Impact of progression sites and line of therapy on survival outcomes in patients with HER-2 positive metastatic breast cancer treated with T-DM1 T-DM1 ile Tedavi Edilen Her-2 Pozitif Metastatik Meme Kanserli Hastalarda Progressyon (Hastalığın İlerlemesi) Bölgeleri ve Tedavi Sırasının Sağkalım Üzerindeki Etkisi

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Surmeli H., Buyukmurat N.

Northern Clinics of Istanbul, cilt.12, sa.4, ss.461-467, 2025 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 12 Sayı: 4
  • Basım Tarihi: 2025
  • Doi Numarası: 10.14744/nci.2025.48902
  • Dergi Adı: Northern Clinics of Istanbul
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.461-467
  • Anahtar Kelimeler: Ado-trastuzumab emtansine, brain metastases, HER2-positive breast cancer, liver metastases, metastatic progression, therapy line
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

OBJECTIVE: Ado-trastuzumab emtansine (T-DM1) is a key treatment for HER2-positive metastatic breast cancer (HER2+ MBC), yet the influence of progression sites and therapy lines on outcomes remains unclear.To assess the relationship between progression sites and the line of T-DM1 therapy with survival outcomes in HER2+ MBC. METHODS: We retrospectively analyzed 123 patients with HER2+ MBC treated with T-DM1. Data on metastatic progression sites (brain, liver, bone, lung, lymph nodes), line of T-DM1 therapy (2nd-line vs ≥3rd-line), and death status were examined. Due to limited survival time data, mortality was used as the primary outcome. Death rates were compared across subgroups using descriptive statistics. RESULTS: Brain and lung progression were associated with the highest mortality rates (76.7% and 73.1%, respectively). Liver and bone progression also showed elevated death rates (70.0% and 64.3%). Notably, more patients who used T-DM1 as the second-line therapy had a higher mortality rate at 66.7% compared to those treated with it in the third line or after (45.1%). CONCLUSION: Progression to brain and lung during T-DM1 treatment correlates with higher mortality. Early-line use of T-DM1 may be linked with worse outcomes, possibly due to more aggressive disease biology. The obtained data could inform the decision-making process when treating patients with HER2+ MBC and predict their prognosis.