Metatastatic HER2 Postive Breast Cancer

  • In patients with metastatic HER2-positive breast cancer:
    • The addition of pertuzumab to trastuzumab and chemotherapy:
      • Improves progression-free survival
  • The Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) trial:
    • Randomized:
      • 808 women with HER2-positive metastatic breast cancer:
        • To trastuzumab and docetaxel plus pertuzumab versus placebo
      • Median 50-month follow-up
      • Results:
        • The trastuzumab, docetaxel, pertuzumab arm:
          • Was associated with a 15.7-month improvement:
            • In median overall survival
          • A 6.3-month improvement:
            • In median progression-free survival:
        • Compared to the trastuzumab, docetaxel, placebo arm:
          • Single-agent trastuzumab:
            • Results in reduced efficacy and should only be reserved for patients:
              • Who elect to avoid chemotherapy or
              • For those whom are poor candidates for chemotherapy
  • Trastuzumab plus anthracyclines (doxorubicin):
    • Are effective:
      • But there is higher cardiotoxicity with this combination
  • BCIRG 007:
    • Showed that multi-agent chemotherapy plus trastuzumab:
      • Paclitaxel, carboplatin, and trastuzumab:
        • Does not increase overall survival:
          • Compared to single-agent chemotherapy:
            • With docetaxel plus trastuzumab in patients with metastatic HER2-positive breast cancer
  • References:
    • Baselga J, Cortes J, Kim SB, et al. Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med. 2012;366(2):109-119.
    • Swain SM, Kim SB, Cortes J, et al. Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA study): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncol. 2013;14(6):461-471.
    • Swain SM, Baselga J, Kim SB, et al. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. N Engl J Med. 2015;372(8):724-734.
    • Valero V, Forbes J, Pegram MD, et al. Multicenter phase III randomized trial comparing docetaxel and trastuzumab with docetaxel, carboplatin, and trastuzumab as first-line chemotherapy for patients with HER2-gene-amplified metastatic breast cancer (BCIRG 007 study): two highly active therapeutic regimens. J Clin Oncol. 2011;29(2):149-156.

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #BreastCancer #Teacher #Surgeon

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s