Data from the CLEOPATRA study show that the combination of pertuzumab plus trastuzumab plus docetaxel, as compared with placebo plus trastuzumab plus docetaxel, when used as first-line treatment for HER2-positive metastatic breast cancer, significantly prolonged progression-free survival and overall survival, with no increase in cardiac toxic effects.
European Society for Medical Oncology (ESMO) guidelines state that systemic therapy need not be discontinued or changed in patients with HER2-positive metastatic breast cancer who develop brain metastases with stable extracranial disease. When patients have progressive brain metastases as the principal cause of disease burden, however, a change in systemic therapy, preferably in clinical trials, is reasonable, particularly when no other appropriate local therapy options are available.
Vinorelbine can be used as a first- or second-line agent, with ORRs of up to 40%. Retrospective studies have described a response to trastuzumab in multiple lines of therapy. In fact, patients treated with more than two trastuzumab-containing regimens appear to have advantageous overall survival.
For additional information, refer to the ESMO guidelines.
Learn more about the treatment of HER2-positive metastatic breast cancer.
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Cite this: Winston W. Tan. Fast Five Quiz: Test Your Knowledge of Systemic Treatment for Metastatic Breast Cancer - Medscape - Jan 25, 2022.
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