Current Treatment Options for Human Epidermal Growth Factor Receptor 2-Directed Therapy in Metastatic Breast Cancer: An Indian Perspective

Abstract

Human epidermal growth factor receptor 2 (HER2)-positive is an aggressive subtype of breast cancer and has historically been associated with poor outcomes. The availability of various anti-HER2 therapies, including trastuzumab, lapatinib, pertuzumab, and trastuzumab emtansine (TDM-1), has remarkably improved the clinical outcomes in patients with HER2-positive metastatic breast cancer (mBC). However, there is a need to optimize treatment within this population, given the wide variability in clinical presentation. Additionally, geographical and socio-economic considerations too need to be taken into account. To clarify and collate evidence pertaining to HER2-positive metastatic breast cancer, a panel of medical and clinical oncologists from across India developed representative clinical scenarios commonly encountered in clinical practice in the country. This was followed by two meetings wherein each clinical scenario was discussed in detail and relevant evidence appraised. The result of this process is presented in this manuscript as evidence followed by therapeutic recommendations of this panel for management of HER2-positive mBC in the Indian population.

Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, staging and treatment of patients with metastatic breast cancer

“…The choice of treatment depends on prior second-line therapy, patient characteristics, toxicity profile and availability. In later lines of therapy, lapatinib is an evidence-based therapy option to be used preferably in combination 90 , 91 , 92 , 93 , 94 (e.g. with capecitabine, trastuzumab or ET) [I, C].…”

“…In later lines of therapy, lapatinib is an evidence-based therapy option to be used preferably in combination 90 , 91 , 92 , 93 , 94 (e.g. with capecitabine, trastuzumab or ET) [I, C].…”