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Fulvestrant (faslodex) effective for her2+ER+ Stage IV bc
I have posted before about how Dr. Slamon has described at meetings the relative resistance of her2+ bc to antihormonal treatments and his feeling that fulvestrant may end up being the best "antihormonal" treatment for her2+ breast cancer.Here is the results of a combined retrospective study (as her2+ER+ bc is relatively rare, they had to combine the results of many hospitals to get what they felt were meaningful statistics on the effect of fulvestrant on Stage IV her2+ER+ bc. By the way, the article discussed the feeling that fulvestrant would be even more effective at double the dose and that clinical trials with the increased dose are already underway.
Ann Oncol. 2009 Oct 29. [Epub ahead of print]
Activity of fulvestrant in HER2-overexpressing advanced breast cancer.
Robertson JF, Steger GG, Neven P, Barni S, Gieseking F, Nolè F, Pritchard KI, O'Malley FP, Simon SD, Kaufman B, Petruzelka L.
Professorial Unit of Surgery, Division of Breast Surgery, University of Nottingham, Nottingham City Hospital, Nottingham, UK.
BACKGROUND: Human epidermal growth factor receptor 2 (HER2) overexpression increases the aggressiveness of breast cancer cells resulting in poorer prognosis. Patients with HER2-positive disease are less responsive to endocrine therapies. Trastuzumab monotherapy results in objective responses in only approximately 15% of patients. Fulvestrant retains activity in cells overexpressing HER2 that are resistant to other endocrine treatments. This retrospective study evaluated response to fulvestrant treatment among HER2-positive patients with advanced breast cancer (ABC). PATIENTS AND METHODS: Clinical experience data from 10 treatment centres were pooled. Postmenopausal patients with predominantly hormone receptor-positive and HER2-positive disease were included. Clinical benefit (CB) was defined as the proportion of patients achieving a response to treatment (partial or complete) or stable disease lasting >/=6 months. RESULTS: Data for 102 patients were analysed. Fulvestrant resulted in an overall CB rate of 42% (43/101) in HER2-positive patients and 40% (25/63) in patients with visceral disease. Median duration of treatment was 14.5 months (range 6-44 months). Fulvestrant showed activity up to the fourth line of endocrine therapy and up to the seventh line of overall therapy. CONCLUSIONS: Results indicate that fulvestrant may be a suitable treatment option in extensively pre-treated patients with HER2-positive, hormone receptor-positive ABC. Further exploration of its use in this patient population is warranted.
PMID: 19875750
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