Duration of Trastuzumab in Patients with HER2-Positive Metastatic Breast Cancer in Prolonged Remission

Haq, Rizwan Ul; Gulasingam, Pauline

doi:10.3747/co.23.2743

Cited by 14 publications

(7 citation statements)

References 22 publications

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“…Prolonged stable disease has been reported with trastuzumab-based maintenance therapy in a small number of patients with HER2+ disease [6, 11, 12]. Here we describe a patient with stable metastatic inflammatory breast cancer for 4 years on trastuzumab plus lapatinib maintenance therapy.…”

Section: Discussion/conclusionmentioning

confidence: 92%

“…The inflammatory subtype occurs in approximately 1–5% of all breast cancer cases, and represents extremely aggressive disease [2]. Initial treatment for HER2-enriched breast cancer is typically chemotherapy and HER2-targeted therapy [3, 4, 5, 6]. In the case of metastatic disease, HER2-targeted therapy is continued as a form of maintenance therapy until disease progression [3, 4, 5, 6].…”

Section: Introductionmentioning

confidence: 99%

“…Initial treatment for HER2-enriched breast cancer is typically chemotherapy and HER2-targeted therapy [3, 4, 5, 6]. In the case of metastatic disease, HER2-targeted therapy is continued as a form of maintenance therapy until disease progression [3, 4, 5, 6]. Trastuzumab and lapatinib are two different HER2-targeted agents: trastuzumab binds the extracellular domain of HER2 and inhibits ligand- independent signaling; lapatinib binds the intracellular domain and blocks activation of downstream signaling [7, 8, 9].…”

Section: Introductionmentioning

confidence: 99%

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Dual HER2 Suppression with Lapatinib plus Trastuzumab for Metastatic Inflammatory Breast Cancer: A Case Report of Prolonged Stable Disease

Ogawa

Lindquist

2018

Case Rep Oncol

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Background: Continuous therapy targeting human epidermal growth factor receptor 2 (HER2) is recommended until disease progression for patients with HER2-overexpressing (HER2+) metastatic breast cancer. Prolonged stable disease has been observed with such maintenance therapy using trastuzumab, but the frequency of these cases remains low. Whether combined maintenance therapy with two different HER2-targeted agents could improve the rates of durable progression-free survival compared with trastuzumab alone is under investigation. Objectives: To evaluate the efficacy of the combined HER2-targeted agents, trastuzumab and lapatinib, as maintenance therapy in one patient. Methods: We describe a patient with HER2+, hormone receptor-negative, inflammatory metastatic breast cancer who was previously treated with doxorubicin, cyclophosphamide, and zoledronic acid followed by paclitaxel and trastuzumab. After completion, the patient underwent a bilateral mastectomy and then enrolled into a Phase III open-label clinical trial of trastuzumab plus lapatinib. Results: The patient experienced long-term stable disease on combined lapatinib and trastuzumab maintenance therapy over 4 years. Conclusions: This case demonstrates that prolonged stable disease is possible with lapatinib plus trastuzumab, even in patients with the aggressive inflammatory subtype. Optimization of maintenance therapy could improve outcomes for patients with HER2+ metastatic breast cancer.

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Section: Discussion/conclusionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dual HER2 Suppression with Lapatinib plus Trastuzumab for Metastatic Inflammatory Breast Cancer: A Case Report of Prolonged Stable Disease

Ogawa

Lindquist

2018

Case Rep Oncol

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“…How long the appropriate maintenance period is an important theme discussed among experts. Previous reports about HER2-positive metastatic breast cancer patients who achieved cCR was referred [ [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] ]. Furthermore, all patients underwent tapering of maintenance therapy dose ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Patients who achieved long-term clinical complete response and subsequently terminated multidisciplinary and anti-HER2 therapy for metastatic breast cancer: A case series

Takuwa

Tsuji

Yotsumoto

2018

International Journal of Surgery Case Reports

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HighlightsBreast cancers that are positive for human epidermal growth factor receptor 2 (HER2) are aggressive and typically associated with a poor prognosis.Novel anti-HER2 therapies have recently improved the outcomes in these cases.We report a case series in which women were treated for metastatic HER2-positive breast cancer using trastuzumab and various chemotherapies.These patients ultimately achieved clinical complete response, and subsequently terminated their systemic therapy after maintenance therapy.Our findings indicate that select patients may be suitable for treatment termination if they have achieved a prolonged period of complete response.

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“…Because of the response to chemotherapy and sclerotic bony lesions on computed tomography imaging, the patient was sent for postoperative radiation therapy. At 18 months after her initial diagnosis, she remains very stable, with minimal residual disease on maintenance monoclonal antibody treatment (trastuzumab and pertuzumab), tamoxifen, and pamidronate 7 .…”

Section: Case Descriptionmentioning

confidence: 99%

Breast Cancer and Dermatomyositis: A Case Study and Literature Review

et al. 2017

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A 49-year-old woman presents with an extensive violaceous rash, rapidly progressive proximal muscle weakness, and dysphagia to solids, consistent with a diagnosis of dermatomyositis. Two weeks later, she palpates a mass in her left breast and is diagnosed with her2-positive metastatic invasive ductal carcinoma of the breast.There is a well-established association between dermatomyositis and malignancy. However, the specific association between breast cancer and dermatomyositis has not been well characterized. No guideline for oncologists managing these patients has been established. Recently, 3 cases of breast cancer and dermatomyositis were diagnosed at our institution. A review of the literature was pursued to characterize the association between breast cancer and dermatomyositis.A review of 178 papers identified 22 cases of breast cancer with dermatomyositis. Most patients (71%) presented with stage iii or iv breast cancer. The median time between the diagnosis of breast cancer and the onset of dermatomyositis symptoms was 1 month. Three quarters of the patients were steroid-responsive and able to taper. Half the women with follow-up data experienced a documented cancer relapse associated with a new flare of cutaneous symptoms.The presence of dermatomyositis appears to be associated with more-advanced breast cancer stage and is most commonly associated with invasive ductal carcinoma. In our review, treatment of cancer alone is insufficient to adequately control the cutaneous and myopathic manifestations of dermatomyositis, which can significantly affect quality of life. A multidisciplinary approach, including close collaboration with rheumatologists and dermatologists, is therefore important in the diagnosis and management of oncology patients with dermatomyositis.

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Duration of Trastuzumab in Patients with HER2-Positive Metastatic Breast Cancer in Prolonged Remission

Abstract: Background Outcomes in metastatic breast cancer (mbc) positive for her2 (human epidermal growth factor

Cited by 14 publications

References 22 publications

Dual HER2 Suppression with Lapatinib plus Trastuzumab for Metastatic Inflammatory Breast Cancer: A Case Report of Prolonged Stable Disease

Dual HER2 Suppression with Lapatinib plus Trastuzumab for Metastatic Inflammatory Breast Cancer: A Case Report of Prolonged Stable Disease

Patients who achieved long-term clinical complete response and subsequently terminated multidisciplinary and anti-HER2 therapy for metastatic breast cancer: A case series

Breast Cancer and Dermatomyositis: A Case Study and Literature Review

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