(Breast Cancer) Confirming Efficacy of T-DM1 After Pertuzumab + Trastuzumab + Chemotherapy in HER2-Positive Breast Cancer
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This article is a summary of international medical information and is not medical advice; it cannot replace the diagnosis or treatment plan of your attending physician. The medical technologies, drug information and clinical data presented here are compiled from public literature and official statements of major Japanese medical institutions; the applicability and outcome of any therapy vary with each patient and must be assessed individually by a qualified physician.
Clinical verification confirms that T-DM1 (trastuzumab emtansine) is effective as a subsequent treatment for HER2-positive metastatic breast cancer patients who have previously received pertuzumab, trastuzumab, and chemotherapy combination. This was presented by Dr. Tomoko Shibayama from the Cancer Institute Hospital of JFCR (Ariake Hospital) at the Japan Breast Cancer Society meeting held in Fukuoka from July 13–15. In June, at ASCO 2017 held in the United States, Dr. Gunter Von Minckwitz from the German Breast Group also presented that pertuzumab and trastuzumab combined with chemotherapy is effective.
Currently in Japan, first-line treatment for breast cancer is pertuzumab + trastuzumab + chemotherapy, and T-DM1 is recommended as a second-line treatment. However, T-DM1 approval was based on the EMILIA clinical trial, which enrolled patients who were HER2-positive (IHC3+, FISH+, or both) and had previously received...
Dr. Shibayama's research team conducted a retrospective analysis from February 2014 to 2016 at the Cancer Institute Hospital of JFCR (Ariake Hospital), evaluating T-DM1 as second-line treatment in 67 patients with HER2-positive metastatic breast cancer. Among these, 36 had previously received pertuzumab + trastuzumab + chemotherapy. These 36 cases were analyzed retrospectively for efficacy.
In these 36 cases, the median age was 59 years (range 35–77). At diagnosis: Stage I–III 20 patients, Stage IV 16 patients. Of the 36, 16 had received T-DM1 as second-line therapy. For the combination group: trastuzumab + pertuzumab + chemotherapy, along with docetaxel (n=22) or irinotecan (n=14).
Among patients receiving T-DM1: CR 1 (2.7%), PR 1 (2.7%), SD 28 (77.7%). Those with continuous treatment for 6 months or more: 19 (52.7%); 12 months or more: 7 (19.4%). The median effective treatment duration with T-DM1 after pertuzumab + trastuzumab + chemotherapy was 8 months (range 2–32). Based on these clinical findings, the efficacy of T-DM1 following pertuzumab + trastuzumab + chemotherapy was confirmed.
Notes:
- T-DM1: Representative drug Kadcyla
- Pertuzumab: Representative drug Perjeta
- Trastuzumab: Representative drug Herceptin
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