期刊
BREAST CANCER-TARGETS AND THERAPY
卷 13, 期 -, 页码 361-381出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/BCTT.S268451
关键词
central nervous system; CNS; HER2-positive; metastatic breast cancer; tucatinib; tyrosine kinase inhibitor
类别
Targeted therapies have transformed the management of HER2 positive breast cancer, with dual blockade using monoclonal antibodies trastuzumab and pertuzumab becoming internationally recognized standards. New drugs like tucatinib and trastuzumab deruxtecan have shown promising efficacy in post-T-DM1 treatment, providing additional options for patients with advanced HER2 positive breast cancer.
The management of HER2 positive breast cancer has been transformed by the development of targeted therapies. Dual blockade with the monoclonal antibodies, trastuzumab and pertuzumab, added to first-line taxane chemotherapy and second-line therapy with the antibody-drug conjugate, T-DM1, are internationally agreed standards of care for advanced HER2 positive breast cancer, where available. However, until recently, options for patients for third-line therapy and beyond were of modest efficacy or limited by toxicity. In 2019, the results of trials of two exciting new agents for this space were presented. A third-generation HER2 tyrosine kinase inhibitor, tucatinib, combines the efficacy of the second-generation drug, neratinib, with a more manageable toxicity profile and has become a new standard of care after T-DM1, in combination with capecitabine and trastuzumab. The antibody-drug conjugate, trastuzumab deruxtecan, demonstrated remarkable efficacy in heavily pre-treated patients and received accelerated approval in the United States, whilst confirmatory Phase 3 trials are completed. This review will discuss the available data for the post-T-DM1 setting, focusing on tyrosine kinase inhibitors including tucatinib.
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