Adverse events leading to treatment discontinuation for any study drug was 10.7% in the capecitabine plus lapatinib arm and 5.9% in the T-DM1 arm; AEs leading to death on treatment was 1.0% in the capecitabine arm (CAD, multiorgan failure, coma, hydrocephalus, ARDS) and 0.2% on the T-DM1 arm (metabolic encephalopathy).
T-DM1 offers an important therapeutic option in the treatment of HER2+ MBC, Dr. Blackwell concluded. Future directions for the use of T-DM1 include defining new clinical niches in patients with HER2+ MBC, such as other T-DM1-based combinations; determining the value of adjuvant T-DM1; and exploring its mechanisms of action.
Continue Reading
References
1. Blackwell KL, Miles D, Gianni L, et al. Primary results from EMILIA, a phase III study of trastuzumab emtansine (T-DM1) versus capecitabine (X) and lapatinib (L) in HER2-positive locally advanced or metastatic breast cancer (MBC) previously treated with trastuzumab (T) and a taxane. J Clin Oncol. 2012;30(suppl; abstr LBA1).
2. Junttila TT, Li G, Parsons K, Phillips GL, Sliwkowski MX. Trastuzumab-DM1 (T-DM1) retains all the mechanisms of action of trastuzumab and efficiently inhibits growth of lapatinib insensitive breast cancer. Breast Cancer Res Treat. 2011;128(2):347-356. Epub 2010 Aug 21.
3. Burris HA, Rugo HS, Vukelja SJ, et al. Phase II study of the antibody drug conjugate trastuzumab-DM1 for the treatment of human epidermal growth factor receptor 2 (HER2)-positive breast cancer after prior HER2-directed therapy. J Clin Oncol. 2011;29(4):398-405.
4. Krop IE, Lorusso P, Miller KD, et al. A Phase II study of trastuzumab emtansine in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer who were previously treated with trastuzumab, lapatinib, an anthracycline, a taxane, and capecitabine. J Clin Oncol. 2012 May 29. [Epub ahead of print].
5. Hurvitz S, Dirix L, Kocksis J, et al. Trastuzumab emtansine (T-DM1) versus trastuzumab plus docetaxel in previously untreated HER2-positive metastatic breast cancer: primary results of a randomized, multicenter, open-label phase II study. 2011 European Multidisciplinary Cancer Congress. Abstract 5001. Presented September 25, 2011.
6. Geyer CE, Forster J, Lindquist D, et al. Lapatinib plus capecitabine for HER2-positive advanced breast cancer. N Engl J Med. 2006;355:2733-2743.
7. Brady MJ, Cella DF, Mo F, et al. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol. 1997;15:974-986.
HOW TO TAKE THE POST-TEST: To obtain CME credit, please click here after reading the article to take the post-test on myCME.com.
