{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T07:43:50Z","timestamp":1790408630328,"version":"4.1.0"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The evolution of therapeutic landscape of human epidermal growth factor receptor-2 (HER2)-positive breast cancer (BC) has led to an unprecedented outcome improvement, even if the optimal sequence strategy is still debated. To address this issue and to provide a picture of the advancement of anti-HER2 treatments, we performed a large, multicenter, retrospective study of HER2-positive BC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The observational PANHER study included 1,328 HER2-positive advanced BC patients treated with HER2 blocking agents since June 2000 throughout July 2020. Endpoints of efficacy were progression-free survival (PFS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients who received a first-line pertuzumab-based regimen showed better PFS ( p &lt; 0.0001) and OS ( p = 0.004) than those receiving other treatments. Median PFS and mOS from second-line starting were 8 and 28 months, without significant differences among various regimens. Pertuzumab-pretreated patients showed a mPFS and a mOS from second-line starting not significantly affected by type of second line, that is, T-DM1 or lapatinib\/capecitabine ( p = 0.80 and p = 0.45, respectively). Conversely, pertuzumab-na\u00efve patients receiving second-line T-DM1 showed a significantly higher mPFS compared with that of patients treated with lapatinib\/capecitabine ( p = 0.004). Median OS from metastatic disease diagnosis was higher in patients treated with trastuzumab-based first line followed by second-line T-DM1 in comparison to pertuzumab-based first-line and second-line T-DM1 ( p = 0.003), although these data might be partially influenced by more favorable prognostic characteristics of patients in the pre-pertuzumab era. No significant differences emerged when comparing patients treated with \u2018old\u2019 or \u2018new\u2019 drugs ( p = 0.43), even though differences in the length of the follow-up between the two cohorts should be taken into account.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our results confirmed a relevant impact of first-line pertuzumab-based treatment and showed lower efficacy of second-line T-DM1 in trastuzumab\/pertuzumab pretreated, as compared with pertuzumab-na\u00efve patients. Our findings may help delineate a more appropriate therapeutic strategy in HER2-positive metastatic BC. Prospective randomized trials addressing this topic are awaited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359211059873","type":"journal-article","created":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T06:07:41Z","timestamp":1638166061000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["PANHER study: a 20-year treatment outcome analysis from a multicentre observational study of HER2-positive advanced breast cancer patients from the real-world setting"],"prefix":"10.1177","volume":"13","author":[{"given":"Laura","family":"Pizzuti","sequence":"first","affiliation":[{"name":"Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eriseld","family":"Krasniqi","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Sperduti","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Barba","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, via Elio Chianesi 53, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Gamucci","sequence":"additional","affiliation":[{"name":"Medical Oncology, Sandro Pertini Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mauri","sequence":"additional","affiliation":[{"name":"Division of Oncology, San Giovanni Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo Maria","family":"Veltri","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Santa Maria Goretti, Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Icro","family":"Meattini","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit and Department of Clinical and Experimental Biomedical Sciences \u2018Mario Serio\u2019, Careggi University Hospital, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Berardi","sequence":"additional","affiliation":[{"name":"Oncology Clinic, \u2018Ospedali iuniti di Ancona\u2019 Hospital, Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Sofia","family":"Di Lisa","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy"},{"name":"Medical Oncology A, Policlinico Umberto I, Rome, Italy"},{"name":"Department of Radiological, Oncological and Anatomo-Pathological Sciences, \u2018Sapienza\u2019 University of Rome, Umberto I University Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Natoli","sequence":"additional","affiliation":[{"name":"Department of Medical, Oral and Biotechnological Sciences and Center for Advanced Studies and Technology (CAST), G. D\u2019Annunzio University, Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirco","family":"Pistelli","sequence":"additional","affiliation":[{"name":"Oncology Clinic, \u2018Ospedali Riuniti di Ancona\u2019 Hospital, Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Iezzi","sequence":"additional","affiliation":[{"name":"Oncology Division, Hospital \u2018Maria SS. dello Splendore\u2019 ASL 4, Giulianova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9307-9760","authenticated-orcid":false,"given":"Emanuela","family":"Risi","sequence":"additional","affiliation":[{"name":"Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"D\u2019Ostilio","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit, Lanciano-Vasto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silverio","family":"Tomao","sequence":"additional","affiliation":[{"name":"Medical Oncology A, Policlinico Umberto I, Rome, Italy"},{"name":"Department of Radiological, Oncological and Anatomo-Pathological Sciences, \u2018Sapienza\u2019 University of Rome, Umberto I University Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Ficorella","sequence":"additional","affiliation":[{"name":"Medical Oncology, Department of Biotechnological and Applied Clinical Sciences, University of L\u2019Aquila, L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"Cannita","sequence":"additional","affiliation":[{"name":"Medical Oncology, Mazzini Hospital, Teramo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferdinando","family":"Riccardi","sequence":"additional","affiliation":[{"name":"Oncology Unit, Antonio Cardarelli Hospital, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Cassano","sequence":"additional","affiliation":[{"name":"U.O.C. 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