Open AccessAdvances in First‐Line Treatment for Patients with HER‐2 + Metastatic Breast Cancer
Author(s) -
De MattosArruda Leticia,
Cortes Javier
Publication year - 2012
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2011-0187
Subject(s) - medicine , vinorelbine , trastuzumab , oncology , metastatic breast cancer , breast cancer , capecitabine , gemcitabine , chemotherapy , clinical trial , cancer , colorectal cancer , cisplatin
Learning Objectives: After completing this course, the reader will be able to: Discuss the optimal strategies to treat HER‐2 + metastatic breast cancer patients in the first‐line setting and after recurrence with adjuvant trastuzumab. Identify the current first‐line therapeutic options for HER‐2 + metastatic breast cancer, including HER‐2/hormone receptor copositive tumors. Discuss the most important advances for HER‐2 + metastatic breast cancer and the potential of novel anti‐HER‐2 therapies.This article is available for continuing medical education credit at CME.TheOncologist.comBackground. The prognosis for breast cancer patients overexpressing human epidermal growth factor receptor (HER)‐2 has changed with anti–HER‐2–targeted therapy. Although anti–HER‐2 therapy with trastuzumab and chemotherapy is the standard first‐line treatment, the best therapeutic regimen has yet to be defined, and new strategies are evolving. Methods. A literature review of well‐established and recently published trials, reviews, and ongoing clinical trials addressing first‐line treatment for HER‐2 + metastatic breast cancer patients was performed. Results. Taxanes are the agents most commonly used in combination with trastuzumab, but other chemotherapy drugs, such as anthracyclines, vinorelbine, and gemcitabine and triple‐combination therapies including platinum compounds, capecitabine, and taxanes have been studied. The combination of aromatase inhibitors with anti–HER‐2 therapies is a new therapeutic option for some patients who coexpress HER‐2 and hormone receptors, although its activity observed in randomized clinical trials seems to be inferior to that of chemotherapy plus anti–HER‐2 therapies. In addition, new anti–HER‐2 therapies have shown activity in HER‐2 + tumors, both alone and in combination with trastuzumab. Conclusions. Trastuzumab plus chemotherapy is the current standard of care for the upfront treatment of HER‐2 + breast cancer patients, though other anti–HER‐2–targeting agents may appear as new standards in the upcoming years.