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Introduction <p>The treatment landscape for human epidermal growth factor receptor&#xa0;2-negative (HER2−) metastatic breast cancer (mBC) in Canada is rapidly evolving. This retrospective cohort study described real-world historical treatment patterns and clinical outcomes for patients with HER2− mBC.</p> Methods <p>Adults enrolled in the pan-Canadian ‘Personalize My Treatment’ cancer registry and diagnosed with stage&#xa0;IV HER2− mBC (01/01/2015–03/01/2022) were eligible and followed until 03/01/2023. Hormone receptor-positive (HR+)/HER2− mBC and triple-negative mBC (mTNBC) were analyzed separately and further stratified by line of therapy. Main study outcomes included treatment patterns, <i>PIK3CA</i>/<i>AKT1</i>/<i>PTEN</i> alteration testing/positivity rates, and overall survival (OS), all analyzed descriptively.</p> Results <p>A total of 507 patients with HER2− mBC were included (HR+/HER2− mBC: 387; mTNBC: 120; median follow-up: 54.1&#xa0;months). The most common HR+/HER2− mBC treatments were cyclin‑dependent kinase&#xa0;4/6 inhibitors (CDK4/6is) plus endocrine therapy (ET) in first line (1L; 55.0%), targeted therapies (22.9%) and CDK4/6i + ET (22.0%) in second line (2L), and chemotherapy (CT) monotherapy (42.7%) in third line (3L). CT monotherapy was the most common mTNBC treatment in 1L (35.1%), 2L (50.6%), and 3L (54.8%). Attrition was similar for HR+/HER2− mBC and mTNBC from 1L–2L (16.9% and 16.3%, respectively) but was lower for HR+/HER2− mBC from 2L–3L (33.2% and 38.6%) and 3L–4L (48.1% and 62.1%). <i>PIK3CA</i>/<i>AKT1</i>/<i>PTEN</i> alteration testing was performed in 31.8% of patients with HR+/HER2− mBC and 50.0% with mTNBC, with alterations identified in 15.4% and 20.0% of patients, respectively. Median OS (65.9 and 31.4&#xa0;months, respectively), OS rates (1&#xa0;year: 94.8% and 79.8%; 5&#xa0;years: 56.0% and 21.7%), and time to next treatment (1L–2L: 24.5 and 8.1&#xa0;months; 2L–3L: 10.1 and 5.1&#xa0;months) were greater for HR+/HER2− mBC than mTNBC.</p> Conclusions <p>These findings describe historical HER2− mBC treatment patterns and associated outcomes in Canada. Ongoing research is needed to optimize therapeutic strategies, expand novel treatment access, and improve patient outcomes.</p>

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Treatment Patterns and Clinical Outcomes in Metastatic HR+/HER2− and Triple-Negative Breast Cancer in Canada: The HER2− TRENDS Study

  • 期刊论文

  • 发表日期：

    2026年3月10日

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  • Karen Gambaro,
  • Kahina Rachedi,
  • Mark Basik,
  • Gerald Batist,
  • Fred Saad,
  • Saima Hassan,
  • Anne-Marie Mes-Masson,
  • Dominique Boudreau,
  • Francois Vincent,
  • Eve St-Hilaire,
  • Helen Mackay,
  • Mahmoud Abdelsalam,
  • Steven M. Yip,
  • Robert Hanel,
  • Simran Shokar,
  • Zhor Senhaji Mouhri,
  • Matthew Badin,
  • Kristoph Klein-Panneton,
  • Arif Ali Awan,
  • Maud Marques

摘要

Introduction

The treatment landscape for human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer (mBC) in Canada is rapidly evolving. This retrospective cohort study described real-world historical treatment patterns and clinical outcomes for patients with HER2− mBC.

Methods

Adults enrolled in the pan-Canadian ‘Personalize My Treatment’ cancer registry and diagnosed with stage IV HER2− mBC (01/01/2015–03/01/2022) were eligible and followed until 03/01/2023. Hormone receptor-positive (HR+)/HER2− mBC and triple-negative mBC (mTNBC) were analyzed separately and further stratified by line of therapy. Main study outcomes included treatment patterns, PIK3CA/AKT1/PTEN alteration testing/positivity rates, and overall survival (OS), all analyzed descriptively.

Results

A total of 507 patients with HER2− mBC were included (HR+/HER2− mBC: 387; mTNBC: 120; median follow-up: 54.1 months). The most common HR+/HER2− mBC treatments were cyclin‑dependent kinase 4/6 inhibitors (CDK4/6is) plus endocrine therapy (ET) in first line (1L; 55.0%), targeted therapies (22.9%) and CDK4/6i + ET (22.0%) in second line (2L), and chemotherapy (CT) monotherapy (42.7%) in third line (3L). CT monotherapy was the most common mTNBC treatment in 1L (35.1%), 2L (50.6%), and 3L (54.8%). Attrition was similar for HR+/HER2− mBC and mTNBC from 1L–2L (16.9% and 16.3%, respectively) but was lower for HR+/HER2− mBC from 2L–3L (33.2% and 38.6%) and 3L–4L (48.1% and 62.1%). PIK3CA/AKT1/PTEN alteration testing was performed in 31.8% of patients with HR+/HER2− mBC and 50.0% with mTNBC, with alterations identified in 15.4% and 20.0% of patients, respectively. Median OS (65.9 and 31.4 months, respectively), OS rates (1 year: 94.8% and 79.8%; 5 years: 56.0% and 21.7%), and time to next treatment (1L–2L: 24.5 and 8.1 months; 2L–3L: 10.1 and 5.1 months) were greater for HR+/HER2− mBC than mTNBC.

Conclusions

These findings describe historical HER2− mBC treatment patterns and associated outcomes in Canada. Ongoing research is needed to optimize therapeutic strategies, expand novel treatment access, and improve patient outcomes.