Human epidermal growth factor receptor 2 positive (HER2+) advanced breast cancer (ABC) accounts for about 15–20% of all ABC cases. Large randomized trials have determined the standard first- and second-line treatments for this subgroup of patients, namely dual blockade plus chemotherapy and TDM1. However, no standard treatment is specifically recommended after TDM1, and most of the subsequent therapeutic choices commonly rely on old trials not optimally reflecting the current patient population. The recent FDA-approval of three novel anti-HER2 compounds is revolutionizing the field. In particular, trastuzumab deruxtecan was approved after showing unprecedented activity in a phase 2 trial for highly pretreated HER2+ ABC patients; tucatinib and neratinib were approved based on the results of the randomized HER2CLIMB and NALA trial, respectively. With an increasing arsenal of treatment options, clinical decision-making will need to take into account a variety of aspects, including differences in clinical trial designs, outcomes and toxicity profile of each drug, patient's characteristics and preferences.

Third-line treatment of HER2-positive advanced breast cancer: From no standard to a Pandora's box / P. Tarantino, A. Prat, J. Cortes, F. Cardoso, G. Curigliano. - In: BIOCHIMICA ET BIOPHYSICA ACTA-REVIEWS ON CANCER. - ISSN 0304-419X. - 1875:1(2021 Jan). [10.1016/j.bbcan.2020.188487]

Third-line treatment of HER2-positive advanced breast cancer: From no standard to a Pandora's box

G. Curigliano
Ultimo
Conceptualization
2021

Abstract

Human epidermal growth factor receptor 2 positive (HER2+) advanced breast cancer (ABC) accounts for about 15–20% of all ABC cases. Large randomized trials have determined the standard first- and second-line treatments for this subgroup of patients, namely dual blockade plus chemotherapy and TDM1. However, no standard treatment is specifically recommended after TDM1, and most of the subsequent therapeutic choices commonly rely on old trials not optimally reflecting the current patient population. The recent FDA-approval of three novel anti-HER2 compounds is revolutionizing the field. In particular, trastuzumab deruxtecan was approved after showing unprecedented activity in a phase 2 trial for highly pretreated HER2+ ABC patients; tucatinib and neratinib were approved based on the results of the randomized HER2CLIMB and NALA trial, respectively. With an increasing arsenal of treatment options, clinical decision-making will need to take into account a variety of aspects, including differences in clinical trial designs, outcomes and toxicity profile of each drug, patient's characteristics and preferences.
Breast cancer; ds8201a; HER2 +; Third line; Trastuzumab deruxtecan; Tucatinib
Settore MED/06 - Oncologia Medica
28-nov-2020
Article (author)
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/824922
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