Trastuzumab, Pertuzumab, and Docetaxel as the First Line for HER-2-Positive Metastatic Breast Cancer among Arabs

Kausar Suleman; Ali Hassan Mushtaq; Emaan Haque; Ahmed Ali Badran; Dahish Ajarim; Ahmed Mohammed Elashwah; Ahmed Mostafa Gad; Amgad Shaheen Abdelsamad; Ayman Omar; Khurshid Ahmed Khan; Taher Al-Tweigeri; Ayman Elshentenawy; Adher Alsayed

doi:10.1159/000506824

Trastuzumab, Pertuzumab, and Docetaxel as the First Line for HER-2-Positive Metastatic Breast Cancer among Arabs

Breast Care (Basel). 2021 Feb;16(1):59-65. doi: 10.1159/000506824. Epub 2020 Apr 6.

Authors

Kausar Suleman^{1

2}, Ali Hassan Mushtaq³, Emaan Haque³, Ahmed Ali Badran^{1

4}, Dahish Ajarim¹, Ahmed Mohammed Elashwah^{1

5}, Ahmed Mostafa Gad^{1

4}, Amgad Shaheen Abdelsamad^{1

6}, Ayman Omar^{1

2

7}, Khurshid Ahmed Khan¹, Taher Al-Tweigeri¹, Ayman Elshentenawy^{1

5}, Adher Alsayed¹

Affiliations

¹ Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
² Associate Professor for Al Faisal University, Riyadh, Saudi Arabia.
³ Al Faisal University, Riyadh, Saudi Arabia, Riyadh, Saudi Arabia.
⁴ Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁵ Kasr Aleini center of Clinical Oncology and Nuclear Medicine (NEMROCK), Cairo University, Cairo, Egypt.
⁶ Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
⁷ Department of Clinical Oncology and Nuclear Medicine, Suez Canal University Hospital, Ismailia, Egypt.

Abstract

Introduction: Human epidermal growth factor receptor 2 (HER-2) targeted therapy regimens can improve tumor response in HER-2-positive metastatic breast cancer (MBC), with overall survival benefits.

Objective: We evaluated the efficacy of dual HER-2 blockade combined with chemotherapy for HER-2-positive MBC patients as a first-line therapy in our patient population.

Patients and methods: We identified 75 patients at King Faisal Specialist Hospital and Research Center that received trastuzumab, pertuzumab, and docetaxel as a first-line therapy in HER-2 positive MBC in 2013-2016.

Results: Median age at diagnosis was 45 years; 54.7% were estrogen receptor (ER)-positive. 10% of patients presented with only bone metastasis. The median follow-up time was 36 months with an objective response rate of 74.7% (complete response [CR] 18.7%; partial response [PR] 56%). The 5-year progression-free survival (PFS) and overall survival (OS) were 21% and 71.9% respectively, with a median PFS of 36 months (95% confidence interval [CI] 23.6-48.4). The 5-year OS for ER-negative and ER-positive patients was 93.9% and 59.4% respectively (p = 0.189); 23 patients experienced grade 1/2 toxicity and 2 patients had grade 3/4 toxicity. In terms of OS and PFS, the site of metastasis did not make any significant difference.

Conclusions: First line pertuzumab, trastuzumab, and docetaxel for HER-2-positive MBC patients was found to be an effective and safe therapy in the Saudi population. This finding was consistent with the results seen in the CLEOPATRA trials.

Keywords: Dual targeted therapy; HER-2-positive MBC; Metastatic breast cancer (MBC); Pertuzumab.