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1. Long term outcome data from the EORTC 75111-10114 ETF/BCG randomized phase II study: Pertuzumab and trastuzumab with or without metronomic chemotherapy for older patients with HER2-positive metastatic breast cancer, followed by T-DM1 after progression

Author

Hans Wildiers, Thomas Meyskens, Sandrine Marréaud, Lissandra Dal Lago, Peter Vuylsteke, Giuseppe Curigliano, Simon Waters, Barbara Brouwers, Bart Meulemans, Berta Sousa, Coralie Poncet, Etienne Brain, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service d'oncologie médicale

Subjects
Receptor, ErbB-2, T-DM1, Breast Neoplasms, Ado-Trastuzumab Emtansine, Antibodies, Monoclonal, Humanized, HER2 positive breast cancer, AGE, Antineoplastic Combined Chemotherapy Protocols, Older patients, MANAGEMENT, Humans, skin and connective tissue diseases, Aged, Aged, 80 and over, Science & Technology, Pertuzumab, Metronomic chemotherapy, Obstetrics & Gynecology, WOMEN, Neoplasms, Second Primary, General Medicine, Trastuzumab, OPEN-LABEL, Oncology, EMTANSINE, BCG Vaccine, Disease Progression, PAPER, Female, Surgery, Life Sciences & Biomedicine, Frail patients
Abstract

INTRODUCTION: Older patients are at higher risk of chemotherapy-induced toxicity, raising interest in less toxic anti-HER2 regimens for older persons with HER2-positive (HER2+) metastatic breast cancer (MBC). PATIENTS AND METHODS: This phase II study randomized (1:1) patients with HER2+ MBC, aged 70+ or frail 60+, to first line chemotherapy with metronomic oral cyclophosphamide (M) + Trastuzumab (T) and Pertuzumab (P) or TP alone. T-DM1 was offered in case of progression. RESULTS: In total, 39 and 41 patients were randomized to TP and TPM arm respectively. Median follow-up is 54.0 months. 24-month PFS was 18.7% (95% CI 8.2-32.4) and 28.7% (95% CI 15.8-43.0), respectively. A total of 49 (61.3%) patients died of whom 37 (75.5%) from disease progression; number of deaths per arm was 27 (69.2%) for TP and 22 (53.7%) for TPM. There was no significant difference in OS between the two arms (median OS TP vs TPM: 32.1 vs 37.5 months, p 0.25). Among the 40 patients who have started T-DM1 after disease progression on TP/TPM, PFS rate at 6 months after start of T-DM1 was 43.6% (95% CI: 27.7-58.5) and grade 3 or higher AE occurred in 18 pts (45%). CONCLUSIONS: Metronomic chemotherapy-based dual blockade (TPM), followed by T-DM1 after progression, provides an active and relatively well tolerated treatment option in an older/frail HER2+ MBC population, with a median survival of over 3 years. Nevertheless, the majority of this older/frail population died from breast cancer, highlighting the need for well tolerated and efficacious treatments in these patients. ispartof: BREAST vol:64 pages:100-111 ispartof: location:Netherlands status: published

Published
2022

2. Measurement of phenylalanine in blood on filter paper as a method of monitoring PKU treatment

Author

E. Kostyk, M. Otarzewski, and Dorota Tylek-Lemanska

Subjects
Paper, Pediatrics, medicine.medical_specialty, Phenylalanine, Gastroenterology, Older patients, Reference Values, Internal medicine, Phenylketonurias, medicine, Humans, Fluorometry, Child, Blood Specimen Collection, Filter paper, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Infant, Treatment Outcome, Child, Preschool, Regression Analysis, Colorimetry, Poland, business, Software, Treatment monitoring
Abstract

OBJECTIVES: Phenylketonuria (PKU) is a genetic disease with autosomal recessive inheritance. In Poland the microbiological Guthrie test for this disease was replaced by an enzymatic colorimetric test. The question is whether the colorimetric test might be used in monitoring treatment of PKU. SETTING: In 80 patients with PKU on routine treatment monitoring of serum phenylalanine concentrations (SPh) was compared with phenylalanine concentrations in blood on filter paper (PhBFP). METHODS: Measurements of SPh were by a fluorimetric method (McCaman and Robins), and those of PhBFP were by an enzymatic colorimetric method. RESULTS: The regression analysis of SPh compared with PhBFP gave the equation y=0.9219x+0.2389; for the reversed ratio: it gave y=1.0220x+0.55083. The correlation was 0.97 at p

Published
2002