BJMO - volume 16, issue 6, october 2022
E. Agostinetto MD, V. Debien MD, G. Nader-Marta MD, D. Martins-Branco MD, E. de Azambuja MD, PhD
Neoadjuvant treatments in patients with breast cancer provide the opportunity for a direct evaluation of treatment effect on tumour size, allow higher rates of conservative surgery and give the chance to tailor systemic treatments after surgery. Patients who achieve a pathological complete response experience better long-term survival, compared to those with residual disease after the completion of neoadjuvant therapy, and those with residual invasive disease at surgery may benefit from additional post-neoadjuvant treatment strategies. Some systemic post-neoadjuvant treatments for patients with residual disease at surgery are already approved in clinical practice (i.e., capecitabine for patients with triple-negative breast cancer, or T-DM1 for patients with HER2-positive disease), and several new strategies are currently under evaluation. The present review discusses the available evidence for the implementation of systemic post-neoadjuvant treatment strategies into clinical practice for patients with early breast cancer, shading light on the pitfalls and limitations of different studies, and summarising data on novel promising treatment strategies that are being explored in clinical trials.
(BELG J MED ONCOL 2022;16(6):262–73)
Read moreBJMO - volume 16, issue 6, october 2022
G. Nader-Marta MD, F.P. Duhoux MD, PhD, D. Taylor MD, T. Van den Mooter MD, H. Denys MD, PhD, J-L. Canon MD, J. Mebis MD, A. Awada MD, PhD, H. Wildiers MD, PhD, K. Punie MD, E. de Azambuja MD, PhD
HER2-targeted agents are the central component of HER2-positive metastatic breast cancer (MBC) treatment. The combination of trastuzumab, pertuzumab and a taxane is the preferred first-line regimen in most settings. For patients with disease relapse after adjuvant therapy, treatment decisions in the first-line are influenced by the treatment-free interval and the regimens used in the (neo)adjuvant setting. T-DXd has been recently established as the preferred second-line therapy. T-DM1, or the combination of tucatinib, trastuzumab and capecitabine, are reasonable third-line options, although efficacy and safety data of these regimens after prior exposure to T-DXd are lacking. In fourth and later lines, trastuzumab duocarmazine, neratinib plus capecitabine, margetuximab plus chemotherapy, lapatinib-based combinations or the continuation of trastuzumab with different chemotherapy partners are valid alternatives.
(BELG J MED ONCOL 2022;16(6): 287–92)
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