Pyrotinib plus capecitabine could significantly improve overall survival in HER2-positive metastatic breast cancer
Xiuwen Guan, Fei Ma, Qiao Li, Shanshan Chen, Ying Fan, Jiayu Wang, Yang Luo, Pin Zhang, Qing Li, Binghe Xu
Abstract
The irreversible pan-ErbB tyrosine kinase inhibitors (TKIs), including neratinib and pyrotinib, demonstrated more complete inhibition towards ErbB -family and promising antitumor activity compared to lapatinib, a reversible TKI. 1 In the phase III NALA study for HER2-positive metastatic breast cancer (MBC) who were progressed after two lines of HER2-targeted regimens, 2 significant improvement was observed in progression-free survival (PFS) in patients receiving neratinib combined with capecitabine when compared to lapatinib plus capecitabine (L + C) group. However, the 2.2-month PFS improvement in neratinib plus capecitabine cohort failed to translate to a significant benefit in the overall survival (OS, 24.0 vs 22.2 months, P = 0.2086). 2 While another irreversible TKI, pyrotinib combined with capecitabine (P + C) achieved clinically and statistically significant improvement in the PFS and a trend of benefits in the OS when compared to the L + C group, based on the interim analysis (with the cutoff of March 31, 2019) of the phase III PHOEBE study. 3 Generally speaking, current evidence was still limited regarding the survival data of irreversible TKIs.