UpdatesfromtheSanAntonioBreastCancerSymposium.ppt

UpdatesfromtheSanAntonioBreastCancerSymposium2013HER2+,*HER-2Over-ExpressingBreastCancercelldivisionHER-2nucleuscancercellTrastuzumabAnti-HER-2AntibodyHER-2Oncogene:amplifiedandoverexpressedin20-25%ofbreastcancerLapatinibDualHER-1/HER-2TyrosineKinaseInhibitorPertuzumabAnti-HER-2AntibodyT-DM1Antibody-DrugConjugateAPTStudy:PhaseIIStudyofPaclitaxel+TrastuzumabasAdjuvantTherapyforSmall,Node-negativeHER2+BreastCancerTolaneySMetal,SABCS2013,abstract#S1-04RandomizedadjuvantHER2+trialsincludedfewsmall,lymphnodenegativebreastcancersPatients:406ptswithnode-negative,HER2+breastcancer,<3cm2/3ER+,20%<:Paclitaxelandtrastuzumabweeklyx12,followedby9monthsofsingleagenttrastuzumabResults:-up10recurrences/deaths(%):2distant,4locoregional,3contralateralbreastcancers,1non-breastcancerdeath(ovarianca)%APTStudy:PhaseIIStudyofPaclitaxel+TrastuzumabasAdjuvantTherapyforSmall,Node-negativeHER2+BreastCancerTolaneySMetal,SABCS2013,abstract#S1-04Toxicity:HF(resolvedonstoppingtrastuzumab)13asymptomaticdeclinesinLVEF(abletoresumetrastuzumabin11)Conclusion:Paclitaxelplustrastuzumabcanbeconsideredareasonableapproachformajorityofpatientswithsmall,lymphnodenegative,HER2+binationsNeoALTTO:PreopHER2+BaselgaJetal,Lancet379:633-640,2012Invasive,operableHER2+breastcancerT>2cmN=450lapatinibtrastuzumablapatinibtrastuzumabFECX3SURGERYRANDOMIZELapatinib1500mg/dTrastuzumabweeklyLapatinib1000to750trastuzumabpaclitaxel80mg/m2paclitaxelpaclitaxelpCRNeoALTTO:SurvivalFollow-upAnalysisartMetal,SABCS2013abstract#S1-01Lapatanib+TrastuzumabTrastuzumabLapatinib3yrEFS(all)84%78%78%HR+83%80%86%HR-86%72%70%3yrOS(all)95%90%93%HR+97%94%93%HR-93%87%93%NonestatisticallysignificantNeoALTTO:EFSandOSbypCRartMetal,SABCS2013abstract#S1-01NeoALTTOSurvivalFollow-upAnalysis:ConclusionsUnderpoweredtodet