Update on neoadjuvant treatment of breast cancer

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Update on neoadjuvant treatment of breast cancer"

Transcription

1 Update on neoadjuvant treatment of breast cancer

2 «IS PATHOLOGIC COMPLETE RESPONSE STILL A GOOD SURROGATE OF SURVIVAL?»

3 Complete histological response varies according to tumoral type pcr (%) Luminal A (N=572) Luminal B (HER2-) (N=211) Luminal B (HER2+) (N=281) HER2+ (non-luminal) (N=178) Triple-negative N=362) Untch M, et al J Clin Oncol. 2010, Apr 20;28(12):

4 Prognostic impact of pathologic complete response (pcr) on disease-free survival (DFS) in 4,193 patients according to breast cancer intrinsic subtype. with luminal A luminal B, HER2 neg luminal B, HER2 pos pcr rate after neoadjuvant chemotherapy is associated with better outcome only for patients with: HER2-positive/hormone receptor negative or triple-negative and some more aggressive HER2-negative/hormone HER2-positive (nonluminal luminal B, HER2 neg receptor positive tumours. TN von Minckwitz G et al. JCO 2012;30:

5 Update HER2+++ breast cancers What s new?

6 Unresolved questions Noah study (and other phase II studies) have shown that Traztuzumab should be added to chemotherapy in neoadjuvant setting Questions : Traztuzumab and Anthracyclins combination? Precocity of Traztuzumab use?

7 Trastuzumab and anthracyclin Joint use of anthracyclin and Trastuzumab in neoadjuvant studies in HER2+++ patients, acceptable toxicity This combination is doubtfull as for its innocuousness Retrospective analysis of 583 patients who received anthracyclins and Traztuzumab (3 neoadjuvant trials) Cardiac toxicity rate (linear variable ) Increase cardiac toxicity (OR = 1,95, 95% CI 1,16-3,29) 44 cardiac events in the group with T vs 28 in the group without T Bozovic-Spasojevic ILancet Oncol Mar;12(3):209-11

8 What is the optimal time for Traztuzumab initiation? There are no direct data answering to this question as there are no studies comparing Traztuzumab in neoadjuvant vs adjuvant setting (except Remagus study.) In metastatic setting, arguments in favor of an early use (1) In adjuvant setting (NCCTG) in favor of an early use With a 6 years follow up DFS (2) AC-P (12 weeks) = 71,9 % AC-P (12 weeks then )-T = 80,1 % AC-PT (concommitant) = 84,2 % HR : 0,69 [0,57-0,85], p = 0,0005 HR : 0,75 [0,60-1,11], p = 0,02 (1) Marty et al, J clin oncol, 2005, (23) (2) Perez EA J Clin Oncol. 2011, 29(34):

9 The interest of double blockage?

10 Lapatinib in neoadjuvant Tyrosine Kinase inhibitor of EGFR and HER2 Efficacy in metastatic breast cancers HER2 +++ combined with capecitabine or to Traztuzumab Geyer CE N Engl J Med Apr 5;356(14):1487. Blackwell KL, et al: J Clin Oncol Jul 20;30(21):

11 HER2 signaling pathway Trastuzumab HER2/HER3 PTEN TORC2 Lapatinib PI3K PIP 3 Akt PDK1 Ras Raf MEK Anti HER2 treatment are monoclonal antibodies against extracellular portion (traztuzumab) and small molecules which inhibit tyrosin kinase (lapatinib). Tuberin Erk Rheb TORC1 Rsk Baselga J et al. SABCS 2010

12 Two randomised trials

13 Neo-ALTTO Breast cancer HER2+, T > 2 cm (no inflammatory ) FEVG > 50 % n = 450 Stratification : S 5 cm vs. S > 5 cm RE ou RP + vs. RE & RP n 0-1 vs. n 2 Surgery or not Conservative or no R A N D O M I S A T IO N lapatinib trastuzumab paclitaxel lapatinib trastuzumab paclitaxel 6 sem paclitaxel + 12 week s u r g e r y lapatinib trastuzumab lapatinib trastuzumab 34 week 52 semaines de traitement anti-her2 Baselga J et al. Lancet Feb 18;379(9816): F E C X 3

14 Neo-ALTTO Efficacy pcr et tpcr p = p = p = 0.34 p = % 29.5 % 51.3 % 20.0 % 27.6 % 46.9 % L T L + T n = 154 n = 149 n = 152 pcr L T L + T n = 150* n = 145* n = 145* tpcr Loco regional pcr L : lapatinib; T : trastuzumab; L+T : lapatinib plus trastuzumab pcr : pathologic complete response Baselga J et al. Lancet Feb 18;379(9816):

15 Neo-ALTTO Efficacy % of conservative surgery and % N- p = 0.14 p = 0.03 p > 0.5 p > % 38.9 % 41.4 % 48.0 % 56.6 % 69.0 % L T L + T n = 154 n = 149 n = 152 Conservative surgery L T L + T n = 150* n = 143* n = 147* Negative lymph nodes status L : lapatinib; T : trastuzumab; L+T : lapatinib plus trastuzumab Baselga J et al. Lancet Feb 18;379(9816):

16 GeparQuinto-HER2+ EC Doc Trastuzumab (T) T 6 months R EC Doc* 620 Pts 309 ECTH, 311 ECTL Lapatinib (L) T 12 months C : Cyclophosphamide 600 mg/m² E : Epirubicine 90 mg/m² T : Trastuzumab 6 (8) mg/kg * + G-CSF Doc : Docetaxel 100 mg/m² L : mg/j p.o. (cycles de 3 semaines) Untch M et al. Lancet Oncol Feb;13(2):135-44

17 GeparQuinto pcr (non invasive / no invasive carcinoma in breast and lymph nodes by central review ) 50,0% 45,0% 40,0% 35,0% 30,0% 25,0% 20,0% 15,0% 10,0% 5,0% 0,0% EC-Doc + T p < 0.03 EC-Doc + L Untch M et al. Lancet Oncol Feb;13(2):135-44

18 GeparQuinto pcr according to subgroups (pre dfined and stratified 50% 45% 40% Negative RE/RP Positive RE/RP T1-3 and N0-2 T4 or N3 35% 30% 25% 20% 15% 10% 5% 39 % 28 % 26 % 16 % 31 % 20 % 31 % 30 % 0% EC-Doc + H EC-Doc + L EC-Doc + H EC-Doc + L EC-Doc + H EC-Doc + L EC-Doc + H EC-Doc + L Untch M et al. Lancet Oncol Feb;13(2):135-44

19 NSABP B-41 : lapatinib evaluation in neoadjuvant treatment in HER2 +++ breast cancer (1) Operable HER breast cancer 529 ptes R AC - wp + T AC -wp + L Trastuzumab for one year AC- wp + T + L T = trastuzumab ; L = lapatinib ; wp = paclitaxel hebdomadaire Criteria : pcr, cardiac events, progresssion free survival, overall survival ASCO D après Robidoux A et al., LBA506 actualisé

20 NSABP B-41 : lapatinib evaluation in neoadjuvant treatment in HER2 +++ breast cancer (2) Pricipal criteria pcr rate in the breast (non statistically significant ) Secondary criteria pcr rate in the breast and lymph nodes : limit for significativity Taux de réponse histologique p = 0,056 p = 0,78 49,4 47,4 60, AC wp + T (n = 176) wp = paclitaxel hebdomadaire AC wp + L (n = 171) AC wp + T + L (n = 117) ASCO D après Robidoux A et al., LBA506 actualisé

21 Pertuzumab :inhibits HER2 dimerisation Monoclonal anti body against a different target of HER2- HER3 Pertuzumab is a humanised monoclonal antibody, first of a new class : HER2 dimerisation inhibitor With the inhibition of HER2 dimerisation, pertuzumab inhibits HER 2 signaling patways spark off proliferation and survival of cellular cells. Pertuzumab prevent HER2-3 formation Franklin et al. Cancer Cell 2004;5: Augus et al. Cancer Cell 2002;2:

22 surgery NeoSphere Design of the study TH (n = 107) docetaxel + trastuzumab FEC /3 w x 3 trastuzumab /3 w cycles 5 17 HER2 +++ breast cancers operable > 2cm or locally advanced or inflammatory (n = 417) THP (n = 107) docetaxel + trastuzumab + pertuzumab HP (n = 107) trastuzumab + pertuzumab FEC /3 w x 3 trastuzumab /3 w cycles 5 17 docetaxel /3 w x 4 FEC /3 w x 3 trastuzumab /3 w cycles 5 17 TP (n = 96) docetaxel + pertuzumab Schéma : /3 weeks x 4 FEC /3 w x 3 trastuzumab /3 sem cycles 5 21 CS, cancer du sein; FEC, 5-fluorouracile, épirubicine et cyclophosphamide *Localement avancé = T2 3, N2 3, M0 ou T4a c, tout N, M0; opérable = T2 3, N0 1, M0; inflammatoire = T4d, tout N, M0 H, trastuzumab; P, pertuzumab; T, docetaxel Gianni L, Lancet Oncol Jan;13(1):25-32.

23 NeoSphere pcr (ITT) p = p = p = TH THP HP TP H, trastuzumab; P, pertuzumab; T, docetaxel Gianni L et al. SABCS 2010

24 Conclusion These data show that combining anti her2 +++ therapies and transduction pathways inhibitors could bypass resistance mecanisms and improve patients outcome without too much toxicity but a cost..

25 Biomarkers which predict who benefit to the addition of pertuzumab to Traztuzumab In the cleopatra study there are no blood predictive markers nor tissue markers J. Baselga et al., SABCS 2012, S5-1

26 Bevacizumab in neoadjuvant treatment for breast cancer Interest in triple negative cancers?

27 Biology of triple negative breast cancers identification of potential targets Triple negative breast cancers come from myoepithelial cells CK5-6, EGFR (1) Kinase Dysregulation Loss of PTEN (2) Activation of Akt pathway Amplification of FGF2, VEGFA, AR TN breast cancer high level of intracellular VEGF TN could have a higher sensitivity, to angiogenic inhibitors 1) Jones et al, ) Andre ) Turner et al, ) Linderholm et al, Ann Oncol, 20, 2009,

28 Bevacizumab added to neoadjuvant chemotherapy for breast cancer Harry D Bear;M.D; Ph D New england journal of médicine ; Janvier 2012

29 Design of the study Biopsy for biomarkers EC EC EC EC Operable breast cancers T2 T3 HER2 neg N: 1206 ( ) R EC EC EC EC SURGERY EC EC EC EC E: Epirubicine 60 mg/m toutes les 3 semaines C: Cyclophosphamide: 600 mg/m toutes les 3 semaines X: Capecitabine 825 mg/m2 de J1 à J14 GEM:Gencitabine 1000 mg/m2 J1J8 BEV: Bevacizumab 15mg/m2 T: Docetaxel 100 mg/m2 dans le groupe 1 et 75mg/m2 groupe 2 et 3

30 Bevacizumab: pcr rate in the breast p = 0,75 p = 0, ,7 % T-AC p = 0,009 36,1 % 35,8% 31,6 % 27,6% 23,5 % TG-AC TX-AC T-AC TG-AC TX-AC Without Bevacizumab With bevacizumab

31 Bevacizumab: pcr rate in the breast and lymph nodes Bevacizumab addition do not significatively increase pcr rate in breast and lymph nodes (P=0,08)

32 Bevacizumab: pcr rate in breast and lymph nodes

33 pcr, % + IC 95 % Bevacizumab: pcr rate in the breast and lymph nodes in patients with RH+ tumors ,1 % p = 0,03 16,8% Bevacizumab addition statistically increase pcr rate in breast and lymph nodes in RH+ tumors (p=0,03) 0 Without Bevacizumab With Bevacizumab

34

35 Design of the study, 1948 patients No response (clinical and/or ultrasound) >switch Taxol hebdo + Everolimus (group 2) pcr Her 2 (group 1) EC EC+ Bev Réponse R T T+ Bev 14,9 % 18,4 % P = 0,04 E: Epirubicine 90 mg/m2 C: Cyclophosphamide: 600 mg/m2 T:Docetaxel 100mg/m2 BEV: Bevacizumab 15mg/kg T: Docetaxel 100 mg/m2

36 Sub groups analysis Interaction test negative NS (p = 0.07) pcr in TN (663 pts) : 39,3% vs 27,9%, p = 0,0033 pcr in RH + 7,8% vs 7,8%, (p=1,00)

37 Comparison of the two studies pcr increase in the entire population low. pcr increase in TN tumors not found in NSABP study. BUT Smaller population (490 ptes) Inflammatory and T4 tumors in the Geparquinto not in the NSABP trial Anthracyclins given before in the Geparquinto Docetaxel dosage superior in the Geparquinto during 2 cycles Beva given for 2 cycles with antracyclins Only patients with objective response in the gepar received the Beva

38 Translational studies could targeted the patients who will answer «maybe» to Bevazusimab

39 Conclusion The neoadjuvant setting gives the unique opportunity to get insights in breast cancer biology It allows: to evaluate new therapies to find predictive factors for better individualization of the treatment.

Miquel Àngel Seguí Palmer

Miquel Àngel Seguí Palmer Miquel Àngel Seguí Palmer HER2+ Breast Cancer is characterized by overexpression of HER2 receptors HER2+ Breast Cancer is characterized by overexpression of HER2 receptors HER2+ status is associated with

More information

New Approval Mechanism for Breast Cancer using pathologic Complete Response

New Approval Mechanism for Breast Cancer using pathologic Complete Response New Approval Mechanism for Breast Cancer using pathologic Complete Response Sandra M. Swain, MD, FACP Medical Director, Washington Cancer Institute MedStar Washington Hospital Center Professor of Medicine

More information

Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer. Kevin R. Fox, MD University of Pennsylvania

Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer. Kevin R. Fox, MD University of Pennsylvania Breast Cancer Update 2014 Prevention, Risk, and Treatment of Early Stage Breast Cancer Kevin R. Fox, MD University of Pennsylvania Prevention of Breast Cancer Accepted treatments Tamoxifen (premenopausal

More information

Chemotherapy or Not? Anthracycline or Not? Taxane or Not? Does Density Matter? Chemotherapy in Luminal Breast Cancer: Choice of Regimen.

Chemotherapy or Not? Anthracycline or Not? Taxane or Not? Does Density Matter? Chemotherapy in Luminal Breast Cancer: Choice of Regimen. Chemotherapy in Luminal Breast Cancer: Choice of Regimen Andrew D. Seidman, MD Attending Physician Breast Cancer Medicine Service Memorial Sloan Kettering Cancer Center Professor of Medicine Weill Cornell

More information

BREAST CANCER UPDATE C H R I S S Z Y A R T O, D O G E N E S E E H E M A T O L O G Y O N C O L O G Y F L I N T, M I

BREAST CANCER UPDATE C H R I S S Z Y A R T O, D O G E N E S E E H E M A T O L O G Y O N C O L O G Y F L I N T, M I BREAST CANCER UPDATE C H R I S S Z Y A R T O, D O G E N E S E E H E M A T O L O G Y O N C O L O G Y F L I N T, M I Overview Why is it important to understand breast cancer? Choosing wisely Appropriateness

More information

What is the optimal sequence of anti-her2 therapy in metastatic breast cancer?

What is the optimal sequence of anti-her2 therapy in metastatic breast cancer? What is the optimal sequence of anti-her2 therapy in metastatic breast cancer? David Miles Mount Vernon Cancer Centre Northwood Middlesex UKBCM mee)ng: London 2013 Herceptin plus a taxoid extends survival

More information

Avastin in breast cancer: Summary of clinical data

Avastin in breast cancer: Summary of clinical data Avastin in breast cancer: Summary of clinical data Worldwide, over one million people are diagnosed with breast cancer every year 1. It is the most frequently diagnosed cancer in women 1,2, and the leading

More information

Cellular, Molecular, and Biochemical Targets in Breast Cancer

Cellular, Molecular, and Biochemical Targets in Breast Cancer Cellular, Molecular, and Biochemical Targets in Breast Cancer Kristy Kummerow Ingrid Meszoely December 12, 2012 VUMC Resident Bonus Conference One size fits all surgical treatment of breast cancer Wilhelm

More information

Breast Cancer Educational Program. June 5-6, 2015

Breast Cancer Educational Program. June 5-6, 2015 Breast Cancer Educational Program June 5-6, 2015 Adjuvant Systemic Therapy For Early Breast Cancer: Who, What and for How Long? Debjani Grenier MD, FRCPC Medical Oncologist Disclosures Advisory Board Member:

More information

The current treatment landscape for early breast cancer: Advances in cytotoxic and endocrine treatment

The current treatment landscape for early breast cancer: Advances in cytotoxic and endocrine treatment The current treatment landscape for early breast cancer: Advances in cytotoxic and endocrine treatment Ahmad Awada, MD, PhD Head of Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles

More information

Avastin in breast cancer: Summary of clinical data

Avastin in breast cancer: Summary of clinical data Avastin in breast cancer: Summary of clinical data Worldwide, over one million people are diagnosed with breast cancer every year 1. It is the most frequently diagnosed cancer in women 1,2, and the leading

More information

OI PARP ΑΝΑΣΤΟΛΕΙΣ ΣΤΟΝ ΚΑΡΚΙΝΟ ΤΟΥ ΜΑΣΤΟΥ ΝΙΚΟΛΑΙΔΗ ΑΔΑΜΑΝΤΙΑ ΠΑΘΟΛΟΓΟΣ-ΟΓΚΟΛΟΓΟΣ Β ΟΓΚΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΝΟΣ. ΜΗΤΕΡΑ

OI PARP ΑΝΑΣΤΟΛΕΙΣ ΣΤΟΝ ΚΑΡΚΙΝΟ ΤΟΥ ΜΑΣΤΟΥ ΝΙΚΟΛΑΙΔΗ ΑΔΑΜΑΝΤΙΑ ΠΑΘΟΛΟΓΟΣ-ΟΓΚΟΛΟΓΟΣ Β ΟΓΚΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΝΟΣ. ΜΗΤΕΡΑ OI PARP ΑΝΑΣΤΟΛΕΙΣ ΣΤΟΝ ΚΑΡΚΙΝΟ ΤΟΥ ΜΑΣΤΟΥ ΝΙΚΟΛΑΙΔΗ ΑΔΑΜΑΝΤΙΑ ΠΑΘΟΛΟΓΟΣ-ΟΓΚΟΛΟΓΟΣ Β ΟΓΚΟΛΟΓΙΚΗ ΚΛΙΝΙΚΗ ΝΟΣ. ΜΗΤΕΡΑ Study Overview Inhibition of poly(adenosine diphosphate [ADP]-ribose) polymerase

More information

The Platinum Salts in the Treatment of Triple Negative Breast Cancer

The Platinum Salts in the Treatment of Triple Negative Breast Cancer The Platinum Salts in the Treatment of Triple Negative Breast Cancer Eric P. Winer, MD Dana-Farber Cancer Institute Harvard Medical School Boston, USA eric_winer@dfci.harvard.edu The Platinum Salts Old

More information

Adjuvant Therapy with Trastuzumab

Adjuvant Therapy with Trastuzumab Adjuvant Therapy with Trastuzumab Hiroji Iwata, M.D. Department of Breast Oncology, Aichi Cancer Center Hospital Although this presentation includes information regarding pharmaceuticals (including products

More information

Breast Cancer: Background

Breast Cancer: Background Disclaimer This slide deck in its original and unaltered format is for educational purposes and is current as of August 2014. All materials contained herein reflect the views of the faculty, and not those

More information

New Treatment Options for Breast Cancer

New Treatment Options for Breast Cancer New Treatment Options for Breast Cancer Brandon Vakiner, PharmD., BCOP Clinical Pharmacy Specialist - Oncology The University of Iowa Hospitals and Clinics Assistant Professor (Clinical) University of

More information

HER2 positive breast cancer. Rachel Dear MBBS PhD Staff specialist SVH/TKCC 18 March 2016

HER2 positive breast cancer. Rachel Dear MBBS PhD Staff specialist SVH/TKCC 18 March 2016 HER2 positive breast cancer Rachel Dear MBBS PhD Staff specialist SVH/TKCC 18 March 2016 Matching breast cancer types to treatment Triple negative Basal Stem cell Chemotherapy PARP inhibitors Her 2 pos

More information

Seconda linea di trattamento

Seconda linea di trattamento XVIII Congresso Nazionale CIPOMO Roma, Giugno 2013 Nuovo paradigma terapeutico nel trattamento del carcinoma mammario HER2+ metastatico: dagli studi alla pratica clinica Seconda linea di trattamento Giorgio

More information

Positività per HER-2 nei carcinomi subcentimetrici

Positività per HER-2 nei carcinomi subcentimetrici Positività per HER-2 nei carcinomi Antonella Ferro U.O. Oncologia Medica Trento Small Tumors Small tumors are becoming increasingly common with the use of mammography > screening Some of these tumors,

More information

San Antonio Breast Cancer Symposium Cancer Therapy and Research Center at UT Health Science Center December 10 14, 2013

San Antonio Breast Cancer Symposium Cancer Therapy and Research Center at UT Health Science Center December 10 14, 2013 Final Analysis of a Phase II, 3-Arm, Randomized Trial of Neoadjuvant Trastuzumab or Lapatinib or the Combination of Trastuzumab and Lapatinib, Followed by 6 cycles of Docetaxel and Carboplatin with Trastuzumab

More information

Biomarker Trends in Breast Cancer Research

Biomarker Trends in Breast Cancer Research WHITE PAPER Biomarker Trends in Breast Cancer Research Jason Hill, PhD, Associate Director, External Science Affairs, Quintiles Quintiles examines the novel drug combinations and mechanisms of action that

More information

HOW FAR WE VE COME: TREATING HER2- POSITIVE BREAST CANCER WITH TARGETED THERAPIES

HOW FAR WE VE COME: TREATING HER2- POSITIVE BREAST CANCER WITH TARGETED THERAPIES HOW FAR WE VE COME: TREATING HER2- POSITIVE BREAST CANCER WITH TARGETED THERAPIES Javier Cortes, Vall d Hebron Institute of Oncology (VHIO), Medica Scientia Innovation Research (MedSIR) Barcelona, Spain

More information

Molecular Classification of Breast Cancer: The Paradigm Shift in the Treatment of Breast Cancer

Molecular Classification of Breast Cancer: The Paradigm Shift in the Treatment of Breast Cancer Molecular Classification of Breast Cancer: The Paradigm Shift in the Treatment of Breast Cancer Rena D. Callahan, MD Assistant Clinical Professor of Medicine Breast Cancer Program Department of Medicine,

More information

Based on SIOG recommendations: Lancet Oncol 2007 (8) p 1101

Based on SIOG recommendations: Lancet Oncol 2007 (8) p 1101 Breast cancer in the older pts H. Wildiers University Hospitals Leuven Belgium Based on SIOG recommendations: Lancet Oncol 2007 (8) p 1101 Introduction INCIDENCE: >40% occurs > 65y of age TUMOR BIOLOGY:

More information

Qu avons-nous appris du développement des anti-her2? Ahmad Awada MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles

Qu avons-nous appris du développement des anti-her2? Ahmad Awada MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles Qu avons-nous appris du développement des anti-her2? Ahmad Awada MD, PhD Medical Oncology Clinic Institut Jules Bordet Université Libre de Bruxelles FOM Lille 2013 1 Her2 breast cancer expression = Poor

More information

FDA grants Roche s Perjeta regimen Priority Review for use before surgery in HER2-positive early-stage breast cancer

FDA grants Roche s Perjeta regimen Priority Review for use before surgery in HER2-positive early-stage breast cancer Media Release Basel, 2 July, 2013 FDA grants Roche s Perjeta regimen Priority Review for use before surgery in HER2-positive early-stage breast cancer Application follows proposed new FDA pathway designed

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Ado-Trastuzumab Emtansine (Trastuzumab-DM1) for Treatment of File Name: Origination: Last CAP Review: Next CAP Review: Last Review: ado_trastuzumab_emtansine_(trastuzumab-dm1)_for_treatment_of_her-2_positivemalignancies

More information

Advances in Neoadjuvant and Adjuvant Therapy

Advances in Neoadjuvant and Adjuvant Therapy Advances in Neoadjuvant and Adjuvant Therapy Kathy S. Albain, MD, FACP Director, Breast Clinical Research Program Co-Director, Breast Oncology Center Director of the Thoracic Oncology Program Professor

More information

PI3K signaling pathway a new target for breast cancer treatment

PI3K signaling pathway a new target for breast cancer treatment PI3K signaling pathway a new target for breast cancer treatment Introduction At the 37 th annual San Antonio Breast Cancer Symposium, SABCS, a number of interesting research trends, novelties as well as

More information

Monitoring Soluble HER2 Levels in Patients with Metastatic Breast Cancer

Monitoring Soluble HER2 Levels in Patients with Metastatic Breast Cancer Transcript Details This is a transcript of a continuing medical education (CME) activity accessible on the ReachMD network. Additional media formats for the activity and full activity details (including

More information

trastuzumab, 600mg/5mL solution for injection (Herceptin ) SMC No. (928/13) Roche Products Ltd

trastuzumab, 600mg/5mL solution for injection (Herceptin ) SMC No. (928/13) Roche Products Ltd trastuzumab, 600mg/5mL solution for injection (Herceptin ) SMC No. (928/13) Roche Products Ltd 06 December 2013 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product

More information

BREAST CANCER IN YOUNG AGE ( 40 YEARS): THE UNIVERSITY OF TENNESSEE MEDICAL CENTER AT KNOXVILLE 10 YEAR EXPERIENCE

BREAST CANCER IN YOUNG AGE ( 40 YEARS): THE UNIVERSITY OF TENNESSEE MEDICAL CENTER AT KNOXVILLE 10 YEAR EXPERIENCE BREAST CANCER IN YOUNG AGE ( 40 YEARS): THE UNIVERSITY OF TENNESSEE MEDICAL CENTER AT KNOXVILLE 10 YEAR EXPERIENCE Snyder D, Heidel RE, Panella T, Bell J, Orucevic A University of Tennessee Medical Center

More information

SAMO FoROMe Post-ESMO 2013 Breast Cancer

SAMO FoROMe Post-ESMO 2013 Breast Cancer SAMO FoROMe Post-ESMO 2013 Breast Cancer Dr. med. Manuela Rabaglio Klinik und Poliklinik für Medizinische Onkologie Breast Cancer Track 300 Abstracts 142 Poster 11 Proffered paper 4 late breaking news

More information

HER2 Testing in Breast Cancer

HER2 Testing in Breast Cancer HER2 Testing in Breast Cancer GAIL H. VANCE, M.D. AGT MEETING JUNE 13, 2014 LOUISVILLE, KENTUCKY No Conflict of Interest to Report Human Epidermal Growth Factor Receptor 2-HER2 Human epidermal growth factor

More information

Inflammatory Breast Cancer: A Unique Pathologic Entity?

Inflammatory Breast Cancer: A Unique Pathologic Entity? Inflammatory Breast Cancer: A Unique Pathologic Entity? Sandra M. Swain, M.D. Director, Washington Cancer Institute Washington Hospital Center Washington DC Outline Overview Therapy High dose chemotherapy

More information

Adjuvant treatment of breast cancer patients with trastuzumab

Adjuvant treatment of breast cancer patients with trastuzumab doi:10.2478/v10019-007-0020-y review Adjuvant treatment of breast cancer patients with trastuzumab Erika Matos, Tanja Čufer Institute of Oncology Ljubljana, Department of Medical Oncology, Ljubljana, Slovenia

More information

ESMO 2014 Summary Breast Cancer

ESMO 2014 Summary Breast Cancer ESMO 2014 Summary Breast Cancer 1 7. 1 0. 2 0 1 4 A N NA D U R I G OVA M E D I C A L O N CO LO GY U N I V E R S I T Y H O S P I TA L S O F G E N E VA Outline 1. Early Breast Cancer Her2+ Neoadjuvant: Lapatax

More information

La Chemioterapia Adiuvante Dose-Dense. Lo studio GIM 2. Alessandra Fabi

La Chemioterapia Adiuvante Dose-Dense. Lo studio GIM 2. Alessandra Fabi La Chemioterapia Adiuvante Dose-Dense Lo studio GIM 2 Alessandra Fabi San Antonio Breast Cancer Symposium -December 10-14, 2013 GIM 2 study Epirubicin and Cyclophosphamide (EC) followed by Paclitaxel (T)

More information

I. THE IMPORTANCE OF HER2 IN BREAST CANCER

I. THE IMPORTANCE OF HER2 IN BREAST CANCER I. THE IMPORTANCE OF HER2 IN BREAST CANCER The human epidermal growth factor receptors (HER), also known as ERBB receptors, are a family of signal transduction proteins. There are 4 family members in humans

More information

Appendix One. HER2-positive early breast cancer, its treatment and prognosis

Appendix One. HER2-positive early breast cancer, its treatment and prognosis Appendix One. HER2-positive early breast cancer, its treatment and prognosis Breast cancer and HER2/neu over-expression Health need is one of PHARMAC s nine decision criteria (http://www.pharmac.govt.nz/pdf/231205.pdf

More information

Cytotoxic Therapy in Metastatic Breast Cancer

Cytotoxic Therapy in Metastatic Breast Cancer Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer Cytotoxic Therapy in Metastatic Breast Cancer Cytotoxic Therapy in Metastatic Breast Cancer Version 2002: von Minckwitz Versions

More information

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai

Maintenance therapy in in Metastatic NSCLC. Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Maintenance therapy in in Metastatic NSCLC Dr Amit Joshi Associate Professor Dept. Of Medical Oncology Tata Memorial Centre Mumbai Definition of Maintenance therapy The U.S. National Cancer Institute s

More information

Metastatic Breast Cancer 201. Carolyn B. Hendricks, MD October 29, 2011

Metastatic Breast Cancer 201. Carolyn B. Hendricks, MD October 29, 2011 Metastatic Breast Cancer 201 Carolyn B. Hendricks, MD October 29, 2011 Overview Is rebiopsy necessary at the time of recurrence or progression of disease? How dose a very aggressive treatment upfront compare

More information

NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER

NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER NOTTINGHAM UNIVERSITY NHS TRUST BREAST INSTITUTE GUIDELINE NEOADJUVANT CHEMOTHERAPY (NACT) FOR BREAST CANCER Definitions: NACT is recommended initial treatment for inflammatory breast cancer and inoperable

More information

Esin Oktay, Özlem Yersal, Nezih Meydan, Mehmet SaLJroLlu, Ömer UyanJk, andsabribarutca. 1. Introduction. 2. Case Presentation

Esin Oktay, Özlem Yersal, Nezih Meydan, Mehmet SaLJroLlu, Ömer UyanJk, andsabribarutca. 1. Introduction. 2. Case Presentation Case Reports in Oncological Medicine Volume 2013, Article ID 234391, 4 pages http://dx.doi.org/10.1155/2013/234391 Case Report Nearly Complete Response of Brain Metastases from HER2 Overexpressing Breast

More information

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509. Efficacy Results from the ToGA Trial: A Phase III Study of Trastuzumab Added to Standard Chemotherapy in First-Line HER2- Positive Advanced Gastric Cancer Van Cutsem E et al. Proc ASCO 2009;Abstract LBA4509.

More information

La Terapia Personalizzata in Oncologia

La Terapia Personalizzata in Oncologia AZIENDA OSPEDALIERO-UNIVERSITARIA DI MODENA La Terapia Personalizzata in Oncologia Roma, 25-26 Ottobre 2011 Stato dell arte e prospettive della Target Therapy nei tumori mammari PierFranco Conte Department

More information

Food and Drug Administration FDA

Food and Drug Administration FDA 517 1997 Food and Drug Administration FDA 2 HER-2 -DM1 trastuzumab emtansine T- DM1 HER mammalian target of rapamyein mtor Ⅱ Ⅲ HER 1 HER-2 HER-2 HER-2 20% Ⅲ 1-3 HER-2 863 2006AA02A246 100071 E-mail jiangzefei@

More information

LOOKING FORWARD PUMA BIOTECHNOLOGY, INC. 2014 ANNUAL REPORT

LOOKING FORWARD PUMA BIOTECHNOLOGY, INC. 2014 ANNUAL REPORT LOOKING FORWARD PUMA BIOTECHNOLOGY, INC. 2014 ANNUAL REPORT Puma Biotechnology, Inc. is a development stage biopharmaceutical company that acquires and develops innovative products for the treatment of

More information

PROSPETTIVE FUTURE NEL TRATTAMENTO. Cinzia Ortega Dipartimento di Oncologia Medica Fondazione del Piemonte per l Oncologia I.R.C.C.S.

PROSPETTIVE FUTURE NEL TRATTAMENTO. Cinzia Ortega Dipartimento di Oncologia Medica Fondazione del Piemonte per l Oncologia I.R.C.C.S. PROSPETTIVE FUTURE NEL TRATTAMENTO MEDICO DEL mrcc Cinzia Ortega Dipartimento di Oncologia Medica Fondazione del Piemonte per l Oncologia I.R.C.C.S. Candiolo Future strategies in mrcc Improve therapeutic

More information

Targeted Therapy What the Surgeon Needs to Know

Targeted Therapy What the Surgeon Needs to Know Targeted Therapy What the Surgeon Needs to Know AATS Focus in Thoracic Surgery 2014 David R. Jones, M.D. Professor & Chief, Thoracic Surgery Memorial Sloan Kettering Cancer Center I have no disclosures

More information

Effects of Herceptin on circulating tumor cells in HER2 positive early breast cancer

Effects of Herceptin on circulating tumor cells in HER2 positive early breast cancer Effects of Herceptin on circulating tumor cells in HER2 positive early breast cancer J.-L. Zhang, Q. Yao, J.-H. Chen,Y. Wang, H. Wang, Q. Fan, R. Ling, J. Yi and L. Wang Xijing Hospital Vascular Endocrine

More information

Long-term Outcomes of Neoadjuvant Treatment of HER2-Positive Breast Cancer

Long-term Outcomes of Neoadjuvant Treatment of HER2-Positive Breast Cancer Long-term Outcomes of Neoadjuvant Treatment of HER2-Positive Breast Cancer Bingnan Zhang, MD, MBA, and Sara Hurvitz, MD The authors are affiliated with the David Geffen School of Medicine at UCLA in Los

More information

HER2 Status: What is the Difference Between Breast and Gastric Cancer?

HER2 Status: What is the Difference Between Breast and Gastric Cancer? Ask the Experts HER2 Status: What is the Difference Between Breast and Gastric Cancer? Bharat Jasani MBChB, PhD, FRCPath Marco Novelli MBChB, PhD, FRCPath Josef Rüschoff, MD Robert Y. Osamura, MD, FIAC

More information

The Impact of Taxotere on Adjuvant Breast Cancer

The Impact of Taxotere on Adjuvant Breast Cancer The Impact of Taxotere on Adjuvant Breast Cancer a report by Pierre Fumoleau and Henri Roché Centre Georges François Leclerc, Dijon, and Institut Claudius Regaud, Toulouse, France DOI: 10.17925/EOH.2005.0.0.1l

More information

Neoadjuvant (Primary) Systemic Therapy

Neoadjuvant (Primary) Systemic Therapy Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer AGO e. V. in der DGGG e.v. sowie in der DKG e.v. Guidelines Breast Version 2015.1 Neoadjuvant (Primary) Systemic Therapy Neoadjuvant

More information

Treating Patients with Hormone Receptor Positive, HER2 Positive Operable or Locally Advanced Breast Cancer

Treating Patients with Hormone Receptor Positive, HER2 Positive Operable or Locally Advanced Breast Cancer Breast Studies Adjuvant therapy after surgery Her 2 positive Breast Cancer B 52 Docetaxel, Carboplatin, Trastuzumab, and Pertuzumab With or Without Estrogen Deprivation in Treating Patients with Hormone

More information

In treating triple negative breast cancer,

In treating triple negative breast cancer, Treatment of triple negative breast cancer Triple negative breast cancers, as a subgroup, are associated with a poor prognosis. But different subtypes within triple negative disease are associated with

More information

Triple negative Breast Cancer Patient

Triple negative Breast Cancer Patient Triple negative Breast Cancer Patient Alison L Jones November 2013 Mrs Trisha Negative Aged 52) Diagnosed November 2001 T2 N1 (2/11)M0 Left breast. No family history WLE/ANC then FEC/T + RT Relapsed 2013

More information

HER2-Positive Breast Cancer: Update on New and Emerging Agents

HER2-Positive Breast Cancer: Update on New and Emerging Agents HER2-Positive Breast Cancer: Update on New and Emerging Agents Alexandra Drakaki, MD, and Sara A. Hurvitz, MD Abstract The most common malignancy and second leading cause of cancer-related death in women

More information

Jennifer Diamond M.D. Assistant Professor Developmental Therapeutics and Breast Oncology University of Colorado Anschutz Medical Campus SUMO Fall

Jennifer Diamond M.D. Assistant Professor Developmental Therapeutics and Breast Oncology University of Colorado Anschutz Medical Campus SUMO Fall Jennifer Diamond M.D. Assistant Professor Developmental Therapeutics and Breast Oncology University of Colorado Anschutz Medical Campus SUMO Fall Meeting September 26, 2015 To understand the biology and

More information

Neoadjuvant (Primary) Systemic Therapy

Neoadjuvant (Primary) Systemic Therapy Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer AGO e. V. in der DGGG e.v. sowie in der DKG e.v. Guidelines Breast Version 2016.1 Neoadjuvant (Primary) Systemic Therapy Neoadjuvant

More information

Current and future anti-her2 therapy in breast cancer

Current and future anti-her2 therapy in breast cancer J BUON 2013; 18(1): 4-16 ISSN: 1107-0625 www.bu-on.org/jbuon E-mail: jbuon@ath.forthnet.gr REVIEW ARTICLE Current and future anti-her2 therapy in breast cancer S. Vrbic 1,2, I. Pejcic 1,2, S. Filipovic

More information

GENETIC PROFILES AND TARGETED TREATMENT OF CANCER - PERSONALIZED MEDICINE

GENETIC PROFILES AND TARGETED TREATMENT OF CANCER - PERSONALIZED MEDICINE GENETIC PROFILES AND TARGETED TREATMENT OF CANCER - PERSONALIZED MEDICINE Branko Zakotnik MD, PhD Department of Medical Oncology Institute of Oncology Ljubljana 1 I have no conflict of interest to declare

More information

Lung Cancer Research: From Prevention to Cure!

Lung Cancer Research: From Prevention to Cure! Lung Cancer Research: From Prevention to Cure! Ravi Salgia, M.D, Ph.D Associate Professor of Medicine Director, Thoracic Oncology Research Program Department of Medicine Section of Hematology/Oncology

More information

AIDS IN IDENTIFYING CANDIDATES FOR HER2-TARGETED THERAPY

AIDS IN IDENTIFYING CANDIDATES FOR HER2-TARGETED THERAPY AIDS IN IDENTIFYING CANDIDATES FOR HER2-TARGETED THERAPY THE HERMARK BREAST CANCER ASSAY HERmark is based on our proprietary VeraTag technology that precisely quantifies HER2 proteins and protein complexes

More information

Prognostic Factors for Triple-Negative Breast Cancer Patients Receiving Preoperative Systemic Chemotherapy

Prognostic Factors for Triple-Negative Breast Cancer Patients Receiving Preoperative Systemic Chemotherapy Original Study Prognostic Factors for Triple-Negative Breast Cancer Patients Receiving Preoperative Systemic Chemotherapy Sota Asaga, Takayuki Kinoshita, Takashi Hojo, Junko Suzuki, Kenjiro Jimbo, Hitoshi

More information

Overview of Ovarian Cancer. Dr. Sinead Noonan 13/03/2012

Overview of Ovarian Cancer. Dr. Sinead Noonan 13/03/2012 Overview of Ovarian Cancer Dr. Sinead Noonan 13/03/2012 Ovarian Cancer 4 th most common cause of cancer death in women 15,000 deaths/year in the US Each year 300 new cases in Ireland 80% epithelial cell

More information

Progress in Treating Advanced Triple Negative Breast Cancer

Progress in Treating Advanced Triple Negative Breast Cancer Progress in Treating Advanced Triple Negative Breast Cancer Lisa A. Carey, M.D. University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center Triple Negative Breast Cancer by Subtype

More information

BREAST CANCER - METASTATIC & LOCALLY ADVANCED CHEMOTHERAPY REGIMENS Capecitabine. Capecitabine + Docetaxel. Capecitabine + Vinorelbine

BREAST CANCER - METASTATIC & LOCALLY ADVANCED CHEMOTHERAPY REGIMENS Capecitabine. Capecitabine + Docetaxel. Capecitabine + Vinorelbine Capecitabine Capecitabine 1000-1250mg/m 2 oral TWICE daily for 14 days Until disease progression Capecitabine + Docetaxel Capecitabine 750-1000mg/m 2 oral TWICE daily for 14 days Up to 6 cycles Capecitabine

More information

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015

Adjuvant Therapy Non Small Cell Lung Cancer. Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 Adjuvant Therapy Non Small Cell Lung Cancer Sunil Nagpal MD Director, Thoracic Oncology Jan 30, 2015 No Disclosures Number of studies Studies Per Month 12 10 8 6 4 2 0 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3

More information

Symposium article. Trastuzumab combined with chemotherapy for the treatment of HER2-positive metastatic breast cancer: Pivotal trial data

Symposium article. Trastuzumab combined with chemotherapy for the treatment of HER2-positive metastatic breast cancer: Pivotal trial data Annals of Oncology 12 (Suppl. I): S57-S62, 2001. 2001 Kluwer Academic Publishers. Primed in the Netherlands. Symposium article Trastuzumab combined with chemotherapy for the treatment of HER2-positive

More information

Neoadjuvant Breast Cancer Therapy and Drug Development

Neoadjuvant Breast Cancer Therapy and Drug Development Neoadjuvant Breast Cancer Therapy and Drug Development Patricia Cortazar, MD, and Paul G. Kluetz, MD The authors are affiliated with the Office of Hematology and Oncology Products at the Center for Drug

More information

BioPATH: A Study of Biomarker Profiles in Asia Pacific HER2 Breast Cancer Patients Treated with Lapatinib and Other Anti-HER2 Therapy

BioPATH: A Study of Biomarker Profiles in Asia Pacific HER2 Breast Cancer Patients Treated with Lapatinib and Other Anti-HER2 Therapy BioPATH: A Study of Biomarker Profiles in Asia Pacific HER2 Breast Cancer Patients Treated with Lapatinib and Other Anti-HER2 Therapy Soonmyung Paik 1 ; Gyungyub Gong 2 ; Yap Yoon Sim 3 ; Tae- You Kim

More information

Pharmacogenomic markers in EGFR-targeted therapy of lung cancer

Pharmacogenomic markers in EGFR-targeted therapy of lung cancer Pharmacogenomic markers in EGFR-targeted therapy of lung cancer Rafal Dziadziuszko, MD, PhD University of Colorado Cancer Center, Aurora, CO, USA Medical University of Gdansk, Poland EMEA Workshop on Biomarkers,

More information

GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER

GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER GUIDELINES ADJUVANT SYSTEMIC BREAST CANCER Author: Dr Susan O Reilly On behalf of the Breast CNG Written: December 2008 Agreed at CNG: June 2009 & June 2010 Review due: June 2011 Guidelines Adjuvant Systemic

More information

REVIEWS. Treatment of HER2-positive breast cancer: current status and future perspectives

REVIEWS. Treatment of HER2-positive breast cancer: current status and future perspectives Treatment of HER2-positive breast cancer: current status and future perspectives Carlos L. Arteaga, Mark X. Sliwkowski, C. Kent Osborne, Edith A. Perez, Fabio Puglisi and Luca Gianni Abstract The advent

More information

Measurement of HER2. Daniel F. Hayes, MD Clinical Director, Breast Oncology Program University of Michigan Comprehensive Cancer Center

Measurement of HER2. Daniel F. Hayes, MD Clinical Director, Breast Oncology Program University of Michigan Comprehensive Cancer Center Measurement of HER2 Daniel F. Hayes, MD Clinical Director, Breast Oncology Program University of Michigan Comprehensive Cancer Center Trastuzumab Metastatic Adjuvant Lapatinib Metastatic Trials Why Test

More information

Gynäkologische Onkologie-Klinische Studien

Gynäkologische Onkologie-Klinische Studien Gynäkologische Onkologie-Klinische Studien Breast cancer A randomized, phase 2 trial of AEZS-108 in chemotherapy refractory triple negative (ER/PR/HER2-negative) LHRH-R positive metastatic breast cancer

More information

Final version

Final version MINDACT (Microarray In Node negative Disease may Avoid ChemoTherapy) A prospective, randomised study comparing the 70-gene expression signature with common clinical-pathological criteria in selecting patients

More information

Concepts of palliative systemic chemotherapy for Metastatic Breast Cancer. Karen King April 16, 2016

Concepts of palliative systemic chemotherapy for Metastatic Breast Cancer. Karen King April 16, 2016 Concepts of palliative systemic chemotherapy for Metastatic Breast Cancer Karen King April 16, 2016 Faculty/Presenter Disclosure Presenter: Dr. Karen King Relationships with commercial interests: Grants/Research

More information

National Institute for Health and Clinical Excellence

National Institute for Health and Clinical Excellence Comment 1: the draft remit Bevacizumab in combination with a taxane for the first-line treatment of metastatic breast cancer Table of responses to consultee and commentator comments on the draft scope

More information

La biologia molecolare «driver» delle scelte terapeutiche: k mammario HER2+

La biologia molecolare «driver» delle scelte terapeutiche: k mammario HER2+ La biologia molecolare «driver» delle scelte terapeutiche: k mammario HER2+ Dr.ssa Lucia Del Mastro U.O. Sviluppo Terapie Innovative IRCCS AOU San Martino-IST Verona, 18 settembre 2015 Copyright 2014 -

More information

Cancer patients waiting for potentially live-saving treatments in UK

Cancer patients waiting for potentially live-saving treatments in UK Cancer patients waiting for potentially live-saving treatments in UK 29 May 2005 UK patients are waiting too long for new treatments, according to a 'Dossier of Delay' compiled by information charity CancerBACUP.

More information

Novel Targets in Breast Cancer. Vandana Abramson, MD May 1, 2010

Novel Targets in Breast Cancer. Vandana Abramson, MD May 1, 2010 Novel Targets in Breast Cancer Vandana Abramson, MD May 1, 2010 Disclosure Information I have no financial relationships to disclose relevant to the content of this presentation. Breast ca: many diseases

More information

A disease of populations of cells that live, divide, invade and spread without regard to normal limits

A disease of populations of cells that live, divide, invade and spread without regard to normal limits 1 Targeted Cancer Therapies Mark McKeage Medical Oncology Specialist Professor in Clinical Pharmacology 2 Cancer Definition- A disease of populations of cells that live, divide, invade and spread without

More information

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D.

Prognostic and Predictive Factors in Oncology. Mustafa Benekli, M.D. Prognostic and Predictive Factors in Oncology Mustafa Benekli, M.D. NCI Definitions ESMO Course -Essentials of Medical Oncology -Istanbul 2 Prognostic factor: NCI Definition A situation or condition, or

More information

Chemotherapy in Ovarian Cancer. Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group

Chemotherapy in Ovarian Cancer. Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group Chemotherapy in Ovarian Cancer Dr R Jones Consultant Medical Oncologist South Wales Gynaecological Oncology Group Adjuvant chemotherapy for early stage EOC Fewer than 30% women present with FIGO stage

More information

Clinical Management Protocol Chemotherapy Breast Cancer. Protocol for Planning and Treatment

Clinical Management Protocol Chemotherapy Breast Cancer. Protocol for Planning and Treatment Protocol for Planning and Treatment The process to be followed when a course of chemotherapy is required to treat: BREAST CANCER Patient information given at each stage following agreed information pathway

More information

Abstract Introduction. Aim of the study. Conclusion. Patients and methods. Keywords. Results. R. Abo El Hassan 1, M. Moneer 2

Abstract Introduction. Aim of the study. Conclusion. Patients and methods. Keywords. Results. R. Abo El Hassan 1, M. Moneer 2 Original Study Outcome of HER2 positive luminal operable breast cancer in comparison with outcome of other operable luminal breast cancer patients: Long follow-up of single center randomized study R. Abo

More information

Cycle frequency: Every three weeks Total number of cycles: 4 (Adjuvant) 6 (Palliative)

Cycle frequency: Every three weeks Total number of cycles: 4 (Adjuvant) 6 (Palliative) AC (Doxorubicin/Cyclophosphamide) Breast Cancer Adjuvant, Palliative Doxorubicin 60mg/m 2 iv Day 1 Cyclophosphamide 600mg/m 2 iv Day 1 Cycle frequency: Every three weeks Total number of cycles: 4 (Adjuvant)

More information

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment.

Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. 1 Low dose capecitabine is effective and relatively nontoxic in breast cancer treatment. John T. Carpenter, M.D. University of Alabama at Birmingham NP 2508 1720 Second Avenue South Birmingham, AL 35294-3300

More information

Monoclonal Antibodies in Cancer. Ralph Schwall, PhD Associate Director, Translational Oncology Genentech, Inc.

Monoclonal Antibodies in Cancer. Ralph Schwall, PhD Associate Director, Translational Oncology Genentech, Inc. Monoclonal Antibodies in Cancer Ralph Schwall, PhD Associate Director, Translational Oncology Genentech, Inc. Disclaimer I had nothing to do with Herceptin Using lessons learned in new antibody projects

More information

Targeted therapies for Early Stage Breast Cancer. Cynthia Vakhariya D.O. Providence Hospital

Targeted therapies for Early Stage Breast Cancer. Cynthia Vakhariya D.O. Providence Hospital Targeted therapies for Early Stage Breast Cancer Cynthia Vakhariya D.O. Providence Hospital Case 55-year-old postmenopausal woman Routine screening mammogram 3 cm irreg mass in L breast Left breast ultrasound

More information

What is breast cancer?

What is breast cancer? Breast Cancer What is breast cancer? Let us explain it to you. www.anticancerfund.org www.esmo.org ESMO/ACF Patient Guide Series based on the ESMO Clinical Practice Guidelines BREAST CANCER: A GUIDE FOR

More information

Optimizing Anti-HER2 Therapy in Advanced Breast Cancer: Integrating New Data and Agents Into Practice

Optimizing Anti-HER2 Therapy in Advanced Breast Cancer: Integrating New Data and Agents Into Practice Optimizing Anti-HER2 Therapy in Advanced Breast Cancer: Integrating New Data and Agents Into Practice Learning Objectives Discuss recent clinical trials showing survival advantages in the treatment of

More information

Sequential adjuvant docetaxel and anthracycline chemotherapy for node positive breast cancers: a retrospective study

Sequential adjuvant docetaxel and anthracycline chemotherapy for node positive breast cancers: a retrospective study JBUON 2013; 18(2): 314-320 ISSN: 1107-0625 www.jbuon.com E-mail: info@jbuon.com ORIGINAL ARTICLE Sequential adjuvant docetaxel and anthracycline chemotherapy for node positive breast cancers: a retrospective

More information

Nieuwe ontwikkelingen op het gebied van de angiogeneseremmers

Nieuwe ontwikkelingen op het gebied van de angiogeneseremmers Nieuwe ontwikkelingen op het gebied van de angiogeneseremmers Emile Voest, MD, PhD Department of Medical Oncology University Medical Center Utrecht the Netherlands 4e Nascholing Targeted Therapy April

More information

Treatment Paradigm in NSCLC Treatment

Treatment Paradigm in NSCLC Treatment Treatment Paradigm in NSCLC Treatment Era of Targeted Therapy Aumkhae Sookprasert, MD Medicine Department, KKU Which factors taken to be account in NSCLC treatment? 1. Staging 2. ECOG performance status

More information

What s New With HER2?

What s New With HER2? What s New With HER2? Trastuzumab emtansine and pertuzumab for metastatic breast cancer Lindsay Livingston Pharmacist CancerCare Manitoba October 3, 2014 Presenter Disclosure Faculty: Lindsay Livingston

More information