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NCT02896855: PUFFIN

A Study to Evaluate the Efficacy and Safety of Pertuzumab + Trastuzumab + Docetaxel Versus Placebo + Trastuzumab + Docetaxel in Previously Untreated Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Metastatic Breast Cancer

Completed Phase 3 Results posted Last updated 16 December 2021
What this trial tests

Phase 3 trial testing Docetaxel in Breast Cancer in 243 participants. Completed in 22 January 2021.

Timeline
13 September 2016
Primary endpoint
27 June 2018
22 January 2021

Quick facts

Lead sponsorHoffmann-La Roche
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment243
Start date13 September 2016
Primary completion27 June 2018
Estimated completion22 January 2021
Sites15 locations across China

Drugs / interventions tested

Conditions studied

Sponsor

Hoffmann-La Roche — full company profile →

Who can join

18 and older, any sex, with Breast Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression-Free Survival, as Determined by the Investigator Using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1) Primary · From date of randomization until date of PFS event (Median [range] time on study for Arm A vs. Arm B at Primary analysis: 57.14 [3.3-93.3] weeks vs. 59.64 [0.9-90.4] weeks; Final analysis: 145.29 [3.3-225.3] weeks vs. 174.79 [0.9-226.1] weeks)

Progression-free survival (PFS) was defined as the time from randomization to first occurrence of progressive disease (PD), as determined by the investigator using RECIST v1.1, or death from any cause within 18 weeks after the last tumor assessment, whichever occurred first. As per RECIST v1.1, PD is defined as a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 millimeters (mm), and the appearance of new lesions. The Kaplan-Meier approach was used to estimate median PFS for each treatment arm. Data for participants who did not

Primary Analysis
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel12.410.4 – 12.7
Arm B: Pertuzumab + Trastuzumab + Docetaxel14.512.5 – 18.6
Final Analysis
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel12.510.4 – 14.6
Arm B: Pertuzumab + Trastuzumab + Docetaxel16.512.7 – 20.2
Kaplan-Meier Estimate of the Percentage of Participants Event-Free for Progression-Free Survival at 1 to 3 Years, as Determined by the Investigator Using RECIST v1.1 Primary · At 1, 2, and 3 years

Progression-free survival (PFS) was defined as the time from randomization to first occurrence of progressive disease (PD), as determined by the investigator using RECIST v1.1, or death from any cause within 18 weeks after the last tumor assessment, whichever occurred first. As per RECIST v1.1, PD is a 20% increase in the sum of the diameters of target lesions, an increase in size of measurable lesions by at least 5 mm, and the appearance of new lesions. The Kaplan-Meier approach was used to estimate the percentage of participants who were event-free for PFS at 1, 2, and 3 years. Data for part

1 Year
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel52.9043.75 – 62.04
Arm B: Pertuzumab + Trastuzumab + Docetaxel66.3757.86 – 74.87
2 Years
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel19.1911.85 – 26.53
Arm B: Pertuzumab + Trastuzumab + Docetaxel37.8529.03 – 46.66
3 Years
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel12.736.48 – 18.97
Arm B: Pertuzumab + Trastuzumab + Docetaxel29.4421.04 – 37.84
Overall Survival Secondary · From date of randomization until the date of death from any cause (Median [range] time on study for Arm A vs. Arm B at Final analysis: 145.29 [3.3-225.3] weeks vs. 174.79 [0.9-226.1] weeks)

Overall survival (OS) was defined as the time from randomization to death from any cause. The Kaplan-Meier approach was used to estimate median OS for each treatment arm. Participants who were alive or lost to follow-up at the time of the analysis were censored at the date they were last known to be alive. Participants with no post-baseline information were censored at the time of randomization plus 1 day. The results reported here are from the final analysis. At the primary completion date, the median duration of OS had not been reached and OS data was not considered mature due to the few num

GroupValue95% CI
Arm A: Placebo + Trastuzumab + DocetaxelNA22.1 – NA
Arm B: Pertuzumab + Trastuzumab + DocetaxelNA30.6 – NA
Kaplan-Meier Estimate of the Percentage of Participants Event-Free for Overall Survival at 1 to 3 Years Secondary · At 1, 2, and 3 Years

Overall survival (OS) was defined as the time from randomization to death from any cause. The Kaplan-Meier approach was used to estimate the percentage of participants who were event-free for OS (i.e., alive) at 1, 2, and 3 years. Participants who were alive or lost to follow-up at the time of the analysis were censored at the date they were last known to be alive. Participants with no post-baseline information were censored at the time of randomization plus 1 day. At final analysis, the median \[range\] time on study for Arm A vs. Arm B was 145.29 \[3.3-225.3\] weeks vs. 174.79 \[0.9-226.1\]

1 Year
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel90.6485.37 – 95.91
Arm B: Pertuzumab + Trastuzumab + Docetaxel93.4489.05 – 97.84
2 Years
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel73.8565.80 – 81.91
Arm B: Pertuzumab + Trastuzumab + Docetaxel78.8771.50 – 86.24
3 Years
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel58.4149.12 – 67.69
Arm B: Pertuzumab + Trastuzumab + Docetaxel70.7962.50 – 79.09
Percentage of Participants With Measurable Disease at Baseline Who Achieved an Objective Response (Complete or Partial Response), as Determined by the Investigator Using RECIST v1.1 Secondary · At Baseline and every 9 weeks from date of randomization until disease progression or death, whichever occurs first (Median [range] time on study for Arm A vs. Arm B at Primary analysis: 57.14 [3.3-93.3] weeks vs. 59.64 [0.9-90.4] weeks)

An objective response was defined as a complete response (CR) or partial response (PR), as determined by the investigator using RECIST v1.1. As per RECIST v1.1, CR is defined as the disappearance of all target lesions, and PR is defined as at least a 30% decrease in the sum of diameters of target lesions. Also per RECIST v1.1, stable disease (SD) is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking as reference the smallest sum on study; PD is defined as a 20% increase in the sum of the diameters of target lesions,

Objective Response (CR + PR)
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel69.158.88 – 78.07
Arm B: Pertuzumab + Trastuzumab + Docetaxel79.070.01 – 86.38
Complete Response (CR)
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel8.23.63 – 15.61
Arm B: Pertuzumab + Trastuzumab + Docetaxel5.72.13 – 12.02
Partial Response (PR)
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel60.850.39 – 70.58
Arm B: Pertuzumab + Trastuzumab + Docetaxel73.363.81 – 81.49
Stable Disease (SD)
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel20.613.07 – 30.03
Arm B: Pertuzumab + Trastuzumab + Docetaxel15.28.97 – 23.56
Progressive Disease (PD)
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel4.11.13 – 10.22
Arm B: Pertuzumab + Trastuzumab + Docetaxel3.81.05 – 9.47
Missing or Unevaluable
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel6.2NA – NA
Arm B: Pertuzumab + Trastuzumab + Docetaxel1.9NA – NA
Duration of Objective Response, as Determined by the Investigator Using RECIST v1.1 Secondary · From date of first occurrence of documented objective response to date of event (Median [range] time on study for Arm A vs. Arm B at Primary analysis: 57.14 [3.3-93.3] weeks vs. 59.64 [0.9-90.4] weeks)

Duration of objective response was defined as the time from the first occurrence of a documented objective response (complete response \[CR\] or partial response \[PR\]) to the time of disease progression, as determined by the investigator using RECIST v1.1, or death from any cause within 18 weeks after the last tumor assessment, whichever occurred first. As per RECIST v1.1, CR is defined as the disappearance of all target lesions, and PR is defined as at least a 30% decrease in the sum of diameters of target lesions. The Kaplan-Meier approach was used to estimate median duration of objective

GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel10.48.3 – 15.4
Arm B: Pertuzumab + Trastuzumab + Docetaxel12.410.6 – 14.9
Number of Participants With at Least One Adverse Event Secondary · From first dose of study drug until 42 days after last dose of study drug (up to 4 years, 4 months)

The number of participants per treatment arm experiencing at least one adverse event, including all non-serious and serious adverse events, is reported here. Adverse events reported prior to first crossover treatment were included in the Placebo arm, and in the Crossover arm after that date, for participants in Arm A who crossed over from placebo to pertuzumab. At final analysis, the median \[range\] time on study treatment with placebo or pertuzumab per arm was: Arm A - Placebo: 52.3 \[3-207\] weeks; Arm B - Pertuzumab: 66.1 \[3-225\] weeks; Arm A - Crossover to Pertuzumab: 18.1 \[12-24\] wee

GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel115
Arm B: Pertuzumab + Trastuzumab + Docetaxel121
Arm A: Crossover to Pertuzumab + Trastuzumab + Docetaxel5
Number of Participants With at Least One Grade ≥3 Adverse Event Secondary · From first dose of study drug until 42 days after last dose of study drug (up to 4 years, 4 months)

Adverse event (AE) severity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 4.0 (NCI-CTCAE v4.0); if the AE was not specifically listed, the following grades of severity were used: Grade 1 = mild; Grade 2 = moderate; Grade 3 = severe; Grade 4 = life-threatening or disabling; and Grade 5 = death. Severe and serious are not synonymous. Severity refers to the intensity of an AE, whereas a serious AE must meet criteria set out in the protocol; both were independently assessed for each AE. AEs reported prior to first crossover treatmen

GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel83
Arm B: Pertuzumab + Trastuzumab + Docetaxel90
Arm A: Crossover to Pertuzumab + Trastuzumab + Docetaxel1
Number of Participants With at Least One Adverse Event Leading to Withdrawal From Any Treatment Secondary · From first dose of study drug until 42 days after last dose of study drug (up to 4 years, 4 months)

Adverse events reported prior to first crossover treatment were included in the Placebo arm, and in the Crossover arm after that date, for participants in Arm A who crossed over from placebo to pertuzumab. At final analysis, the median \[range\] time on study treatment with placebo or pertuzumab per arm was: Arm A - Placebo: 52.3 \[3-207\] weeks; Arm B - Pertuzumab: 66.1 \[3-225\] weeks; Arm A - Crossover to Pertuzumab: 18.1 \[12-24\] weeks.

GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel10
Arm B: Pertuzumab + Trastuzumab + Docetaxel15
Arm A: Crossover to Pertuzumab + Trastuzumab + Docetaxel0
Number of Participants With Symptomatic Left Ventricular Systolic Dysfunction (LVSD), as Determined Using Echocardiography (ECHO) or Multiple-Gated Acquisition (MUGA) Scan Secondary · From first dose of study drug until 42 days after last dose of study drug (up to 4 years, 4 months)

The number of participants with symptomatic left ventricular systolic dysfunction (LVSD) at any time during the study, as determined using echocardiography (ECHO) or multiple-gated acquisition (MUGA) scan, were summarized by treatment arm. Symptomatic LVSD was evaluated according to NCI CTCAE v4.0 (for "heart failure") and the New York Heart Association (NYHA) classification. At final analysis, the median \[range\] time on study treatment with placebo or pertuzumab per arm was: Arm A - Placebo: 52.3 \[3-207\] weeks; Arm B - Pertuzumab: 66.1 \[3-225\] weeks; Arm A - Crossover to Pertuzumab: 18.

GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel0
Arm A: Crossover to Pertuzumab + Trastuzumab + Docetaxel0
Number of Participants With an Asymptomatic Decline in Left Ventricular Ejection Fraction (LVEF) Event, as Determined Using ECHO or MUGA Scan Secondary · From first dose of study drug until 42 days after last dose of study drug (up to 4 years, 4 months)

An asymptomatic decline in LVEF event is reported as an adverse event of "ejection fraction decreased" and is defined as either of the following: an absolute decrease in LVEF of ≥10 percentage points from baseline to an LVEF of \<50%; or an asymptomatic decrease in LVEF requiring treatment or leading to discontinuation of pertuzumab (or placebo) and trastuzumab. At final analysis, the median \[range\] time on study treatment with placebo or pertuzumab per arm was: Arm A - Placebo: 52.3 \[3-207\] weeks; Arm B - Pertuzumab: 66.1 \[3-225\] weeks; Arm A - Crossover to Pertuzumab: 18.1 \[12-24\] we

GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel2
Arm A: Crossover to Pertuzumab + Trastuzumab + Docetaxel0
Number of Participants by the LVEF Abnormality Status Categories Over Time, as Determined by the Change From Baseline in LVEF Using ECHO or MUGA Scans Secondary · Baseline, Weeks 9, 18, 27, 36, 45, 54, 63, 72, 81, 90, 99, 108, 117, 126, 135, 144, 153, 162, 171, 180, 189, 198, 207, 216, and 225, Study Drug Discontinuation Visit (up to 4 years, 4 months), and Treatment-Free Follow-Up at 6 months, and 1 and 2 years

Left ventricular ejection fraction (LVEF) is the measurement of how much blood is being pumped out of the left ventricle of the heart with each contraction. LVEF was calculated using the modified Simpson method and must have been ≥55% at baseline as determined by the local facility before a participant could be enrolled in the study. The investigator decided which method of LVEF assessment (ECHO \[preferred\] or MUGA scan) would be used for each participant at baseline, and the same method was to be used throughout the study, to the extent possible. The LVEF abnormality status categories, as a

Week 9
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel57
Arm B: Pertuzumab + Trastuzumab + Docetaxel63
Arm A: Placebo + Trastuzumab + Docetaxel51
Arm B: Pertuzumab + Trastuzumab + Docetaxel52
Arm A: Placebo + Trastuzumab + Docetaxel3
Arm B: Pertuzumab + Trastuzumab + Docetaxel4
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel0
Week 18
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel61
Arm B: Pertuzumab + Trastuzumab + Docetaxel62
Arm A: Placebo + Trastuzumab + Docetaxel33
Arm B: Pertuzumab + Trastuzumab + Docetaxel45
Arm A: Placebo + Trastuzumab + Docetaxel4
Arm B: Pertuzumab + Trastuzumab + Docetaxel3
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel1
Week 27
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel54
Arm B: Pertuzumab + Trastuzumab + Docetaxel51
Arm A: Placebo + Trastuzumab + Docetaxel35
Arm B: Pertuzumab + Trastuzumab + Docetaxel43
Arm A: Placebo + Trastuzumab + Docetaxel3
Arm B: Pertuzumab + Trastuzumab + Docetaxel5
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel0
Week 36
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel45
Arm B: Pertuzumab + Trastuzumab + Docetaxel46
Arm A: Placebo + Trastuzumab + Docetaxel28
Arm B: Pertuzumab + Trastuzumab + Docetaxel43
Arm A: Placebo + Trastuzumab + Docetaxel3
Arm B: Pertuzumab + Trastuzumab + Docetaxel4
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel1
Week 45
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel34
Arm B: Pertuzumab + Trastuzumab + Docetaxel36
Arm A: Placebo + Trastuzumab + Docetaxel29
Arm B: Pertuzumab + Trastuzumab + Docetaxel43
Arm A: Placebo + Trastuzumab + Docetaxel5
Arm B: Pertuzumab + Trastuzumab + Docetaxel3
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel0
Week 54
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel26
Arm B: Pertuzumab + Trastuzumab + Docetaxel38
Arm A: Placebo + Trastuzumab + Docetaxel27
Arm B: Pertuzumab + Trastuzumab + Docetaxel34
Arm A: Placebo + Trastuzumab + Docetaxel4
Arm B: Pertuzumab + Trastuzumab + Docetaxel3
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel0
Week 63
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel21
Arm B: Pertuzumab + Trastuzumab + Docetaxel30
Arm A: Placebo + Trastuzumab + Docetaxel17
Arm B: Pertuzumab + Trastuzumab + Docetaxel33
Arm A: Placebo + Trastuzumab + Docetaxel6
Arm B: Pertuzumab + Trastuzumab + Docetaxel3
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel0
Week 72
GroupValue95% CI
Arm A: Placebo + Trastuzumab + Docetaxel17
Arm B: Pertuzumab + Trastuzumab + Docetaxel26
Arm A: Placebo + Trastuzumab + Docetaxel15
Arm B: Pertuzumab + Trastuzumab + Docetaxel31
Arm A: Placebo + Trastuzumab + Docetaxel5
Arm B: Pertuzumab + Trastuzumab + Docetaxel4
Arm A: Placebo + Trastuzumab + Docetaxel0
Arm B: Pertuzumab + Trastuzumab + Docetaxel0

Adverse events — posted to ClinicalTrials.gov

Time frame: From first dose of study drug until 42 days after last dose of study drug (up to 4 years, 4 months). At final analysis, the median [range] time on study treatment with placebo or pertuzumab per arm was: Arm A - Placebo: 52.3 [3-207] weeks; Arm B - Pertuzumab: 66.1 [3-225] weeks; Arm A - Crossover to Pertuzumab: 18.1 [12-24] weeks.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Arm A: Placebo + Trastuzumab + Docetaxel
Serious: 23/120 (19%)
Deaths: 50/120
Arm B: Pertuzumab + Trastuzumab + Docetaxel
Serious: 30/122 (25%)
Deaths: 40/122
Arm A: Crossover to Pertuzumab + Trastuzumab + Docetaxel
Serious: 1/12 (8%)
Deaths: 0/12

Serious adverse events (25 terms)

ReactionSystemArm A: Placebo + Trastuzum…Arm B: Pertuzumab + Trastu…Arm A: Crossover to Pertuz…
NeutropeniaBlood and lymphatic system disorders
PneumoniaInfections and infestations
Febrile neutropeniaBlood and lymphatic system disorders
LeukopeniaBlood and lymphatic system disorders
Cardiac tamponadeCardiac disorders
Alanine aminotransferase increasedInvestigations
Ventricular arrhythmiaCardiac disorders
AscitesGastrointestinal disorders
OesophagitisGastrointestinal disorders
DeathGeneral disorders
Liver injuryHepatobiliary disorders
Upper respiratory tract infectionInfections and infestations
FractureInjury, poisoning and procedural complications
Aspartate aminotransferase increasedInvestigations
Blood glucose increasedInvestigations
HyperuricaemiaMetabolism and nutrition disorders
DizzinessNervous system disorders
MetrorrhagiaReproductive system and breast disorders
Pelvic prolapseReproductive system and breast disorders
Respiratory failureRespiratory, thoracic and mediastinal disorders
Large intestine polypGastrointestinal disorders
Peripheral arterial occlusive diseaseVascular disorders
OsteomyelitisInfections and infestations
Soft tissue infectionInfections and infestations
Gastrointestinal carcinoma in situNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Other adverse events (56 terms — click to expand)

ReactionSystemArm A: Placebo + Trastuzum…Arm B: Pertuzumab + Trastu…Arm A: Crossover to Pertuz…
LeukopeniaBlood and lymphatic system disorders
NeutropeniaBlood and lymphatic system disorders
AnaemiaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
Alanine aminotransferase increasedInvestigations
AlopeciaSkin and subcutaneous tissue disorders
Aspartate aminotransferase increasedInvestigations
PyrexiaGeneral disorders
CoughRespiratory, thoracic and mediastinal disorders
AstheniaGeneral disorders
PainGeneral disorders
Oedema peripheralGeneral disorders
HypokalaemiaMetabolism and nutrition disorders
Upper respiratory tract infectionInfections and infestations
Weight increasedInvestigations
NauseaGastrointestinal disorders
StomatitisGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
Nail discolourationSkin and subcutaneous tissue disorders
Blood bilirubin increasedInvestigations
HyperglycaemiaMetabolism and nutrition disorders
VomitingGastrointestinal disorders
HypoaesthesiaNervous system disorders
ThrombocytopeniaBlood and lymphatic system disorders
HypertensionVascular disorders
ConstipationGastrointestinal disorders
MalaiseGeneral disorders
Blood creatinine increasedInvestigations
Weight decreasedInvestigations
HypoalbuminaemiaMetabolism and nutrition disorders
DizzinessNervous system disorders
RashSkin and subcutaneous tissue disorders
Mouth ulcerationGastrointestinal disorders
Gamma-glutamyltransferase increasedInvestigations
InsomniaPsychiatric disorders
Influenza like illnessGeneral disorders
NasopharyngitisInfections and infestations
Blood alkaline phosphatase increasedInvestigations
Pain in extremityMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders

Most-reported serious reactions: Neutropenia, Pneumonia, Febrile neutropenia, Leukopenia, Cardiac tamponade, Alanine aminotransferase increased, Ventricular arrhythmia, Ascites.

Data from ClinicalTrials.gov NCT02896855 adverse events section.

Sponsor's own description

This Phase III, randomized, double-blind, placebo-controlled, multicenter clinical trial in China will evaluate the efficacy and safety of pertuzumab + trastuzumab + docetaxel compared with placebo + trastuzumab + docetaxel in participants with previously untreated HER2-positive metastatic breast cancer.

Publications & conference data

5 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Development and clinical application of anti-HER2 monoclonal and bispecific antibodies for cancer treatment.
    Yu S, Liu Q, Han X, Qin S, et al · · 2017 · cited 82× · PMID 29209558 · DOI 10.1186/s40164-017-0091-4
  2. Pertuzumab, trastuzumab, and docetaxel for Chinese patients with previously untreated HER2-positive locally recurrent or metastatic breast cancer (PUFFIN): a phase III, randomized, double-blind, placebo-controlled study.
    Xu B, Li W, Zhang Q, Shao Z, et al · · 2020 · cited 38× · PMID 32564260 · DOI 10.1007/s10549-020-05728-w
  3. Photodynamic Therapy and Hyperthermia in Combination Treatment-Neglected Forces in the Fight against Cancer.
    Bienia A, Wiecheć-Cudak O, Murzyn AA, Krzykawska-Serda M. · · 2021 · cited 36× · PMID 34452108 · DOI 10.3390/pharmaceutics13081147
  4. Pertuzumab, trastuzumab, and docetaxel for Chinese patients with previously untreated HER2-positive locally recurrent or metastatic breast cancer (PUFFIN): final analysis of a phase III, randomized, double-blind, placebo-controlled study.
    Xu B, Li W, Zhang Q, Li Q, et al · · 2023 · cited 24× · PMID 36463547 · DOI 10.1007/s10549-022-06775-1
  5. Cardiotoxicity of breast cancer drug treatments.
    Haque M, Atallah N, Patke R, Harris AE, et al · · 2025 · cited 2× · PMID 40090070 · DOI 10.1016/j.tranon.2025.102352

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