Noelia Martínez-Jañez1, Ignacio Chacón2, Ana de Juan3, Luis Cruz-Merino4, Sònia Del Barco5, Isaura Fernández6, Paula García-Teijido7, Amalia Gómez-Bernal8, Arrate Plazaola9, José Ponce10, Sonia Servitja11, Pilar Zamora12. 1. Medical Oncology Department, Hospital Ramón y Cajal, Madrid, Spain. 2. Medical Oncology Department, Hospital Virgen de la Salud, Toledo, Spain. 3. Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 4. Medical Oncology Department, Hospital Virgen de la Macarena, Sevilla, Spain. 5. Instituto Catalán de Oncología, Hospital Universitario Doctor Josep Trueta, Gerona, Spain. 6. Hospital Xeral Cies de Vigo, Pontevedra, Spain. 7. Hospital de Avilés, Asturias, Spain. 8. Hospital Clínico de Salamanca, Salamanca, Spain. 9. Onkologikoa, San Sebastián, Spain. 10. Hospital General Universitario de Alicante, Alicante, Spain. 11. Hospital del Mar, Barcelona, Spain. 12. Hospital la Paz, Madrid, Spain.
Abstract
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.
BACKGROUND: The aim of this project was to provide an expert opinion regarding anti-humanepidermal 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.
Entities:
Keywords:
Anti-HER2; Clinical practice; Metastatic breast cancer
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