In a nutshell
This paper provided recommendations on treatment for patients with human epidermal growth factor 2 (HER2) positive (presence of HER2 on cancer cells) breast cancer.
Some background
HER2 is a protein that can be found on cancer cells. About 15% of breast cancer patients have HER2 positive breast cancer. Therapy that targets HER2 can prevent cancer from spreading. Studies have shown that HER2-targeting treatment has improved survival for patients.
Methods & findings
Experts in the field looked at results from various studies and gave recommendations.
Recommendations.
Treatment targeting HER2 is recommended for initial treatment, except for certain patients with estrogen receptor or progesterone receptor positive and HER2-positive disease. A combination of trastuzumab (Herceptin), pertuzumab (Perjeta), and a taxane (Paclitaxel, Docetaxel) is recommended.
A second-line HER2-targeted therapy is recommended if the cancer has worsened despite initial therapy. All the studies showed that continuing HER2-targeted therapy is beneficial. Trastuzumab emtansine is recommended as a second-line treatment. Studies showed that trastuzumab emtansine is associated with better survival than lapatinib (Tykerb, Tyverb) plus capecitabine (Xeloda).
A third-line HER2-targeted treatment is recommended if cancer has worsened despite second-line treatment. Trastuzumab emtansine, pertuzumab or other HER2-targeted treatment is recommended if the patient has not received that particular medication yet.
The authors looked at patients receiving a combination of HER2-targeted therapy and chemotherapy. They recommended that chemotherapy should be continued for about 4 to 6 months or longer. This depends on the effect of the drug and side effects that occur. After chemotherapy is stopped, HER2-targeted therapy should be continued.
The authors also studied treatment for patients with hormone receptor (estrogen and progesterone receptors) and HER2 positive breast cancer. 3 types of treatment were recommended. HER2-targeted therapy plus chemotherapy, hormone therapy plus trastuzumab, or lapatinib and hormone therapy alone. Hormone therapy targets estrogen and progesterone receptors.
The bottom line
The authors provided some high-level recommendations for treatment of HER2 positive cancer.
What’s next?
Talk to your doctor about your own appropriate treatment plan.
Published By :
Journal of clinical oncology
Date :
May 05, 2014
