First-Line Treatments for HER2-Positive Breast Cancer

Hatem Soliman, MD, medical oncologist in The Center for Women’s Oncology and assistant member of the Experimental Therapeutics Program at Moffitt Cancer Center, discusses the current first-line treatment options for patients with HER2-positive breast cancer.

According to Soliman, the phase 3 CLEOPATRA study (NCT00567190) evaluated the efficacy and safety of pertuzumab (Perjeta), trastuzumab (Herceptin), and docetaxel vs placebo, trastuzumab, and docetaxel in patients with HER2-positive metastatic breast cancer. Findings from this study were positive and showed that both progression-free survival and overall survival rates were significantly improved among patients in the pertuzumab group compared with those in the placebo group.

Based on these results, this combination of pertuzumab and trastuzumab is still the current frontline standard treatment for this patient population, and will remain until a new agent goes head-to-head against this combination.

TRANSCRIPTION:

0:08 | Many of the treatments that we use in the first-line setting for patients with metastatic HER2+ positive breast cancer are based off of the data from the CLEOPATRA trial, which was published in the New England Journal of Medicine a number of years ago. It involved using a taxane-based chemotherapy, in addition to 2 antibodies, pertuzumab and trastuzumab, which cooperate together in order to more fully suppress HER2 signaling. Based on the results of the CLEOPATRA trial, that is still considered the current preferred standard of care for first-line HER2-positive metastatic patients.

0:55 | Often though, what we can do is treat them initially with the taxane plus [pertuzumab] and [trastuzumab] for about 6 cycles or until we get a good response. Then, sometimes we can peel the chemo off and just maintain them on the [pertuzumab and trastuzumab] for a period of time to give them a break from chemotherapy and potentially improve their quality-of-life while maintaining control of their disease over time.