HER2-targeted treatment for older patients with breast cancer: An expert position paper from the International Society of Geriatric Oncology

Publication date: Available online 22 June 2019Source: Journal of Geriatric OncologyAuthor(s): Etienne Brain, Philippe Caillet, Nienke de Glas, Laura Biganzoli, Karis Cheng, Lissandra Dal Lago, Hans WildiersAbstractHER2-positive (HER2+) breast cancer (BC) affects older women nearly as frequently as younger ones. Many older patients have cardiovascular comorbidity and risk greater toxicity from therapy. Treatment therefore requires careful consideration, especially since trials include few patients over 65 and so provide limited guidance. A multidisciplinary task force of the International Society of Geriatric Oncology conducted a literature review to make specific recommendations. In the absence of impaired left ventricular ejection fraction, older patients with HER2+ advanced or metastatic BC (MBC) should receive HER2-targeted therapy adjusted to their general condition. Although trastuzumab combined with pertuzumab and docetaxel or paclitaxel is recommended first-line in fit patients, taxanes are difficult in vulnerable ones, making a better-tolerated chemotherapy partner highly desirable. Hormonal therapy with anti-HER2 treatment is an alternative with hormone sensitive tumours. T-DM1 is the standard for fit trastuzumab- and taxane-exposed patients. Lapatinib activity differs from trastuzumab and causes more side effects and drug interactions that are at higher risk in older patients. For fit HER2+ early BC (EBC) patients, chemotherapy plus one year trastuzumab is standard...
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research

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Oncogene, Published online: 19 July 2019; doi:10.1038/s41388-019-0893-4FABP7 is a key metabolic regulator in HER2+ breast cancer brain metastasis
Source: Oncogene - Category: Cancer & Oncology Authors: Source Type: research
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research
AbstractPurposeTo evaluate the efficacy and safety of lapatinib (L) and trastuzumab (T) combination in HER2-positive metastatic breast cancer (MBC) patients previously treated with T and/or L.Materials and methodsWe conducted a retrospective, post-authorized, multicenter study including patients with HER2-positive MBC or locally advanced breast cancer (ABC) treated with the combination of L –T. Concomitant endocrine therapy, as well as brain metastasis and/or prior exposure to L, were allowed.ResultsOne hundred and fifteen patients from 14 institutions were included. The median age was 59.8  years. The median nu...
Source: Clinical and Translational Oncology - Category: Cancer & Oncology Source Type: research
JÁ, Ruiz-Borrego M, Guerrero-Zotano AL, Huerta M, Cotes-Sanchís A, Lao Romera J, Aguirre E, Cortés J, Llombart-Cussac A Abstract PURPOSE: To evaluate the efficacy and safety of lapatinib (L) and trastuzumab (T) combination in HER2-positive metastatic breast cancer (MBC) patients previously treated with T and/or L. MATERIALS AND METHODS: We conducted a retrospective, post-authorized, multicenter study including patients with HER2-positive MBC or locally advanced breast cancer (ABC) treated with the combination of L-T. Concomitant endocrine therapy, as well as brain metastasis and/or prior ...
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Tags: Clin Transl Oncol Source Type: research
AbstractLittle is known about the comparison of multiple-gated acquisition (MUGA) scanning with cardiovascular magnetic resonance (CMR) for serial monitoring of HER2+ breast cancer patients receiving trastuzumab. The association of cardiac biomarkers with CMR left ventricular (LV) function and volume is also not well studied. Our objectives were to compare CMR and MUGA for left ventricular ejection fraction (LVEF) assessment, and to examine the association between changes in brain natriuretic peptide (NT-BNP) and troponin-I and changes in CMR LV function and volume. This prospective longitudinal two-centre cohort study rec...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
Conclusion This study showed that elacridar influenced the pharmacokinetics of lapatinib. The inhibition of ABCB1 and ABCG2 transporters by elacridar substantially enhanced the penetration of lapatinib into the CSF and BT. The blocking of protein transporters could become indispensable in the treatment of patients with breast cancer and brain metastases.
Source: Investigational New Drugs - Category: Drugs & Pharmacology Source Type: research
ConclusionOur study suggests that the five hub genes (PHLPP1, UBC, ACACB, TGFB1, and ACTB) are associated with HER2 + BC with BM. The GSEA analysis revealed that the ribosomal pathway seems to play a very important role in the pathogenesis of HER2 + BC with BM.
Source: Pathology Research and Practice - Category: Pathology Source Type: research
CONCLUSION: Our study suggests that the five hub genes (PHLPP1, UBC, ACACB, TGFB1, and ACTB) are associated with HER2+BC with BM. The GSEA analysis revealed that the ribosomal pathway seems to play a very important role in the pathogenesis of HER2+BC with BM. PMID: 31178227 [PubMed - as supplied by publisher]
Source: Pathology, Research and Practice - Category: Pathology Authors: Tags: Pathol Res Pract Source Type: research
CONCLUSIONS: ET was the most common first-line treatment for study patients, but its use decreased gradually in the subsequent lines. The heterogeneity in the treatment selection highlights a lack of consensus for the management of HR+/HER2- MBC in routine practice. PMID: 31060392 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Conditions:   Breast Cancer;   Brain Metastases Intervention:   Drug: Pyrotinib Plus Vinorelbine Sponsor:   Chinese Academy of Medical Sciences Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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