Overall survival and subsequent therapy patterns in Japanese patients with ER+/HER2- advanced breast cancer treated with palbociclib plus letrozole in the first-line setting: a final analysis

Breast Cancer. 2025 Nov;32(6):1482-1490. doi: 10.1007/s12282-025-01760-0. Epub 2025 Aug 21.

Abstract

Background: An open-label, single-arm, multicenter Japanese phase 2 study (J-Ph2) found first-line palbociclib plus letrozole to be effective and tolerable in postmenopausal Japanese women with estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2-) advanced breast cancer (ABC), but overall survival (OS) data were immature. Here, we report the final analysis of a follow-up study of J-Ph2 evaluating OS and subsequent therapy.

Methods: Patients (N = 42) who participated in J-Ph2 were included in this follow-up study. Primary endpoint was OS; other endpoints included chemotherapy-free survival (CFS) and type and duration of subsequent therapy. Median OS, CFS, and duration of subsequent therapy were estimated using the Kaplan-Meier method; outcomes were stratified by baseline demographic, disease characteristics, and type of second-line therapies.

Results: At median follow up of 101.0 months, median OS was 85.4 months (95% CI, 64.3-not estimable) and median CFS was 69.1 months (95% CI, 24.2-85.4). Eighty-one percent of patients (34/42) received a second-line therapy; of those, 85.3% (29/34) received endocrine-based therapy and 8.8% (3/34) received chemotherapy. Median duration of second-line therapy was 7.6 months. Sixty-nine percent of patients (29/42) received a third-line therapy; of those, 58.6% (17/29) received endocrine-based therapy and 31.0% (9/29) received chemotherapy; median duration of third-line therapy was 6.0 months.

Conclusion: This analysis showed a median OS of > 7 years with first-line palbociclib plus letrozole in Japanese patients with ER+/HER2- ABC. Patient demographics, disease characteristics, and subsequent therapy decisions may have contributed to the extended median OS observed in this study.

Clinical trial registration: ClinicalTrials.gov, NCT04735367.

Keywords: Breast cancer; Japan; Overall survival; Palbociclib; Subsequent therapies.

Publication types

  • Multicenter Study
  • Clinical Trial, Phase II

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / metabolism
  • Breast Neoplasms* / mortality
  • Breast Neoplasms* / pathology
  • East Asian People
  • Erb-b2 Receptor Tyrosine Kinases / metabolism
  • Female
  • Follow-Up Studies
  • Humans
  • Japan / epidemiology
  • Letrozole / administration & dosage
  • Middle Aged
  • Piperazines / administration & dosage
  • Postmenopause
  • Pyridines / administration & dosage
  • Receptors, Estrogen / metabolism

Substances

  • Letrozole
  • Erb-b2 Receptor Tyrosine Kinases
  • Receptors, Estrogen
  • Pyridines
  • Piperazines
  • palbociclib
  • ERBB2 protein, human

Supplementary concepts

  • Japanese people

Associated data

  • ClinicalTrials.gov/NCT04735367