS, 19.1 versus 22.4 months; HR, 1.19; 95% CI, 0.84 to 1.69; P = 0.34). In patients receiving ribociclib in addition to chemotherapy or endocrine therapy-based treatment, both OS and PFS were significantly improved (median OS: not reached versus 46.1 months; HR, 0.42; P = 0.002; median PFS: 27.2 versus 15.6 months; HR, 0.52; P < 0.001).
“We are awaiting final analysis, as the current analysis is still preliminary, [but] chemotherapy-free treatment [appears to be] an option in certain constellation[s],” Janni told Elsevier’s PracticeUpdate. “The results have to be put into context with potential future first-line standards, such as antibody-drug conjugates.”
Several authors disclosed financial ties to the pharmaceutical industry, including Bristol Myers Squibb, Eisai, Menarini, Novartis, and Roche, which funded the DETECT study.