AGO Recommendations for the Diagnosis and Treatment of Patients with Locally Advanced and Metastatic Breast Cancer: Update 2022

Thill, Marc; Lüftner, Diana; Kolberg‐Liedtke, Cornelia; Albert, Ute‐Susann; Banys‐Paluchowski, Maggie; Bauerfeind, Ingo; Blohmer, Jens-Uwe; Budach, Wilfried; Dall, P.; Fallenberg, Eva Maria; Fasching, Peter A.; Fehm, Tanja; Friedrich, Michael; Gerber, Bernd; Gluz, Oleg; Harbeck, Nadia; Heil, Jörg; Huober, Jens; Jackisch, Christian; Kreipe, Hans; Krug, David; Kühn, Thorsten; Kümmel, Sherko; Loibl, Sibylle; Lux, Michael P.; Maass, Nicolaì; Mundhenke, Christoph; Nitz, Ulrike; Park‐Simon, Tjoung‐Won; Reimer, Toralf; Rhiem, Kerstin; Rody, Achim; Schmidt, Marcus; Schneeweiß, Andreas; Schütz, Florian; Sinn, Hans‐Peter; Solbach, Christine; Solomayer, Erich‐Franz; Stickeler, Elmar; Thomssen, Christoph; Untch, Michael; Witzel, Isabell; Wöckel, Achim; Müller, Volkmar; Janni, Wolfgang; Ditsch, Nina

doi:10.1159/000524789

Cited by 14 publications

(24 citation statements)

References 45 publications

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“…The currently recommended first-line treatment for patients with HER2-positive metastatic disease is a taxane in combination with dual HER2 blockade using trastuzumab and pertuzumab [6–9]. This therapy was established as a standard of care by the phase III CLEOPATRA trial, which showed that the addition of pertuzumab to the combination of docetaxel and trastuzumab resulted in a significantly longer OS [57.1 (95% confidence interval (CI) 50–72) vs. 40.8 (95% CI 36–48) months, respectively] [2 ▪ ].…”

Section: First-line Treatmentmentioning

confidence: 99%

“…Both antibodies are continued until disease progression, and, in case of positive hormone receptor status, endocrine therapy is added after discontinuation of chemotherapy. Due to favorable toxicity and efficacy reported in phase II trials, weekly paclitaxel is a widely accepted alternative to docetaxel in this setting [6–8]. If patient preferences, poor performance status, or relevant comorbidities preclude the use of chemotherapy in patients with hormone receptor (HR)-positive HER2-positive disease, endocrine therapy in combination with anti-HER2 treatment may be used [6,8].…”

Section: First-line Treatmentmentioning

confidence: 99%

“…Due to favorable toxicity and efficacy reported in phase II trials, weekly paclitaxel is a widely accepted alternative to docetaxel in this setting [6–8]. If patient preferences, poor performance status, or relevant comorbidities preclude the use of chemotherapy in patients with hormone receptor (HR)-positive HER2-positive disease, endocrine therapy in combination with anti-HER2 treatment may be used [6,8]. This regimen is currently being evaluated in the phase III DETECT V trial and the first results are expected to be presented at the end of 2022 [10].…”

Section: First-line Treatmentmentioning

confidence: 99%

“…2) [9]. The AGO Breast Committee currently recommends T-DXd for patients after (neo)adjuvant trastuzumab and/or pertuzumab with a treatment-free interval (TFI) of less than 6–12 months [6]. Patients after trastuzumab, pertuzumab, and T-DM1 and a TFI less than 6–12 months can be offered either T-DXd or the combination of tucatinib/trastuzumab/capecitabine as first-line therapy (Fig.…”

Section: First-line Treatmentmentioning

confidence: 99%

“…The ASCO, ESMO, and AGO, respectively (Figs. 1–3), recommend T-DXd in case of disease progression during or after first-line therapy with pertuzumab, trastuzumab, and a taxane as the new standard of care in second-line setting [6,8,9]. This recommendation is based on the results of the approval phase III trial DESTINY-Breast03, published in 2021, which randomly assigned patients previously treated (50% first line) with trastuzumab and a taxane to T-DXd ( n = 261) vs. T-DM1 ( n = 263) [4 ▪▪ ].…”

Section: Second-line Standardmentioning

confidence: 99%

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New treatment strategies for human epidermal growth factor receptor 2-positive breast cancer in 2023

Banys‐Paluchowski

Krawczyk

Stickeler

et al. 2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewTaxanes in combination with trastuzumab and pertuzumab are the established first-line standard in the treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. In the last years, several new HER2-targeted therapies, including antibody--drug conjugates (ADCs) and tyrosine kinase inhibitors, have been approved for therapy after trastuzumab or dual blockade. In this review, the current treatment algorithms are discussed, including these new treatment options. Recent findingsThe ADC T-DM1 was the established second-line standard based on the results of the EMILIA trial. Recently, the DESTINY-Breast03 trial compared T-DM1 with the new ADC trastuzumab deruxtecan (T-DXd) in patients with disease progression after treatment with taxanes and trastuzumab. T-DXd was associated with an improved progression-free survival and a trend toward improved overall survival, establishing T-DXd as a new second-line standard. The HER2CLIMB trial demonstrated a significant progression-free survival and overall survival benefit for the tyrosine kinase inhibitor tucatinib in combination with trastuzumab and capecitabine after T-DM1 and trastuzumab/pertuzumab. This benefit was also observed in patients with active brain metastases defining this combination as the preferred second or third-line option in these patients. SummaryNew treatment strategies in HER2-positive metastatic breast cancer have substantially improved the clinical outcome of these patients, including those with active brain metastases.

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Section: First-line Treatmentmentioning

confidence: 99%

Section: First-line Treatmentmentioning

confidence: 99%