Metastatic breast cancer treatment: Difference between revisions
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*Trastuzumab increases the clinical benefit of first-line chemotherapy in metastatic breast cancer that overexpresses HER2.<ref name="pmid11248153">Slamon DJ, Leyland-Jones B, Shak S, Fuchs H, Paton V, Bajamonde A et al. (2001) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11248153 Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2.] ''N Engl J Med'' 344 (11):783-92. [http://dx.doi.org/10.1056/NEJM200103153441101 DOI:10.1056/NEJM200103153441101] PMID: [http://pubmed.gov/11248153 11248153]</ref> | *Trastuzumab increases the clinical benefit of first-line chemotherapy in metastatic breast cancer that overexpresses HER2.<ref name="pmid11248153">Slamon DJ, Leyland-Jones B, Shak S, Fuchs H, Paton V, Bajamonde A et al. (2001) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11248153 Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2.] ''N Engl J Med'' 344 (11):783-92. [http://dx.doi.org/10.1056/NEJM200103153441101 DOI:10.1056/NEJM200103153441101] PMID: [http://pubmed.gov/11248153 11248153]</ref> | ||
*Single-agent trastuzumab is active and well tolerated as first-line treatment of women with metastatic breast cancer with HER2 3+ overexpression by IHC or gene amplification by FISH.<ref name="pmid11821453">Vogel CL, Cobleigh MA, Tripathy D, Gutheil JC, Harris LN, Fehrenbacher L et al. (2002) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11821453 Efficacy and safety of trastuzumab as a single agent in first-line treatment of HER2-overexpressing metastatic breast cancer.] ''J Clin Oncol'' 20 (3):719-26. PMID: [http://pubmed.gov/11821453 11821453]</ref> | *Single-agent trastuzumab is active and well tolerated as first-line treatment of women with metastatic breast cancer with HER2 3+ overexpression by IHC or gene amplification by FISH.<ref name="pmid11821453">Vogel CL, Cobleigh MA, Tripathy D, Gutheil JC, Harris LN, Fehrenbacher L et al. (2002) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11821453 Efficacy and safety of trastuzumab as a single agent in first-line treatment of HER2-overexpressing metastatic breast cancer.] ''J Clin Oncol'' 20 (3):719-26. PMID: [http://pubmed.gov/11821453 11821453]</ref> | ||
== Chemotherapy == | |||
*Commonly used agents are Anthracyclines, Taxanes, Capecitabine, Gemcitabine, Eribulin, and Vinorelbine | |||
*Bevacizumab has been shown to improve the efficacy of taxanes in frontline treatment of patients with metastatic breast cancer.<ref name="pmid21976315">Alvarez RH, Guarneri V, Icli F, Johnston S, Khayat D, Loibl S et al. (2011) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21976315 Bevacizumab Treatment for Advanced Breast Cancer.] ''Oncologist'' ():. [http://dx.doi.org/10.1634/theoncologist.2011-0113 DOI:10.1634/theoncologist.2011-0113] PMID: [http://pubmed.gov/21976315 21976315]</ref> | |||
== References == | == References == | ||
Revision as of 02:35, 1 December 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Assistant Editor-in-Chief Jack Khouri
Overview
With rare exception, metastatic breast cancer is an incurable but treatable illness. Currently, it is managed as a chronic disease, especially the category that is ER-positive with predominantly bone or soft tissue metastasis. Chemotherapy, biologic therapy and endocrine therapy are all considered in the treatment of metastatic breast cancer.
Principles of therapy
- The main aims of therapy are prolonging survival, improving quality of life and avoiding treatment-induced toxicity. Given that treatment is palliative, patients should be given treatment holidays in order to reduce drug-induced toxicity.
- HER2 overexpression and hormone receptor status are very important factors that guide therapy and influence prognosis.
- Multiagent chemotherapy regimens don't show significant survival benefit compared to single-drug regimens and augment toxicity.
- Chemotherapy is recommended for patients with ER-negative metastatic breast cancer and those with ER-positive breast cancer resistant to endocrine therapy or associated with visceral disease.
- Trastuzumab increases the clinical benefit of first-line chemotherapy in metastatic breast cancer that overexpresses HER2.[1]
- Single-agent trastuzumab is active and well tolerated as first-line treatment of women with metastatic breast cancer with HER2 3+ overexpression by IHC or gene amplification by FISH.[2]
Chemotherapy
- Commonly used agents are Anthracyclines, Taxanes, Capecitabine, Gemcitabine, Eribulin, and Vinorelbine
- Bevacizumab has been shown to improve the efficacy of taxanes in frontline treatment of patients with metastatic breast cancer.[3]
References
- ↑ Slamon DJ, Leyland-Jones B, Shak S, Fuchs H, Paton V, Bajamonde A et al. (2001) Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 344 (11):783-92. DOI:10.1056/NEJM200103153441101 PMID: 11248153
- ↑ Vogel CL, Cobleigh MA, Tripathy D, Gutheil JC, Harris LN, Fehrenbacher L et al. (2002) Efficacy and safety of trastuzumab as a single agent in first-line treatment of HER2-overexpressing metastatic breast cancer. J Clin Oncol 20 (3):719-26. PMID: 11821453
- ↑ Alvarez RH, Guarneri V, Icli F, Johnston S, Khayat D, Loibl S et al. (2011) Bevacizumab Treatment for Advanced Breast Cancer. Oncologist ():. DOI:10.1634/theoncologist.2011-0113 PMID: 21976315