Purpose Intravenous trastuzumab, pertuzumab, and docetaxel are first-line standard of care for patients with HER2-positive metastatic breast cancer (mBC). MetaPHER is the first study assessing the safety and tolerability of subcutaneous trastuzumab plus intravenous pertuzumab and chemotherapy in a global patient population with HER2-positive mBC. Methods In this open-label, single-arm, multicenter, phase 3b study, eligible patients were ≥ 18 years old with histologically/cytologically confirmed previously untreated HER2-positive mBC. All received ≥ 1 subcutaneous trastuzumab 600 mg fixed dose plus intravenous pertuzumab (loading dose: 840 mg/kg; maintenance: 420 mg/kg) and docetaxel (≥ 6 cycles; initial dose 75 mg/m2) every 3 weeks. The primary objective was safety and tolerability; secondary objectives included efficacy. Results At clinical cutoff, 276 patients had completed the study; median duration of follow-up was 27 months. The most common any-grade adverse events were diarrhea, alopecia, and asthenia; the most common grade ≥ 3 events were neutropenia, febrile neutropenia, and hypertension. There were no cardiac deaths and mean left ventricular ejection fraction was stable over time. Median investigator-assessed progression-free survival was 18.7 months; objective response rate was 75.6%. Conclusions Safety and efficacy with subcutaneous trastuzumab plus intravenous pertuzumab and docetaxel in mBC are consistent with historical evidence of intravenous trastuzumab with this combination. Findings further support subcutaneous administration not affecting safety/efficacy profiles of trastuzumab in HER2-positive BC with increased flexibility in patient care. A fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection has recently been approved for the treatment of HER2-positive early/mBC, further addressing the increasing relevance of and need for patient-centric treatment strategies. Trial registration NCT02402712

Introduction: Breast cancer is a common disease diagnosed in Mexican women and the first leading cause of death [1]. Heterogeneity in patients’ response to treatment is consistently observed across populations. Glutathione S-transferases (GSTs) are involved in the metabolism of environmental carcinogens, reactive oxygen species and chemotherapeutic agents by catalyzing the glutathione with electrophilic compounds. The deletion of GSTT1 and GSTM1 genes result in loss of enzyme activity. A few studies evaluated the response to treatment and the polymorphisms of GSTT1 and GSTM1. The aim of this work is to make the association of the null polymorphisms of GSTT1 and GSTM1 with the response to chemotherapy basically doxorubicin and cyclophosphamide. Methods: The genotyping of thirty patients with breast cancer was made with the Polymerase chain reaction, to identify the polymorphisms of GSTT1 and GSTM1. We determine the status of Her-2 neu, estrogen and progesterone receptors, then the response to treatment was made with an ultrasound and pathological data. We made the association with the χi² statistics using a p≤0.05. Results: Using the Sigma Stat 3.5 program and the chi-squared analysis, we do not observe a significant association with the GSTT1+/GSTM1+, GSTT1-/GSTM1+ and GSTT1-/GSTM1-polymorphisms and the better or worse response to cyclophosphamide and doxorubicin. With the Her-2 neu, estrogen and progesterone receptors status, we neither found an association with the response to the therapy. Conclusion: This study suggests that GSTT1 and GSTM1 polymorphisms have no statistical significance between the genotype of women with advanced breast cancer and the response to neoadjuvant chemotherapy, but we can see a clear tendency toward better response with the null genotype

Epidermal growth factor receptor is preferably expressed in head and neck squamous cell carcinomas and is a promising therapeutic target. Cetuximab is the only epidermal growth factor receptor-targeted agent that has been approved for the treatment of squamous cell carcinoma. The 2006 FDA-approved indication refers to the use of cetuximab in combination with radiotherapy for the treatment of locoregional, advanced, unresectable head and neck squamous cell carcinoma, except for nasopharyngeal carcinoma. In 2011, the use of cetuximab in combination with platinum and 5-fluorouracil was approved as first-line treatment for recurrent and/or metastatic head and neck squamous cell carcinoma. In order to homogenize and arrive at a multidisciplinary, multi-institutional consensus based on scientific evidence, a meeting was held where the existing literature was reviewed and the role of cetuximab in the treatment of patients with head and neck squamous cell carcinoma was discussed. This work reviews current evidence-based indications for the use of cetuximab in the treatment of patients with head and neck squamous cell carcinoma. (creativecommons.org/ licenses/by-nc-nd/4.0/).

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Resumen El receptor del factor de crecimiento epidérmico (EGFR, por sus siglas en inglés) se expresa con preferencia en los carcinomas escamosos de cabeza y cuello (CE-CC) y es un blanco terapéutico prometedor. El cetuximab (CTX) es el único agente cuyo blanco es el EGFR que ha sido aprobado para el tratamiento del carcinoma epidermoide. La indicación aprobada por la Food and Drug Administration en 2006 señala el uso de CTX en combinación con radioterapia para el tratamiento de CE-CC locorregionalmente avanzados irresecables, exceptuando el carcinoma nasofaríngeo. En 2011 se aprobó el uso de CTX en combinación con platino y 5-fluorouracilo como tratamiento de primera línea en CE-CC recurrente o metastásico. Para homogeneizar y llegar a un consenso multiinstitucional y multidisciplianario con base en evidencia científica, se realizó una reunión en la que se revisó la literatura existente y se discutió el papel del cetuximab en el tratamiento de pacientes con CE-CC. Este trabajo revisa las indicaciones actuales basadas en la evidencia del uso de CTX en el tratamiento de pacientes con CE-CC. (creativecommons.org/licenses/by-nc-nd/4.0/). PALABRAS CLAVE

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BACKGROUND Intravenous trastuzumab, pertuzumab, and docetaxel is first-line standard of care for patients with HER2-positive metastatic breast cancer. Subcutaneous trastuzumab plus intravenous pertuzumab and chemotherapy has shown similar safety and tolerability to intravenous trastuzumab in patients with HER2-positive early and metastatic breast cancer; however, in the metastatic setting, this has yet to be shown globally.METHODS In this open-label, single-arm, multicenter phase 3b study, eligible patients were ≥18 years old with histologically/cytologically confirmed previously untreated HER2-positive metastatic breast cancer. All patients received ≥1 dose of subcutaneous trastuzumab (fixed-dose 600 mg) plus intravenous pertuzumab (loading dose: 840 mg/kg; maintenance dose: 420 mg/kg) and docetaxel (≥6 cycles; initial dose 75 mg/m2) every 3 weeks. The primary objective was safety and tolerability; secondary objectives included efficacy.RESULTS At clinical cutoff, 276 patients had completed the study; median duration of follow-up was 27 months. The most common any-grade adverse events were diarrhea, alopecia, and asthenia. The most common grade ≥3 adverse events were neutropenia, febrile neutropenia, and hypertension. There were no cardiac deaths and mean left ventricular ejection fraction was stable over time. Median investigator-assessed progression-free survival was 18.7 months; objective response rate was 75.6%.CONCLUSIONS Efficacy/safety results of subcutaneous trastuzumab plus intravenous pertuzumab and docetaxel in metastatic breast cancer are consistent with historical evidence of intravenous trastuzumab. These findings further support the body of evidence indicating that subcutaneous administration does not affect the safety and efficacy profile of trastuzumab in HER2-positive breast cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02402712 (date of registration: 30th March 2015)