Higher efficacy of letrozole in combination with trastuzumab compared to letrozole monotherapy as first-line treatment in patients with HER2-positive, hormone-receptor-positive metastatic breast cancer – Results of the eLEcTRA trial

Huober, Jens; Fasching, Peter A.; Barsoum, Mohsen Samy; Petruželka, Luboš; Wallwiener, D.; Thomssen, Christoph; Reimer, Toralf; Paepke, Stefan; Azim, Hamdy A.; Ragosch, V.; Kubista, E.; Baumgärtner, Anne K.; Beckmann, Matthias W.; May, Christoph; Nimmrich, Inko; Harbeck, Nadia

doi:10.1016/j.breast.2011.07.006

Cited by 199 publications

(117 citation statements)

References 25 publications

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“…And, compared with tamoxifen alone, aromatase inhibitors as monotherapy or after 2-3 years of tamoxifen have been shown to produce similar lower recurrence rates 36 . On the other hand, only women with her2+ status (approximately 10%-15% of those with endocrine-positive breast cancers) could benefit from trastuzumab [37][38][39][40][41] . Thus, only a small proportion of the 2000-2002 population might be candidates for adjuvant trastuzumab after chemotherapy 42 .…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Efficacy of Current Clinical Practice of Adjuvant Chemotherapy in Postmenopausal Women with Early-Stage, Estrogen or Progesterone Receptor–Positive, One-To-Three Positive Axillary Lymph Node, Breast Cancer

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Evaluating the Efficacy of Current Clinical Practice of Adjuvant Chemotherapy in Postmenopausal Women with Early-Stage, Estrogen or Progesterone Receptor–Positive, One-To-Three Positive Axillary Lymph Node, Breast Cancer

et al. 2012

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“…The combination of letrozole plus trastuzumab was compared with letrozole alone in the electra study 20 , which randomized 57 postmenopausal patients to letrozole (2.5 mg daily) with or without trastuzumab (4 mg/kg loading dose, followed by 2 mg/kg weekly). In addition, her2-negative patients were enrolled as a third cohort and were treated with letrozole alone.…”

Section: Hormone Receptor-positive Tumoursmentioning

confidence: 99%

Targeted Therapy in her2-Positive Metastatic Breast Cancer: A Review of the Literature

Zhu¹,

Verma²

2015

Current Oncology

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peers with other subtypes of the disease. Approval in 1998 of the first anti-her2 agent (trastuzumab) ushered in a new era of molecularly targeted therapies for her2-positive breast cancer and significantly improved outcomes in those patients.The anti-her2 agents now in clinical use span a number of drug classes, including the monoclonal antibodies trastuzumab and pertuzumab, which bind to the extracellular portion of the her2 protein; the small-molecule intracellular tyrosine kinase inhibitors lapatinib and neratinib, which block downstream receptor signalling; and the antibody-drug conjugate (adc) ado-trastuzumab emtansine (T-DM1), which combines her2 signalling disruption with direct cytotoxicity. These drugs have been shown to be efficacious in the treatment of her2-positive mbca in the first-line setting and beyond.In this article, we describe the natural history of her2-positive breast cancers, summarize the evidence for the currently available targeted agents from phase iii randomized clinical trials, and discuss the role of targeted agents in the current management of her2-positive mbca.The literature in PubMed from January 1990 to October 2014 was searched for published phase iii clinical trials relating to her2-positive mbca. Abstracts from major conferences, including the annual meetings of the American Society of Clinical Oncology (asco), the European Society for Medical Oncology, and the San Antonio Breast Cancer Symposium, were also examined. Key words included "her-2 positive," "metastatic breast cancer," "phase 3," and "clinical trial." Only English-language publications were reviewed. NATURAL HISTORYAs a transmembrane tyrosine kinase receptor protein, her2 belongs to the human epidermal receptor family of proteins. It is expressed in normal tissue including the gastrointestinal, respiratory, and urinary tracts, and skin, breast, and placenta 2 . Although her2 has ABSTRACTBreast tumours positive for her2 (human epidermal growth factor receptor 2) represent approximately 20% of all breast cancer cases and are associated with an aggressive natural history. The advent of targeted anti-her2 therapies has dramatically improved disease control and survival in patients with metastatic her2-positive breast cancer. Targeted agents are now considered the standard of care in the first-line setting and beyond.The present review summarizes the currently available data on targeted anti-her2 therapies from completed randomized phase iii clinical trials and briefly discusses emerging advances that will address unmet needs in metastatic her 2-positive breast cancer. KEY WORDSher2, metastatic breast cancer, targeted therapy, phase iii trials

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“…In the HER-2 positive subgroup the experimental arm showed a significant extension in PFS (8.2 vs 30 mo; P = 0.019) but once again no benefit was seen in terms of OS and there were more serious adverse events (8% vs 4%) compared with letrozole alone (P < 0.05). Lastly, the small eLEcTRA trial was discontinued due to slow enrollment with only 57 patients analyzed [65] . The cohort was similar to the TAnDEM trial but letrozole was used instead of anastrozole.…”

Section: The Addition Of Conventional Chemotherapeutics Maximizes Thementioning

confidence: 99%

Therapeutic options for HER-2 positive breast cancer: Perspectives and future directions

Recondo¹

2014

WJCO

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During the last 15 years we have witnessed an unprecedented expansion in the drugs developed to target human epidermal growth factor receptor-2 (HER-2) positive breast cancer. Trastuzumab, pertuzumab, adotrastuzumab emtansine and lapatinib are currently food and drug administration (FDA)-approved for the treatment of breast cancer patients with HER-2 overexpressed. However, given the amount of information gathered from years of uninterrupted clinical research, it is essential to have periodic updates that succinctly recapitulate what we have learnt over these last years and help us to apply that information in our daily practice. This review will pursue that objective. We will summarize the most relevant and updated information related to the state of the art management of HER-2 positive breast cancer in all the clinical scenarios including the adjuvant, neoadjuvant and metastatic settings. But we will also critically appraise that literature in order to highlight some key clinical concepts that should not be overlooked. Lastly, this review will also point out some of the most promising strategies that are currently being tested and may soon become available. Key words: Breast cancer; Human epidermal growth factor receptor-2; Trastuzumab; Pertuzumab; Adotrastuzumab; Lapatinib Core tip: This is a review manuscript with the most updated information regarding the state of the art management of human epidermal growth factor receptor-2 positive breast cancer. It summarizes the most relevant and updated information derived from more than 40 phase Ⅱ and Ⅲ clinical trials that constitute the theoretical framework to support our daily practice. It also highlights some key clinical concepts that should not be overlooked by critically appraising the current literature. Finally, it gives the reader with a compilation of potential new agents that are currently being tested and may soon become the next step in the battle against this disease.Recondo G Jr, Dìaz Canton E, de la Vega M, Greco M, Recondo G Sr, Valsecchi ME. Therapeutic options for HER-2 positive breast cancer: Perspectives and future directions.

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Higher efficacy of letrozole in combination with trastuzumab compared to letrozole monotherapy as first-line treatment in patients with HER2-positive, hormone-receptor-positive metastatic breast cancer – Results of the eLEcTRA trial

Cited by 199 publications

References 25 publications

Evaluating the Efficacy of Current Clinical Practice of Adjuvant Chemotherapy in Postmenopausal Women with Early-Stage, Estrogen or Progesterone Receptor–Positive, One-To-Three Positive Axillary Lymph Node, Breast Cancer

Evaluating the Efficacy of Current Clinical Practice of Adjuvant Chemotherapy in Postmenopausal Women with Early-Stage, Estrogen or Progesterone Receptor–Positive, One-To-Three Positive Axillary Lymph Node, Breast Cancer

Targeted Therapy in her2-Positive Metastatic Breast Cancer: A Review of the Literature

Therapeutic options for HER-2 positive breast cancer: Perspectives and future directions

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