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Tykerb

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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