Trastuzumab emtansine (T-DM1) in Asian patients with previously treated HER2-positive locally advanced (LA) or metastatic breast cancer (MBC): Data from the phase III EMILIA study
- Authors
- Im, S-A.; Park, I.; Sohn, J. H.; Im, Y-H.; Lee, S. C.; Chang, H-K.; Macharia, H.; Sun, G.; Lamour, F.; Oh, D-Y.
- Issue Date
- Sep-2021
- Publisher
- ELSEVIER
- Citation
- Annals of Oncology, v.32, no.Suppl 5, pp S488 - S489
- Indexed
- SCIE
SCOPUS
- Journal Title
- Annals of Oncology
- Volume
- 32
- Number
- Suppl 5
- Start Page
- S488
- End Page
- S489
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54529
- DOI
- 10.1016/j.annonc.2021.08.567
- ISSN
- 0923-7534
1569-8041
- Abstract
- Background
The phase 3 EMILIA study (NCT00829166) was initiated based on phase 1 and 2 data identifying the HER2-targeted antibody-drug conjugate T-DM1 as a potential therapy for HER2-positive advanced breast cancer previously treated with trastuzumab (H) and taxane (T). We report a subgroup analysis of Asian patients enrolled in Asia.
Methods
EMILIA, a randomized, open-label, phase 3 study, compared T-DM1 (3.6 mg/kg IV q3w) with capecitabine (C; 1000 mg/m2 po bid, days 1–14, q3w) plus lapatinib (L; 1250 mg/day po qd) in patients with HT-pretreated HER2-positive, LA/MBC. Cox proportional hazards models and the Kaplan-Meier method were used to estimate progression-free (PFS) and overall survival (OS) in Asian patients.
Results
76 and 82 patients from Korea, Taiwan, Singapore, Hong Kong, and The Philippines were randomized to CL and T-DM1, respectively (75 and 80 were safety evaluable). At a median follow up of 13 months, median PFS was 6.9 vs 9.3 months (HR, 0.72; 95% CI: 0.48–1.06) with CL vs T-DM1. Objective response rates (modified RECIST v1.0) were 38.7% (95% CI: 26.7–51.9) and 44.4% (95% CI: 31.9–57.5) with CL and T-DM1 respectively, with median response durations of 6.9 and 9.6 months. At the 2nd interim analysis, with a median follow up of 19 months, median OS was 22.7 vs 34.3 months (HR, 0.43; 95% CI: 0.24–0.77) with CL vs T-DM1. There was an increase in G3-G4 thrombocytopenia in the Asian subgroup (Table); safety profiles were otherwise similar.
Table: 284P.
Adverse events
(CTCAE v3.0; %) Global Asian
CL
(n=488) T-DM1
(n=490) CL
(n=75) T-DM1
(n=80)
≥Grade (G) 3 57.0 40.8 54.7 60.0
Leading to discontinuation C: 9.4
L: 7.6 5.9 C: 4.0
L: 1.3 6.3
Thrombocytopenia
G1
G2
G3
G4
1.8
0.8
0
0.2
6.9
9.6
11.2
2.7
1.3
0
0
0
3.8
5.0
30.5
8.8
Hemorrhage
G1
G2
G3
G4
12.3
2.7
0.8
0
24.7
3.7
1.2
0.2
13.3
1.3
2.7
0
36.3
0
0
0
Conclusions
T-DM1 conferred a clinically meaningful benefit compared with CL in Asian patients with HT-pretreated HER2-positive LA/MBC, which was generally consistent with that in the global population. Although generally similar to the global safety profile, increased G3 and G4 thrombocytopenia was noted with T-DM1 in Asian patients but there was no G>1 hemorrhage.
Clinical trial identification
NCT00829166.
Editorial acknowledgement
Medical writing support was provided by Tracy McNally, PhD, and Holly Strausbaugh, PhD, on behalf of Twist Medical, LLC, and funded by F. Hoffmann-La Roche, Ltd.
Legal entity responsible for the study
F. Hoffmann-La Roche Ltd.
Funding
F. Hoffmann-La Roche Ltd.
Disclosure
S. Im: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Eisai; Financial Interests, Personal, Advisory Board: Hanmi; Financial Interests, Personal, Advisory Board: Lilly; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Roche; Non-Financial Interests, Personal, Other, Investigational agent for trial: Dae Woong; Financial Interests, Personal, Advisory Board: GSK. I. Park: Financial Interests, Personal, Full or part-time Employment: Korea University Guro hospital National Cancer Center, Korea. J.H. Sohn: Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Institutional, Research Grant: Roche; Financial Interests, Institutional, Research Grant: Novartis; Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Institutional, Research Grant: Lilly; Financial Interests, Institutional, Research Grant: Pfizer; Financial Interests, Institutional, Research Grant: GSK; Financial Interests, Institutional, Research Grant: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: Sanofi; Financial Interests, Institutional, Research Grant: Boehringer Ingelheim. S.C. Lee: Financial Interests, Personal and Institutional, Invited Speaker: Pf
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