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Indication details

Combined Agent(s)
Standard adjuvant ChT + 1 year of treatment with trastuzumab
Control Arm
Placebo + standard adjuvant ChT + 1 year of treatment with trastuzumab
FDA Therapeutic Indication
Adjuvant treatment of adult patients with HER2-positive early breast cancer at high risk of recurrence (node-positive or hormone receptor-negative disease)
Tumour Sub-type
Early Breast Cancer
Tumour Stage
Adjuvant
Tumour Sub-Group
HER2+
Trial Name
APHINITY
NCT Number
NCT01358877
Trial Phase
Phase III

Approval details

FDA Approval
FDA regular approval December 2017
EMA Approval
EMA (CHMP) April 2018 EC decision June 2018

Primary Outcome(s)

Primary Outcome(s)
iDFS
Evaluated Outcome
iDFS
Form(s)
Form 1

Outcome Data

OS Control
94% 6-year: 93.9%
OS Gain
1% 6-year 0.9%
OS HR
NS in the second interim
DFS Control
6-year: 88.10%
DFS Gain
6-year: 2.90%
DFS HR
0.76 (0.64-0.91) in the ITT population

Adjustments

Toxicity Comment
Increased grade 3 diarrhoea (9.8% vs 3.7%)

Score (after adjustments)

Curative score

A

Comment
Node positive show 4.5% IDFS gain 83.4 vs 87.9% at 6 years 0.72 (0.59-0.82)
6-year analysis in node-positive patients: control iDFS 83.4%; iDFS gain 4.5%; iDFS HR 0.72 (0.59-0.87)
6-year analysis in hormone-receptor negative patients: control iDFS 87.0%; iDFS gain 2.5%; iDFS HR 0.83 (0.63-1.10)

Scorecard details

ESMO-MCBS version
ESMO-MCBS v1.1
Scorecard ID
133
Scorecard version
1
Issue date
05.06.2019
Last update
13.05.2022
Pertuzumab APHINITY

PRELIMINARY SCORE

DFS

ADJUSTMENTS

Pertuzumab APHINITY

SCORE

A

Overall Survival / Disease-Free Survival / Pathological Complete Response
Overall Survival
Progression-Free Survival
Non-inferiority (Improved Quality of Life or Reduced Adverse Events) / Response Rate
Overall Response Rate / Duration of Response
Adjuvant treatment of adult patients with HER2-positive early breast cancer at high risk of recurrence (node-positive or hormone receptor-negative disease)
Pertuzumab + Standard adjuvant ChT + 1 year of treatment with trastuzumab
Placebo + standard adjuvant ChT + 1 year of treatment with trastuzumab

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    Legend

    Information about symbols, abbrevations and color codes

    Red = negative
    Green = positive
    Grey = neutral
    ? Grey + ? = neutral with pending data
    DFS
    Disease-Free Survival
    DoR
    Duration of Response
    EFS
    Event-Free Survival
    HR
    Hazard Ratio
    NEB
    No evaluable benefit
    NI
    Non-inferiority Study
    ORR
    Overall Response Rate
    OS
    Overall Surival
    pCR
    Pathological Complete Response/Remission
    PFS
    Progression-Free Survival
    QoL
    Quality of Life
    RFS
    Relapse-Free Survival
    RR
    Response Rate

    QoL adjustments

    Other adjustments*

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    QoL adjustments

    Red = negative / deterioration

    Green = positive / improvement

    Other adjustments*

    Red = negative / deterioration

    Green = positive / improvement

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    * Other adjustments include:

    - Long-term plateau in the survival curve
    - Long-term plateau in the PFS curve
    - Early stopping or crossover
    - Only improved PFS mature data shows no OS advantage and no improved Qol.

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