Real World Outcomes of First Line Pertuzumab Based Therapy in HER2 Positive Metastatic Breast Cancer: Performance Status, Metastatic Burden and Nutritional Status as Prognostic Factors
Savaş Gökçek11Department of Medical Oncology, Necip Fazıl City Hospital, Kahramanmaraş, Türkiye
Objectives: To describe real-world outcomes of first-line pertuzumab, trastuzumab, and taxane therapy in HER2-positive metastatic breast cancer and identify factors associated with survival Methods: We retrospectively reviewed 110 consecutive patients treated at two centres between August 2016 and December 2025. Progression-free survival (PFS) and overall survival (OS) were measured from the first pertuzumab infusion. Survival factors were evaluated using Cox regression. Seven inflammatory and nutritional indices were dichotomised at their medians, with Benjamini–Hochberg correction. Results: The median age was 56 years; 82 patients (74.5%) had de novo metastatic disease. During a median follow-up of 33.4 months, 61 progression events and 37 deaths occurred. Median PFS was 21.6 months, and median OS was 47.1 months. ECOG performance status 1 (HR=2.74; p=0.003) and at least three metastatic sites (HR=2.29; p=0.013) were independently associated with shorter OS. At least three metastatic sites (HR=2.14; p=0.005) and a low prognostic nutritional index (HR=1.87; p=0.023) were associated with shorter PFS. No index remained significant after multiple-testing correction. No grade 3–4 event was documented. Conclusion: Performance status and metastatic burden were the strongest prognostic factors. De novo versus recurrent presentation was not prognostic when measured from a common starting point. Keywords: Dual HER2 blockade, HER2 positive breast cancer, metastatic breast cancer, pertuzumab, prognostic nutritional index, real world outcomes
Cite This Article
Gökçek S. Real World Outcomes of First Line Pertuzumab Based Therapy in HER2 Positive Metastatic Breast Cancer: Performance Status, Metastatic Burden and Nutritional Status as Prognostic Factors. EJMI. 2026; 10(4): 459-472
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