TY - JOUR
T1 - Overall survival of patients with de Novo HER2-positive metastatic breast cancer in the Netherlands from 2008 to 2017
T2 - A population-based cohort study of systemically treated patients
AU - Ding, Nan
AU - Hermans, Karlijn E.P.E.
AU - van Nijnatten, Thiemo J.A.
AU - Engelen, Sanne M.E.
AU - Tol, Jolien
AU - Kooreman, Loes
AU - Vrancken-Peeters, Marie Jeanne T.F.D.
AU - Siesling, Sabine
AU - Voogd, Adri C.
AU - Tjan-Heijnen, Vivianne C.G.
AU - Geurts, Sandra M.E.
N1 - Funding Information:
ND acknowledges the support of the China Scholarship Council program (Project ID: 202208500008).
Publisher Copyright:
© 2025 The Authors
PY - 2025/6/3
Y1 - 2025/6/3
N2 - Aim: This study aims to determine whether real-world overall survival (OS) of patients with de Novo HER2-positive (HER2 +) metastatic breast cancer (MBC) in the Netherlands improved over time. Methods: Data of patients diagnosed with de Novo HER2 + MBC in 2008–2017 were retrieved from the Netherlands Cancer Registry. OS was estimated per two-year period using the Kaplan-Meier method and compared using the log-rank test for trend and the multivariable Cox proportional hazards analysis, adjusted for baseline characteristics and local therapy. First-given systemic and local therapy use was determined per two-year period. Results: Among 1458 patients included, 99 % (1452/1458) were female and 53 % (775/1458) aged 50–74 years at diagnosis. Comparing patients diagnosed with de Novo HER2 + MBC in 2008–2009 versus 2016–2017, the median OS improved from 30·9 months (95 %CI:25·0–35·4) to 57·3 months (95 %CI:46·7–68·1) (p-value for trend<0·001) (adjusted hazard rate ratio =0·49, 95 %CI:0·40–0·59). The use of any HER2-targeted therapy increased from 64 % (178/279) to 84 % (287/340), while the use of pertuzumab-based therapy increased from 0 % to 67 % (227/340) over the same period. The use of surgery remained stable over time, while radiotherapy use for both the primary tumour and metastases increased in recent years, from 16 % (44/279) and 15 % (42/279) in 2008–2009–22 % (76/340) and 26 % (88/340) in 2016–2017, respectively. Conclusion: OS has doubled over ten years, for patients diagnosed with de Novo HER2 + MBC in the Netherlands between 2008 and 2017. No change in metastatic presentation was observed over time, suggesting the improved OS is most likely explained by treatment improvements.
AB - Aim: This study aims to determine whether real-world overall survival (OS) of patients with de Novo HER2-positive (HER2 +) metastatic breast cancer (MBC) in the Netherlands improved over time. Methods: Data of patients diagnosed with de Novo HER2 + MBC in 2008–2017 were retrieved from the Netherlands Cancer Registry. OS was estimated per two-year period using the Kaplan-Meier method and compared using the log-rank test for trend and the multivariable Cox proportional hazards analysis, adjusted for baseline characteristics and local therapy. First-given systemic and local therapy use was determined per two-year period. Results: Among 1458 patients included, 99 % (1452/1458) were female and 53 % (775/1458) aged 50–74 years at diagnosis. Comparing patients diagnosed with de Novo HER2 + MBC in 2008–2009 versus 2016–2017, the median OS improved from 30·9 months (95 %CI:25·0–35·4) to 57·3 months (95 %CI:46·7–68·1) (p-value for trend<0·001) (adjusted hazard rate ratio =0·49, 95 %CI:0·40–0·59). The use of any HER2-targeted therapy increased from 64 % (178/279) to 84 % (287/340), while the use of pertuzumab-based therapy increased from 0 % to 67 % (227/340) over the same period. The use of surgery remained stable over time, while radiotherapy use for both the primary tumour and metastases increased in recent years, from 16 % (44/279) and 15 % (42/279) in 2008–2009–22 % (76/340) and 26 % (88/340) in 2016–2017, respectively. Conclusion: OS has doubled over ten years, for patients diagnosed with de Novo HER2 + MBC in the Netherlands between 2008 and 2017. No change in metastatic presentation was observed over time, suggesting the improved OS is most likely explained by treatment improvements.
KW - HER2
KW - Metastatic breast cancer
KW - Overall survival
KW - Pertuzumab
KW - Real-life
U2 - 10.1016/j.ejca.2025.115475
DO - 10.1016/j.ejca.2025.115475
M3 - Article
SN - 0959-8049
VL - 222
JO - European Journal of Cancer
JF - European Journal of Cancer
M1 - 115475
ER -