- In patients with metastatic HER2-positive breast cancer:
- The addition of pertuzumab to trastuzumab and chemotherapy:
- Improves progression-free survival
- The addition of pertuzumab to trastuzumab and chemotherapy:
- 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:
- Was associated with a 15.7-month improvement:
- 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
- Results in reduced efficacy and should only be reserved for patients:
- Single-agent trastuzumab:
- The trastuzumab, docetaxel, pertuzumab arm:
- 808 women with HER2-positive metastatic breast cancer:
- Randomized:
- Trastuzumab plus anthracyclines (doxorubicin):
- Are effective:
- But there is higher cardiotoxicity with this combination
- Are effective:
- 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
- Compared to single-agent chemotherapy:
- Does not increase overall survival:
- Paclitaxel, carboplatin, and trastuzumab:
- Showed that multi-agent chemotherapy plus trastuzumab:
- 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.
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Rodrigo Arrangoiz MS, MD, FACS, FSSO 