scholarly journals Treatment Landscape for Patients with HER2-Positive Metastatic Breast Cancer: A Review on Emerging Treatment Options

2020 ◽  
Vol Volume 12 ◽  
pp. 10615-10629
Author(s):  
Simon Peter Gampenrieder ◽  
Vanessa Castagnaviz ◽  
Gabriel Rinnerthaler ◽  
Richard Greil
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Her2 Positive

scholarly journals Therapy Algorithms for the Diagnosis and Treatment of Patients with Early and Advanced Breast Cancer

Breast Care ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. 608-618
Author(s):  
Andreas Schneeweiss ◽  
Ingo Bauerfeind ◽  
Tanja Fehm ◽  
Wolfgang Janni ◽  
Christoph Thomssen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Advanced Breast Cancer ◽  
Endocrine Therapy ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Evidence Based ◽  
Complex Treatment ◽  
Her2 Positive ◽  
Evidence Based Treatment

<b><i>Background:</i></b> In order to offer optimal treatment approaches based on available evidence, the Commission Breast of the Working Group Gynecologic Oncology (AGO) of the German Cancer Society developed therapy algorithms for eight complex treatment situations in primary and advanced breast cancer. <b><i>Summary:</i></b> Therapy algorithms for the following complex treatment situations are outlined in this paper: (neo)adjuvant therapy of human epidermal growth factor receptor 2 (HER2)-positive breast cancer; axillary surgery and neoadjuvant chemotherapy; adjuvant endocrine therapy in premenopausal patients; adjuvant endocrine therapy in postmenopausal patients; hormone receptor (HR)-positive/HER2-negative metastatic breast cancer: strategies; HR-positive/HER2-negative metastatic breast cancer: endocrine-based first-line treatment; HER2-positive metastatic breast cancer: first to third-line; metastatic triple-negative breast cancer. <b><i>Key Messages:</i></b> The therapy options shown in these algorithms are based on the current AGO recommendations updated in January 2020 but cannot represent all evidence-based treatment options. Prior therapies, performance status, comorbidities, patient preference, etc. must be taken into account for the actual treatment choice. Therefore, in individual cases, other evidence-based treatment options not listed here may also be appropriate and justified.

scholarly journals New Therapeutic Strategies in Advanced Nonoperable or Metastatic HER2-positive Breast Cancer

2021 ◽  
Vol 81 (06) ◽  
pp. 666-678
Author(s):  
Diana Lüftner ◽  
Matthias Peipp
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Antibody Engineering ◽  
Antibody Drug Conjugate ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
The Us ◽  
Positive Breast Cancer

AbstractDespite therapeutic gains in the treatment of HER2-positive (HER2: human epidermal growth factor receptor 2) advanced/metastatic breast cancer, there remains an urgent need for more effective treatment options. At present, there is no definitive approved standard therapy beyond second-line treatment. One of the major challenges is overcoming treatment resistance. Depending on the underlying resistance mechanism, different strategies are being pursued for new innovative treatment concepts in HER2-positive breast cancer. Specifically designed antibodies for targeted therapy are one important focus to successfully meet these challenges. Trastuzumab deruxtecan (T-DXd, DS-8201a), an optimised antibody drug conjugate (ADC) is in clinical trials, showing promising outcomes in patients with advanced, nonoperable or metastatic HER2-positive breast cancer who had already undergone intensive prior treatment. Based on this data, T-DXd has already been approved in the US and Japan for HER2-positive advanced nonoperable and metastatic breast cancer – in the US after at least two prior anti-HER2 targeted treatment lines and in Japan after prior chemotherapy. T-DXd represents successful “antibody engineering”. Since the beginning of the year, T-DXd has also been approved in Europe as monotherapy for inoperable or metastatic HER2-positive breast cancer in patients who are pretreated with at least two anti-HER2 directed therapies. This paper presents strategies for improving treatment options in advanced nonoperable and metastatic HER2-positive breast cancer, with the development of T-DXd as an example.

scholarly journals Practical consensus recommendations regarding the management of HER2 neu positive metastatic breast cancer

2018 ◽  
Vol 07 (02) ◽  
pp. 146-150 ◽  
Author(s):  
M. Basade ◽  
M. Singhal ◽  
A. K. Rathi ◽  
M. Nandi ◽  
S. Minhas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Hormone Receptors ◽  
Treatment Options ◽  
Breast Cancer Mortality ◽  
Metastatic Breast ◽  
Practical Experience ◽  
The Body ◽  
Her2 Positive ◽  
Consensus Recommendations

AbstractMetastatic breast cancer (MBC) is cancer that has spread from the breast to another part of the body or has come back in another distant location. Treatment options for MBC depend on several factors, including where the cancer has spread, the patient's overall health, and the levels of hormone receptors and HER2 in the tumour. Over-expression of HER2 is generally considered to be a negative prognostic feature because it accompanies an increase in breast cancer mortality. However, the development of agents that specifically target HER2 has improved the management of patients with these tumours.[7],[8],[9],[10] This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations in regards with the use of these agents and the management of HER2 positive MBC for the benefit of community oncologists.

Treatment options for HER2-positive metastatic breast cancer

2020 ◽  
Vol 2 (51) ◽  
pp. 28
Author(s):  
Ciprian Ciobotaru ◽  
Alexandru C. Grigorescu
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Treatment Options ◽  
Metastatic Breast ◽  
Her2 Positive

Real-world effectiveness of post-T-DM1 treatments in HER2-positive metastatic breast cancer: KBCSG-TR1917 observational study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13020-e13020
Author(s):  
Norikazu Masuda ◽  
Tetsuhiro Yoshinami ◽  
Hiroyuki Yasojima ◽  
Nobuyoshi Kittaka ◽  
Masato Takahashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Observational Study ◽  
Real World ◽  
Treatment Options ◽  
Objective Response ◽  
Metastatic Breast ◽  
Investigational Drug ◽  
Current Standard ◽  
Her2 Positive

e13020 Background: For patients with HER2-positive, unresectable and/or metastatic breast cancer (HER2+ mBC), T-DM1 is now the standard of care after trastuzumab and/or pertuzumab-based therapy. On the other hand, there is limited evidence after T-DM1 treatment. To clarify the treatment options and the effectiveness of drug therapy just after T-DM1 (post–T-DM1 therapy), we performed a multicenter observational study in patients with HER2+ mBC. Methods: This study enrolled consecutive patients who met eligibility criteria; Japanese female patients with HER2+ mBC, 20 years of age or older, who received at least one subsequent drug treatment except for an investigational drug after discontinuing T-DM1 between Jan 2014 and Dec 2018. To investigate the effectiveness of post–T-DM1 therapy, the real-world progression-free survival (rwPFS), time to treatment failure (TTF), overall survival (OS), objective response rate (ORR) and clinical benefit rate (CBR) were evaluated. Tumor response was exactly assessed by investigators according to RECISTv1.1. Results: Of 205 patients who were treated with T-DM1 at five institutions, 138 patients were enrolled and 128 patients were included in the analysis (data-cut off: Jul 31 2019). The median age of the patients was 59 years (range 27–84), and the median duration of T-DM1 treatment was 5.1 months (range 0.0–41.4). Ninety-two patients (71.9%) had an ECOG PS score of 0 or 1. Of the 128 patients, 34 (26.6%) patients received lapatinib + capecitabine therapy, 35 (27.3%) trastuzumab-based therapy (excluding pertuzumab), 36 (28.1%) pertuzumab-containing therapy, and 23 (18.0%) other therapy except for anti-HER2 therapy. In the 111 patients with measurable lesions, ORR was 22.5% (95% CI: 15.1–31.4). The median rwPFS was 5.7 months (95% CI: 4.8–6.9), median TTF 5.6 months (95% CI: 4.6–6.4), median OS 22.8 months (95% CI: 18.2–32.4), and the CBR was 47.7% (95% CI: 38.8–56.7) in the 128 patients. Conclusions: We clarified that the effectiveness of post–T-DM1 therapy was limited among the current standard treatment options. Therefore, to improve the prognosis in the later settings of HER2+ mBC, novel treatment options are warranted in the future. Clinical trial information: UMIN000038296 .

scholarly journals Anti-HER2 Therapy Beyond Second-Line for HER2- Positive Metastatic Breast Cancer: A Short Review and Recommendations for Several Clinical Scenarios from a Spanish Expert Panel

Breast Care ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Noelia Martínez-Jañez ◽  
Ignacio Chacón ◽  
Ana de Juan ◽  
Luis Cruz-Merino ◽  
Sònia del Barco ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Treatment Options ◽  
Objective Response ◽  
Local Treatment ◽  
Metastatic Breast ◽  
Line Treatment ◽  
Second Line ◽  
Her2 Positive ◽  
Clinical Scenarios

Background: The aim of this project was to provide an expert opinion regarding anti-human epidermal growth factor receptor 2 (HER2) therapy beyond second-line treatment of metastatic breast cancer (mBC). Methods: A group of experts discussed specific issues concerning anti-HER2 therapy in late-line settings in mBC. Results: Trastuzumab emtansine (T-DM1) or dual HER2 blockade appeared to be good options for HER2-positive mBC after ≥ 2 HER2-targeted therapies. Once an objective response has been achieved with anti-HER2-containing therapy, the anti-HER2 agent can be continued until progression of the disease, unacceptable toxicity or patient decision. mBC treated with ≥ 3 consecutive lines of anti-HER therapy, ≥ 1 being a dual HER2 blockade and with early progression of disease during a fourth or later-line treatment, are clinically resistant to anti-HER therapy. For progression of metastasis in the brain after anti-HER2 therapy, lapatinib and chemotherapy appear to be a good alternative after best local treatment. Conclusions: Further clinical trials are needed to provide valuable knowledge about the best treatment options in the later settings of mBC.

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