Paper of the month: survival analysis of the GeparQuinto trial

The efficacy data of patients with primary HER2-positive breast cancer enrolled in the GeparQuinto trial that compared two anti-HER2-targeted agents, lapatinib versus trastuzumab, in combination with anthracycline-taxane chemotherapy has demonstrated a lower pathological complete response (pCR, pT0 ypN0) rate in patients after neoadjuvant chemotherapy plus lapatinib compared with those treated with chemotherapy plus trastuzumab (Untch et al. Lancet Oncol. 2012).

The long-term outcomes (3-year disease-free [DFS], distance disease-free [DDFS] and overall survival [OS]) did not significantly differ between the two treatment arms. Overall, patients with pCR had statistically significant better DFS, DDFS, and OS compared with patients with residual disease (hazard ration for DFS 0.63 [95%CI 0.40-0.99]; for DDFS 0.55 [95%CI 0.32-0.92]; for OS 0.31 [95%CI 0.13-0.73]). Additionally, a benefit for OS was observed within a subgroup of patients treated with trastuzumab and who achieved pCR compared with those without pCR as well as in a subgroup of hormone receptor-positive patients treated with lapatinib followed by trastuzumab compared with those treated with transtuzumab alone.

Untch M, von Minckwitz G, Gerber B, Schem C, Rezai M, Fasching PA, Tesch H, Eggemann H, Hanusch C, Huober J, Solbach C, Jackisch C, Kunz G, Blohmer JU, Hauschild M, Fehm T, Nekljudova V, Loibl S; GBG and the AGO-B Study Group. Survival Analysis After Neoadjuvant Chemotherapy With Trastuzumab or Lapatinib in Patients With Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer in the GeparQuinto (G5) Study (GBG 44). J Clin Oncol. 2018;36:1308-1316

Link in PubMed