Early thrombocytopenia predicts longer time‑to‑treatment discontinuation in trastuzumab emtansine treatment.
adverse event
breast cancer
survival
thrombocytopenia
trastuzumab emtansine
Journal
Oncology letters
ISSN: 1792-1082
Titre abrégé: Oncol Lett
Pays: Greece
ID NLM: 101531236
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
10
11
2022
accepted:
22
09
2023
medline:
6
11
2023
pubmed:
6
11
2023
entrez:
6
11
2023
Statut:
epublish
Résumé
Thrombocytopenia is a characteristic adverse event of trastuzumab emtansine (T-DM1), one of the essential treatment options for human epithelial growth factor receptor 2 (HER2)-positive breast cancer. The present study investigated the predictive value of thrombocytopenia for time-to-treatment discontinuation (TTD) in patients receiving T-DM1 for advanced-stage HER2-positive breast cancer. The present observational study enrolled 138 patients who received T-DM1 at six oncology centers from January 2016 to December 2021. Univariate and multivariate Cox regression analyses were performed to determine the factors affecting TTD. The median age of patients was 50 years (range, 26-83). The median number of T-DM1 cycles was 9 (range, 2-58), the overall response rate was 50.0% and the disease control rate was 69.6%. At a median follow-up time of 19.3 months, the median TTD was 9.5 months [95% confidence interval (CI), 7.3-11.7], and the median overall survival was 28.2 months (95% CI, 19.2-37.2). Thrombocytopenia during treatment was observed in 39% of all patients, and 66.7% of these patients experienced early thrombocytopenia (in the first four treatment cycles). Multivariate analysis revealed that the independent factors for TTD were hormone receptor status [hazard ratio (HR), 1.837; 95% CI, 1.249-2.701; P=0.002], Eastern Cooperative Oncology Group performance status score (HR, 3.269; 95% CI, 1.788-5.976; P<0.001) and thrombocytopenia during treatment (HR, 0.297; 95% CI, 0.198-0.446; P<0.001). Patients with early thrombocytopenia had a significantly longer TTD of 17.3 months (95% CI, 11.8-22.8) compared with 7.6 months (95% CI, 5.8-9.4) for patients without early thrombocytopenia (P<0.001). The results of the present study indicated that patients with early thrombocytopenia had improved survival outcomes compared with those without. Thus, maximum benefit from T-DM1 treatment may be achieved by confirming the predictive role of thrombocytopenia in T-DM1 treatment in prospective studies and large-scale cohorts.
Identifiants
pubmed: 37927419
doi: 10.3892/ol.2023.14110
pii: OL-26-6-14110
pmc: PMC10623092
doi:
Types de publication
Journal Article
Langues
eng
Pagination
523Informations de copyright
Copyright © 2023, Spandidos Publications.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
Références
Eur J Cancer. 2009 Jan;45(2):228-47
pubmed: 19097774
Lancet Oncol. 2014 Jun;15(7):689-99
pubmed: 24793816
Cancer J. 2015 Sep-Oct;21(5):357-64
pubmed: 26389758
Cancer Immunol Immunother. 2022 Aug;71(8):1949-1958
pubmed: 35075516
Breast. 2019 Aug;46:90-94
pubmed: 31170589
Blood. 2012 Sep 6;120(10):1975-84
pubmed: 22665936
Mol Cancer Ther. 2017 Sep;16(9):1877-1886
pubmed: 28655784
Transl Lung Cancer Res. 2020 Dec;9(6):2391-2400
pubmed: 33489801
J Oncol Pharm Pract. 2021 Apr;27(3):547-554
pubmed: 32423326
J Cancer Res Clin Oncol. 2023 Jul;149(7):3599-3606
pubmed: 35960374
Oncologist. 2009 Apr;14(4):320-68
pubmed: 19346299
Hong Kong Med J. 2018 Feb;24(1):56-62
pubmed: 29326401
Oncotarget. 2017 May 25;8(34):56921-56931
pubmed: 28915642
Int J Cancer. 2021 Apr 12;:
pubmed: 33844843
Ann Oncol. 2021 Dec;32(12):1475-1495
pubmed: 34678411
Am J Clin Oncol. 1982 Dec;5(6):649-55
pubmed: 7165009
Breast Cancer Res Treat. 2019 Nov;178(2):473-477
pubmed: 31399933
Int J Radiat Oncol Biol Phys. 2016 Aug 1;95(5):1346-1354
pubmed: 27212198
Biomed Pharmacother. 2020 Sep;129:110407
pubmed: 32570117
Arch Pathol Lab Med. 2018 Nov;142(11):1364-1382
pubmed: 29846104
Cancer. 2019 Nov 15;125(22):3974-3984
pubmed: 31318460
Cancer. 2013 Jun 1;119(11):1969-75
pubmed: 23505007
Nat Rev Clin Oncol. 2022 Feb;19(2):75-90
pubmed: 34642484
Oncotarget. 2017 Mar 18;8(38):64481-64489
pubmed: 28969087
J Clin Oncol. 2020 Apr 20;38(12):1346-1366
pubmed: 31928404
BMC Urol. 2019 Jun 7;19(1):49
pubmed: 31174518
Signal Transduct Target Ther. 2022 Mar 22;7(1):93
pubmed: 35318309
Clin Breast Cancer. 2020 Apr;20(2):e220-e228
pubmed: 31892489
Cancer Epidemiol Biomarkers Prev. 2017 Apr;26(4):632-641
pubmed: 27956436
Cancer. 2019 Sep 15;125(18):3208-3218
pubmed: 31246283
Cancer Chemother Pharmacol. 2012 May;69(5):1229-40
pubmed: 22271209
Eur Urol. 2017 Sep;72(3):368-376
pubmed: 28410865
Lancet Oncol. 2017 Jun;18(6):743-754
pubmed: 28526538
JAMA Oncol. 2016 Mar;2(3):305-12
pubmed: 26720423
Ann Oncol. 2020 Jan;31(1):72-78
pubmed: 31912799
CA Cancer J Clin. 2023 Jan;73(1):17-48
pubmed: 36633525
Lancet Oncol. 2017 Jun;18(6):732-742
pubmed: 28526536
N Engl J Med. 2012 Nov 8;367(19):1783-91
pubmed: 23020162
ESMO Open. 2017 Sep 14;2(4):e000214
pubmed: 29018574
Eur J Cancer. 2019 Mar;109:92-102
pubmed: 30708264
Lancet Oncol. 2013 Jan;14(1):29-37
pubmed: 23168366
Ann Oncol. 2019 May 1;30(5):830-838
pubmed: 30796424