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| HER2-Positive Breast Cancer |
Overexpression of HER2 occurs in approximately 20% of breast cancers and was correlated with a more aggressive phenotype and worse prognosis before the development of HER2-targeted therapies. The advent of trastuzumab, a monoclonal antibody (mAb) targeting the extracellular domain of the receptor, has changed the treatment paradigm for HER2-positive breast cancer. Trastuzumab has a powerful synergism with a variety of chemotherapeutics, yet lacks the side effects (with the notable exception of cardiotoxicity, which means it generally should not be given with anthracyclines).
Results are available from studies (HERA, FinHer, NSABP B-31, BCIRG006, N9831) that have demonstrated that the inclusion of trastuzumab produces roughly a 50% improvement in disease-free survival and 33% improvement in overall survival, regardless of the chemotherapy regimen or sequence of trastuzumab delivery. These trials randomized 11,650 women with early-stage HER2-positive breast cancer to trastuzumab versus non-trastuzumab-based adjuvant chemotherapy, and based on their results, trastuzumab was approved by the US Food and Drug Administration (FDA) for the treatment of HER2-positive disease in the adjuvant setting.
Another study from the BCIRG006 further established that adjuvant trastuzumab for 1 year improved disease-free and overall survival among women with early-stage HER2-positive breast cancer at 5 years, and found that a nonanthracycline regimen plus trastuzumab had a more favorable risk-benefit ratio than anthracycline-based regimens due to similar efficacy, fewer acute toxic effects, and lower risks of cardiotoxicity and leukemia.
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| HER2-Positive Breast Cancer |
Baselga et al reported that adding pertuzumab to traditional therapy with trastuzumab and docetaxel improved disease-free survival time in patients with HER2- positive metatstatic breast cancer.
Pertuzumab gained approvals for neoadjuvant treatment in combination with trastuzumab and docetaxel for patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer.
Source: HER2-Positive Breast Cancer
2 comments:
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