Updates in Treatment of HER2-positive Metastatic Breast Cancer.

Autor: Avelino ARM; Division of Hematology-Oncology, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA., Pulipati S; Division of Hematology-Oncology, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA., Jamouss K; Department of Internal Medicine, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA., Bhardwaj PV; Division of Hematology-Oncology, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, USA. Prarthna.bhardwaj@baystatehealth.org.
Jazyk: angličtina
Zdroj: Current treatment options in oncology [Curr Treat Options Oncol] 2024 Nov 09. Date of Electronic Publication: 2024 Nov 09.
DOI: 10.1007/s11864-024-01277-2
Abstrakt: Opinion Statement: The therapeutic landscape for HER2-positive metastatic breast cancer has exploded in the last two decades following the initial advent of trastuzumab, a monoclonal antibody. While the first line treatment has remained a combination of dual HER2 blockade with taxane chemotherapy, we now have several exciting options in the second line and beyond. The introduction of antibody-drug conjugates, in specific trastuzumab deruxtecan, has resulted in the best progression-free survival among patients with this subtype of breast cancer. Given the excellent outcomes of these drugs, clinical trials are now evaluating the role of ADCs in the front-line setting in previously untreated patients. In addition, there are also clinical trials evaluating the role of other targets in patients with HER2-positive cancers, including PI3KCA mutations, PD-L1 and CDK4/6. Given the predilection for brain metastases in this population, there is enthusiasm to identify the optimal combination of effective treatments. Tucatinib, capecitabine, and trastuzumab combination represent one such promising strategy. With the increasing longevity of these patients, important clinical questions include optimal treatment sequencing, the role of de-escalation of treatment in excellent responders, and the associated financial toxicity. Despite the aggressive nature of this subtype of breast cancer, the outcomes continue to improve for these patients with the evolving treatments.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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