new review article on treatment of her2+ breast cancer by Dr Pegram

[Lani]

Dr Pegram worked hand-in-hand with Dr Slamon for decades before moving to Miami and now Stanford.

He hosts an large number of panel discussions and poster discussion seions on her2+ bc at SABCS, ASCO, and other bc specific conferences

Unfortunately it does not appear to be open access.






Hematol Oncol Clin North Am. 2013 Aug;27(4):751-765. doi: 10.1016/j.hoc.2013.05.007.
Treating the HER2 Pathway in Early and Advanced Breast Cancer.
Pegram MD.
Source
Medical Oncology, Stanford Cancer Institute, Stanford University School of Medicine, G2021B Lorry I. Lokey Building, 265 Campus Drive West, Stanford, CA 94305-5456, USA; Stanford Breast Oncology Program, Stanford Cancer Institute, Stanford University School of Medicine, G2021B Lorry I. Lokey Building, 265 Campus Drive West, Stanford, CA 94305-5456, USA; Molecular Therapeutics Program, Stanford Cancer Institute, Stanford University School of Medicine, G2021B Lorry I. Lokey Building, 265 Campus Drive West, Stanford, CA 94305-5456, USA. Electronic address: mpegram@stanford.edu.
Abstract
ERBB2 gene amplification occurs in ∼20% of human breast cancers (BC) and is associated with an adverse clinical prognosis, indicating that it may be playing a critical role in disease pathogenesis. Therapeutic strategies targeting pathologic ERBB2 overexpression have revolutionized the diagnosis and treatment of BC. Indeed, humanized anti-ERBB2 antibodies, small molecule ERBB2 kinase inhibitors and ERBB2-targeting antibody-drug conjugates have proven safety and efficacy based upon evidence from randomized phase III clinical trials. Recent progress in targeting ERBB2 alteration will be reviewed, with focus on data that has informed changes in clinical practice for the treatment of BC.
Copyright © 2013 Elsevier Inc. All rights reserved.
KEYWORDS:
Antibody-drug conjugate, HER2 pathway, Human breast cancers

PMID: 23915743

[kk1]

Here are the main points of the article

KEY POINTS
Level I evidence from multiple large, prospective, randomized, phase III clinical trials sup-
ports the use of trastuzumab in combination with chemotherapy as treatment for early-
stage ERBB2-positive breast cancer in the adjuvant or neoadjuvant settings.
For patients with metastatic ERBB2-positive disease, there is level I evidence that pertu-
zumab in combination with trastuzumab and a taxane (docetaxel) yields superior progres-
sion-free and overall survival in the first-line setting compared with docetaxel plus
trastuzumab alone. This regimen has secured regulatory approval and is a preferred
first-line regimen according to guidelines established by the National Comprehensive
Cancer Network.
For patients with metastatic ERBB2-positive disease who have progressed following prior
treatment with a taxane and trastuzumab, or relapsed within 6 months of completion of an
adjuvant trastuzumab regimen, ado-trastuzumab emtansine (T-DM1) has been shown to
be significantly superior (for both progression-free and overall survival) to lapatinib plus
capecitabine, and is associated with fewer grade 3/4 clinical adverse events. Ado-trastu-
zumab emtansine was approved by the U.S. Food and Drug Administration in February 2013

[tricia keegan]

Thanks Lani for posting this and thanks also KK1 for explaining the main points!

[sarah]

thanks for this
sarah