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ORIGINAL RESEARCH article

Front. Oncol.

Sec. Breast Cancer

This article is part of the Research TopicMolecular Mechanisms and Innovative Therapies for Advancing Cancer TreatmentView all articles

Maintenance Therapy in Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Positive Metastatic Breast Cancer: A Real-World Multicenter Retrospective Study

Provisionally accepted
  • 1Nantong Tumor Hospital, Nantong, China
  • 2The First Affiliated Hospital With Nanjing Medical University, Nanjing, China

The final, formatted version of the article will be published soon.

Introduction: The optimal choice of maintenance therapy after standard first-line treatment for hormone receptor (HR)-and human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) remains uncertain. Therefore, we evaluated the clinical value of trastuzumab combined with endocrine therapy (ET group) compared with trastuzumab combined with chemotherapy (CT group) as maintenance therapy in patients with HR+/HER2+ MBC. Methods: The clinical data of 117 patients with HR+/HER2+ MBC who received trastuzumab combined with endocrine therapy or chemotherapy as maintenance therapy at three hospitals in China between January 2012 and October 2022 were retrospectively analyzed. The primary endpoint was progression-free survival (PFS). To construct a nomogram, a Cox regression model was used for both the univariate and multivariate analyses. The predictive ability and accuracy of the nomogram were assessed using the concordance index and calibration curves. Results: Herein, 73 and 44 patients were assigned to the ET and CT groups, respectively. PFS was significantly longer in the ET group than the CT group (median PFS, 10.8 months vs. 7.2 months; adjusted hazard ratio, 0.68; 95% confidence interval, 0.46 to 0.99]; p=0.039). Based on the results of the multivariate analysis, a nomogram was established, which enabled visual risk prediction and demonstrated acceptable predictive ability. Discussion: Maintenance therapy using trastuzumab combined with endocrine therapy following standard first-line treatment may improve the survival and safety of patients with HR+/HER2+ MBC.

Keywords: Hormone Receptor, Human epidermal growth factor receptor 2, Maintenance therapy, metastatic breast cancer, nomogram

Received: 11 Sep 2025; Accepted: 09 Dec 2025.

Copyright: © 2025 Bao, Chen and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Jia Chen
Yongmei Yin

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