Multinational study of the efficacy and safety of humanized anti-HER2 monoclonal antibody in women who have HER2-overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease

Purpose: Overexpression of the HER2 protein occurs in 25% to 30% of human b reast cancers and leads to a particularly aggressive form of the disease. E fficacy and safety of recombinant humanized anti-HER2 monoclonal antibody a s a single agent was evaluated in women with HER2-overexpressing metastatic breast cancer that had progressed after chemotherapy for metastatic diseas e. Patients and Methods: Two hundred twenty-two women, with HER2-overexpressin g metastatic breast cancer that had progressed after one or two chemotherap y regimens, were enrolled. Patients received a loading dose of 4 mg/kg intr avenously, followed by a 2-mg/kg maintenance dose at weekly intervals. Results: Study patients had advanced metastatic disease and had received ex tensive prior therapy. A blinded, independent response evaluation committee identified eight complete and 26 partial responses, for an objective respo nse rate of 15% in the intent-to-treat population (95% confidence interval, 11% to 21%). The median duration of response wets 9.1 months; the median d uration of survival was 13 months. The most common adverse events, which oc curred in approximately 40% of patients, were infusion-associated fever and /or chills that usually occurred only during the first infusion, and were o f mild to moderate severity, These symptoms were treated successfully with acetaminophen and/or diphenhydramine, The most clinically significant adver se event was cardiac dysfunction, which occurred in 4.7% of patients, Only 1% of patients discontinued the study because of treatment-related adverse events, Conclusion: Recombinant humanized anti-HER2 monoclonal antibody, administer ed as a single agent, produces durable objective responses and is well tole rated by women with HERS-overexpressing metastatic breast cancer that has p rogressed after chemotherapy for metastatic disease, Side effects that are commonly observed with chemotherapy, such as alopecia, mucositis, and neutr openia, are rarely seen. (C) 1999 by American Society of Clinical Oncology.