scholarly journals PREVENTION AND MONITORING OF CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH LUMINAL HER2-NEGATIVE METASTATIC BREAST CANCER

2018 ◽  
Vol 14 (2) ◽  
pp. 61-71
Author(s):  
N. A. Kozyavin ◽  
T. Yu. Semiglazova
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Systemic Treatment ◽  
Myocardial Dysfunction ◽  
Treatment Strategies ◽  
Metastatic Breast ◽  
Cardiovascular Complications ◽  
New Drugs ◽  
Qtc Interval ◽  
Optimal Patient Management

Myocardial dysfunction, heart failure and prolongation of the QTc interval are dangerous cardiovascular complications associated with systemic treatment for luminal HER2-negative metastatic breast cancer. Special monitoring is required to control such complications, especially when introducing new drugs. Understanding the mechanisms underlying the development of cardiovascular complications as well as diagnostic, prevention, and treatment strategies is important for optimal patient management.

scholarly journals Clinical benefit of treatment after trastuzumab emtansine for HER2-positive metastatic breast cancer: a real-world multi-centre cohort study in Japan (WJOG12519B)

Breast Cancer ◽  
2021 ◽  
Author(s):  
Takamichi Yokoe ◽  
Sasagu Kurozumi ◽  
Kazuki Nozawa ◽  
Yukinori Ozaki ◽  
Tetsuyo Maeda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Metastatic Breast Cancer ◽  
Cancer Patients ◽  
Real World ◽  
Treatment Strategies ◽  
Metastatic Breast ◽  
Trastuzumab Emtansine ◽  
Breast Cancer Patients ◽  
Her2 Positive

Abstract Background Trastuzumab emtansine (T-DM1) treatment for human epidermal growth factor receptor-2 (HER2)-positive metastatic breast cancer after taxane with trastuzumab and pertuzumab is standard therapy. However, treatment strategies beyond T-DM1 are still in development with insufficient evidence of their effectiveness. Here, we aimed to evaluate real-world treatment choice and efficacy of treatments after T-DM1 for HER2-positive metastatic breast cancer. Methods In this multi-centre retrospective cohort study involving 17 hospitals, 325 female HER2-positive metastatic breast cancer patients whose post-T-DM1 treatment began between April 15, 2014 and December 31, 2018 were enrolled. The primary end point was the objective response rate (ORR) of post-T-DM1 treatments. Secondary end points included disease control rate (DCR), progression-free survival (PFS), time to treatment failure (TTF), and overall survival (OS). Results The median number of prior treatments of post-T-DM1 treatment was four. The types of post-T-DM1 treatments included (1) chemotherapy in combination with trastuzumab and pertuzumab (n = 102; 31.4%), (2) chemotherapy concomitant with trastuzumab (n = 78; 24.0%), (3), lapatinib with capecitabine (n = 63; 19.4%), and (4) others (n = 82; 25.2%). ORR was 22.8% [95% confidence interval (CI): 18.1–28.0], DCR = 66.6% (95% CI 60.8–72.0), median PFS = 6.1 months (95% CI 5.3–6.7), median TTF = 5.1 months (95% CI 4.4–5.6), and median OS = 23.7 months (95% CI 20.7–27.4). Conclusion The benefits of treatments after T-DM1 are limited. Further investigation of new treatment strategies beyond T-DM1 is awaited for HER2-positive metastatic breast cancer patients.

Systemic Treatment of Metastatic Breast Cancer in Older Adults

2020 ◽  
pp. 643-654
Author(s):  
Anna Rachelle Mislang ◽  
Laura Biganzoli ◽  
Etienne Brain
Keyword(s):  
Breast Cancer ◽  
Older Adults ◽  
Metastatic Breast Cancer ◽  
Systemic Treatment ◽  
Metastatic Breast

scholarly journals Nab-paclitaxel in Treatment of Metastatic Breast Cancer

2019 ◽  
Vol 2 (17) ◽  
pp. 12-18
Author(s):  
E. I. Kovalenko ◽  
E. V. Artamonova
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
New Drugs ◽  
High Concentration ◽  
Sequential Administration ◽  
Previously Treated ◽  
Significant Stage

Despite the development of new systems for the treatment of metastatic breast cancer (mBC), chemotherapy remains an integral and significant stage of treatment for any molecular tumor subtype. In accordance with modern concepts, the optimal strategy of therapy in the vast majority of cases of mBC is the sequential administration of cytostatics in mono modes. This approach allows long-term control of tumor growth, translating pathology into a chronic discharge and maintaining a high quality of life. The emergence of new drugs or innovative dosage forms of existing cytostatics expands the possibilities of treatment of this chronic disease and allows long-term control over the disease. One of such new options was nab-paclitaxel, nano-dispersed paclitaxel stabilized with albumin. This dosage form provides active transport of the drug through the vascular endothelium with the creation of its high concentration in the tumor tissue. Clinical studies comparing nab-paclitaxel with traditional taxanes (paclitaxel and docetaxel) demonstrated high efficacy and safety of the drug both in a wide population of patients and in individual subgroups, including patients previously treated with anthracycline taxane, cases with aggressive disease, lesions of visceral organs, elderly patients and others. In addition, due to its unique formula, the drug does not cause hypersensitivity reactions, differing from traditional These taxanes are easy to use and safe. The lack of need for premedication with dexamethasone allows it to be prescribed for such comorbidities as severe hypertension, diabetes mellitus, stomach ulcer and duodenal ulcer, etc., and also successfully combine it with inhibitors of control points of the immune response, which confidently removes the drug on arena of immuno-oncology.

scholarly journals Systemic treatment and surgery versus systemic treatment alone for metastatic breast cancer

2020 ◽  
Vol 66 (8) ◽  
pp. 1026-1026
Author(s):  
Glauce Romeiro de Almeida ◽  
Antônio Silvinato ◽  
Wanderley Marques Bernardo
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Systemic Treatment ◽  
Metastatic Breast

scholarly journals Systemic treatment of hormone receptor positive, human epidermal growth factor 2 negative metastatic breast cancer: retrospective analysis from Leeds Cancer Centre

2019 ◽  
Author(s):  
Chris Twelves ◽  
Sue Cheeseman ◽  
Will Sopwith ◽  
Matthew Thompson ◽  
Majid Riaz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Hormone Receptor ◽  
Systemic Treatment ◽  
Metastatic Breast ◽  
Visceral Metastasis ◽  
Hormone Receptor Positive ◽  
Epidermal Growth

Abstract BACKGROUND Study aimed to characterise treatment and outcomes for patients with hormone receptor positive (HR+), human epidermal growth factor 2 negative (HER2-) metastatic breast cancer (MBC) within a large regional cancer centre, as a benchmark for evaluating real-world impact of novel therapies.METHODS Retrospective longitudinal cohort, using electronic patient records of adult females with a first diagnosis of HR+/HER2- MBC January 2012 - March 2018.RESULTS 196 women were identified with HR+/HER2- MBC. Median age was 67 years, 85.2% were post-menopausal and median time between primary diagnosis and metastasis was 5.4 years. Most (75.1%) patients received endocrine therapy as first line systemic treatment (1st LoT); use of 1st LoT chemotherapy halved between 2012 and 2017. Patients receiving 1st LoT chemotherapy were younger and more likely to have visceral metastasis (p<0.01). Median OS was 29.5 months and significantly greater for patients with exclusively non-visceral metastasis (p<0.01). The adjusted hazard ratio for death of patients with visceral (or CNS) metastasis was 1.91 relative to those with exclusively non-visceral metastasis.CONCLUSIONS Diverse endocrine therapies predominate as 1st LoT for patients with HR+/HER2- MBC, chemotherapy being associated with more aggressive disease in younger patients, emphasising the importance of using effective and tolerable therapies early.

Cost-effectiveness of HER2 testing and trastuzumab therapy for metastatic breast cancer (MBC) patients in Sweden

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1088-1088
Author(s):  
M. Lidgren ◽  
C. Rehnberg ◽  
N. Wilking ◽  
B. Jönsson
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Cost Effectiveness ◽  
Treatment Strategies ◽  
Metastatic Breast ◽  
Chemotherapy Treatment ◽  
Her2 Testing ◽  
Trastuzumab Treatment ◽  
Life Years ◽  
The Cost

1088 Background: Trastuzumab is a monoclonal antibody that together with chemotherapy significantly improves time to progression and overall survival for MBC patients with tumours overexpressing HER2. The aim of this study was to analyse the cost- effectiveness of HER2 testing and trastuzumab in combination with chemotherapy compared with chemotherapy alone from a societal perspective in a Swedish setting. Methods: We used a Markov state transition model to simulate HER2 testing and subsequent treatment in a hypothetical cohort of 65 year old metastatic breast cancer patients based on the study by Marty et al (Marty et al, J Clin Oncol. Jul 1 2005;23(19):4265–4274). Outcomes included life-time costs, quality adjusted life years (QALY), and cost per QALY gained. Five different testing and treatment strategies were evaluated. Results: We estimated the cost per QALY gained to be about 485,000 SEK (approximately 70,000 USD) and the cost per life year (LY) gained to be about 332,000 SEK (approximately 47,000 USD) for the strategy of IHC testing for all patients, with FISH confirmation of 2+ and 3+, and trastuzumab and chemotherapy treatment for FISH positive patients. For the strategy of FISH testing for all patients, with trastuzumab and chemotherapy for FISH positive patients, we estimated the cost per QALY gained to about 561,000 SEK (approximately 80,000 USD) and the cost per LY gained to be 384,000 SEK (approximately 55,000 USD). The remaining testing and treatment strategies were dominated. Results were sensitive to changes in the quality adjustment of life years with metastatic disease, the risk of breast cancer related death, and test characteristics. Conclusions: Our analysis indicate that the present Swedish guidelines of IHC testing for all patients with metastatic breast cancer, with FISH confirmation of 2+ and 3+, followed by trastuzumab and chemotherapy treatment for FISH positive patients is a cost-effective treatment option. However, further research on budget impact of trastuzumab treatment and patient accessibility to trastuzumab treatment is needed. No significant financial relationships to disclose.

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