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Oliveira M, Falato C, Cejalvo JM, Vila MM, Tolosa P, Salvador-Bofill FJ, Cruz J, Arumi M, Luna AM, Guerra JA, Vidal M, Martínez-Sáez O, Paré L, González-Farré B, Sanfeliu E, Ciruelos E, Espinosa-Bravo M, Pernas S, Izarzugaza Y, Esker S, Fan PD, Parul P, Santhanagopal A, Sellami D, Villacampa G, Ferrero-Cafiero JM, Pascual T, Prat A. Patritumab Deruxtecan in Untreated Hormone Receptor-Positive/HER2-Negative Early Breast Cancer: Final Results from Part A of the Window-of-Opportunity SOLTI TOT-HER3 Pre-Operative Study. Ann Oncol 2023:S0923-7534(23)00685-3. [PMID: 37211044 DOI: 10.1016/j.annonc.2023.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Patritumab deruxtecan (HER3-DXd) is a HER3-directed antibody-drug conjugate composed of a fully human anti-HER3 monoclonal antibody (patritumab) covalently linked to a topoisomerase I inhibitor payload via a stable, tumor-selective, tetrapeptide-based cleavable linker. TOT-HER3 is a window-of-opportunity study designed to assess the biological activity, measured by CelTIL score [ = -.8 × tumor cellularity (in %) + 1.3 × TILs (in %)], and clinical activity of HER3-DXd during short-term (21 days) pre-operative treatment in patients with primary operable HER2-negative early breast cancer. PATIENTS AND METHODS Patients with previously untreated hormone receptor (HR)-positive/HER2-negative tumors were allocated to one of four cohorts according to baseline ERBB3 mRNA expression. All patients received one dose of HER3-DXd 6.4 mg/kg. The primary objective was to evaluate change from baseline in CelTIL score. RESULTS Seventy-seven patients were evaluated for efficacy. A significant change in CelTIL score was observed, with a median increase from baseline of 3.5 (interquartile range, -3.8 to 12.7; P=.003). Among patients evaluable for clinical response (n=62), an overall response rate of 45% was observed (tumor measurement by caliper), with a trend toward an increase in CelTIL score among responders compared with non-responders (mean difference, +11.9 vs +1.9). Change in CelTIL score was independent of baseline ERBB3 mRNA and HER3 protein levels. Genomic changes occurred, including switching toward a less proliferative tumor phenotype based on PAM50 subtypes, suppression of cell proliferation genes, and induction of genes associated with immunity. Treatment-emergent adverse events were observed in 96% of patients (14% grade ≥3); most common were nausea, fatigue, alopecia, diarrhea, vomiting, abdominal pain, and neutrophil count decrease. CONCLUSIONS A single dose of HER3-DXd was associated with clinical response, increased immune infiltration, suppression of proliferation in HR-positive/HER2-negative early breast cancer, and a tolerable safety profile consistent with previously reported results. These findings support further study of HER3-DXd in early breast cancer.
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Affiliation(s)
- M Oliveira
- Medical Oncology Department, Vall d'Hebron University Hospital, and Breast Cancer Group, Vall D'Hebron Institute of Oncology (VHIO), Barcelona, Spain;; SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - C Falato
- SOLTI Breast Cancer Research Group, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain, and Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - J M Cejalvo
- SOLTI Breast Cancer Research Group, Department of Medical Oncology, Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - M Margelí Vila
- SOLTI Breast Cancer Research Group, Medical Oncology Department, ICO - Institut Català d'Oncologia Badalona (Hospital Universitario Germans Trias i Pujol), Badalona, Spain
| | - P Tolosa
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital 12 de Octubre, Madrid, Spain
| | - F J Salvador-Bofill
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - J Cruz
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - M Arumi
- Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A M Luna
- Centro Integral Oncológico Clara Campal HM (CIOCC), Madrid, Spain
| | - J A Guerra
- Medical Oncology Department, Hospital de Fuenlabrada, Fuenlabrada, Spain
| | - M Vidal
- Medical Oncology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - O Martínez-Sáez
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - L Paré
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | - B González-Farré
- SOLTI Breast Cancer Research Group, Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - E Sanfeliu
- SOLTI Breast Cancer Research Group, Pathology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - E Ciruelos
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital 12 de Octubre, Centro Integral Oncológico Clara Campal HM (CIOCC), Madrid, Spain
| | - M Espinosa-Bravo
- SOLTI Breast Cancer Research Group, Breast Cancer Surgical Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Pernas
- SOLTI Breast Cancer Research Group, Department of Medical Oncology, Catalan Institute of Oncology - ICO, Breast Cancer Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Y Izarzugaza
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Fundación Jimenez Díaz, Madrid, Spain
| | - S Esker
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - P-D Fan
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - P Parul
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - A Santhanagopal
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - D Sellami
- Research and Development, Daiichi Sankyo, Inc, Basking Ridge, NJ, USA
| | - G Villacampa
- SOLTI Breast Cancer Research Group, Barcelona, Spain
| | | | - T Pascual
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - A Prat
- SOLTI Breast Cancer Research Group, Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, August Pi Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain;.
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Echarri González M, Ayala de la Peña F, Márquez Vázquez R, García-Saenz J, Galve Calvo E, Illarramendi Mañas J, Millastre Bocos E, Margelí Vila M, Sánchez Rovira P, Chacón López-Muñiz J, Cerezuela Fuentes P, Andrés Conejero R, Cerrato Crespan L, Marrodán Ciordia I, Ocana Fernandez A, Álvarez López I, Alés Martínez J, Palomar Abad L, Orcajo Rincon L, Rodríguez-Villanueva J. Retrospective observational study to evaluate the use of halaven plus trastuzumab for the treatment of HER2(+) metastatic breast cancer (MBC) in Spain: HALATRUST study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx365.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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