Neratinib as extended adjuvant treatment of HER2-positive/HR-positive early breast cancer patients in Germany, Austria and Switzerland: interim results of the prospective, observational ELEANOR study

  • N Harbeck
  • , D Wrobel
  • , M Zaiss
  • , J Terhaag
  • , D Guth
  • , A Distelrath
  • , MO Zahn
  • , R Wuerstlein
  • , A Lorenz
  • , R Bartsch
  • , U Breitenstein
  • , M Schwitter
  • , M Balic
  • , C Jackisch
  • , V Mueller
  • , G Rinnerthaler (Co-author)
  • , M Schmidt
  • , K Zaman
  • , T Schinköthe
  • , A Resch
  • R Valenti, D Lüftner

Research output: Contribution to journalOriginal Articlepeer-review

2 Citations (Web of Science)

Abstract

Introduction: Prognosis of patients diagnosed with HER2+ early breast cancer (eBC) has substantially improved, but distant recurrences impacting quality of life and survival still occur. One treatment option for extended adjuvant treatment in patients with HER2+/HR+ eBC is neratinib; available in Europe for patients who completed adjuvant trastuzumab-based therapy within 1 year. The ELEANOR study is investigating the real-world use of neratinib in Germany, Austria and Switzerland. Results from an interim analysis of the first 200 patients observed for >= 3 months are reported.Methods: The primary objective of this prospective, multicentre, observational study is to assess patient adherence to neratinib (defined as percentage of patients taking neratinib on >= 75% prescribed days). Secondary objectives are patient characteristics and treatment outcomes.Results: At cut-off (May 2, 2022), 202 patients had been observed for >= 3 months, with neratinib treatment documented for 187 patients (median age 53.0 years; 67.9% at increased risk of disease recurrence). In total 151 (80.7%) patients had received prior neoadjuvant treatment; of these 82 (54.3%) achieved a pathological complete response. Neratinib was initiated at a median 3.6 months after trastuzumab-based treatment, with 36.4% starting at a dose <240 mg/day. Treatment is ongoing for 46.0% of patients, with median treatment duration of 11.2 (interquartile range 0.9-12.0) months. Diarrhoea was the most common adverse event (78.6% any grade, 20.3% Grade >= 3); pharmacologic prophylaxis was used in 85.6% of patients.Conclusions: The pattern of anti-HER2 pretreatment observed reflected the current treatment for HER2+/HR+ eBC in Germany, Austria and Switzerland. These interim results suggest that neratinib as an extended adjuvant is a feasible option after various anti-HER2 pretreatments, and that its tolerability can be managed and improved with proactive diarrhoea management.
Original languageEnglish
Number of pages22
JournalBreast care (Basel, Switzerland)
Early online dateOct 2023
DOIs
Publication statusPublished - 5 Oct 2023

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