GRACE :: Breast Cancer

HER2-positive breast cancer

Perjeta (Pertuzumab) Approved by FDA for HER2-Positive Advanced Breast Cancer

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On June 8, The U.S. Food and Drug Administration (FDA) approved Perjeta (pertuzumab) to treat patients with metastatic, HER2-positive breast cancer who have not received previous treatment with either chemotherapy or HER2-targeted therapy. Approximately 20-30% of breast cancer is HER2-positive.

Herceptin is a monoclonal antibody that works by blocking HER2. While Perjeta also targets HER2, it binds to a different area of the HER2 protein and prevents the HER2 protein from combining with other HER receptors (HER1, HER3, and HER4). This prevents tumor growth and survival. Perjeta’s mechanism of action is therefore believed to be complimentary to that of Herceptin. In fact, Perjeta by itself has very little activity; its real use is in combination with Herceptin.

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Antibody-Drug Conjugate T-DM1 Offers New Mechanism and Significant Benefit in HER2-Positive Breast Cancer

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Right at the top of the list of the most exciting news from the 2012 American Society of Clinical Oncology (ASCO) meeting in Chicago this week involved using T-DM1 to treat metastatic, HER2-positive breast cancer.  T-DM1 is an “antibody-drug conjugate” (ADC).

ADCs combine a tumor-specific antibody with a chemotherapy drug. They are therefore specifically designed to be able to deliver chemotherapy drugs directly to tumor cells (like a “smart bomb”), potentially increasing efficacy and decreasing damage to normal cells. T-DM1 combines the anti-HER2 antibody Herceptin (trastuzumab), a stable linker and a chemotherapy agent, DM1, also known as emtansine.

Befitting its importance, the EMILIA trial was presented at the high profile Plenary Session. In this study almost 1000 patients with metastatic, HER2-positive breast cancer whose disease had progressed after treatment with a taxane and Herceptin were randomized to receive Xeloda (capecitable) plus Tykerb (HER2-inhibiting tyrosine kinase inhibitor lapatinib) or T-DM1. Xeloda and Tykerb are oral drugs; the T-DM1 was given intravenously every 3 weeks. There was no “cross-over”, meaning that patients whose disease progressed on Xeloda and Tykerb did not have access to T-DM1.

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