What is the optimal sequence of anti-her2 therapy in metastatic breast cancer?
|
|
- Garry Thomas
- 8 years ago
- Views:
Transcription
1 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
2 Herceptin plus a taxoid extends survival compared with taxoid alone Paclitaxel Docetaxel H+P IHC 3+ (n=68) P IHC 3+ (n=77) H+D (n=92) (n=94) ORR (%) * 36 D DR (median, months) TTP (median, months) OS (median, months) ** *** H = Herceptin ; P = paclitaxel; D = docetaxel * p=0.001; ** p=<0.05; ***p= Slamon D, et al. N Eng J Med 2001;344: Marty et al JCO, 2005; 23:
3 With trastuzumab, HER2-positive disease no longer dictates the probability of survival in MBC Overall survival (%) HER2-normal HER2-positive with trastuzumab HER2-positive without trastuzumab Time (months from diagnosis) MBC, metastatic breast cancer Dawood et al. JCO 2010
4 Importance of continued HER2 inhibition What to do beyond disease progression? Herceptin beyond progression (GBG-26) n=156 Cap + trast Cap P value Lapatinib with capecitabine ( 151 study) n=399 Cap + Lap Cap P value TTP (months) TTP (months) <0.001 RR (%) CBR (%) RR (%) OR= CBR (%) OR= OS (months) OS (months) von Minckwitz JCO (2009) 27: Cameron BCRT (2008) 112:
5 Importance of combined HER2 inhibition Herceptin and Lapatinib Downstream signaling cascade
6 Importance of combined HER2 inhibition EGF : lapatinib ± trastzumab Key Inclusion HER2+(FISH+/ IHC3+) MBC Progression on Anthracycline Taxane Trastuzumab Progression on most recent trastuzumab regimen Stratification Factors Visceral Disease Hormone Receptor R A N D O M I Z A T I O N Lapatinib 1500 mg/day PO N=148 Crossover if PD after 4wk therapy (N=73) Lapatinib 1000 mg/day PO Trastuzumab 4 2 mg/kg IV qw N=148 Blackwell, JCO 2012, 30:
7 Cumulative % Alive without Progression EGF : Lapatinib ± trastuzumab progression-free survival Subjects At Risk L 148 L+T % % L N = 145 L+T N = 146 Progressed or Died, n Median, wks Hazard ratio (95% CI) 0.73 (0.57, 0.93) P value Mo PFS Time from Randomization (wks) Blackwell, JCO 2012, 30:
8 EGF : Lapatinib ± trastuzumab overall survival Died n (%) Median P-value Lapatinib (n=145) 113 (78%) 9.5 months Lapatinib + trastuzumab (n=146) 105 (72%) 14 months HR: 0.74 (95% CI 0.57, 0.97) Survival (%) Time from randomisation (months) EMA licensing recommendation ER+ve ER-ve Lapatinib 11 months 9 months Lapatinib + trastuzumab 12 months 16 months Blackwell, JCO 2012, 30:
9 Importance of combined HER2 inhibition Herceptin and Lapatinib Pertuzumab Downstream signaling cascade Activates antibody-dependent cellular cytotoxicity Prevents receptor dimerisation Potent inhibitor of HER2/HER2- and HER2/HER3-mediated signalling pathways
10 Pertuzumab-Herceptin is effective in patients whose disease is progressing on herceptin (P + H) (n=66) CR, % 7.6 PR, % 16.7 ORR, % 24.2 SD >6 months, % 25.8 CBR, % (CR + PR + SD >6 months) 50.0 PD, % 50.0 CBR, clinical benefit rate; CR, complete response; ORR, overall response rate; P, Perjeta; PD, progressive disease; PR, partial response; SD, stable disease; H, Herceptin; cohorts 1 and 2 were a Simon 2-stage design 1. Baselga J et al. J Clin Oncol 2010;
11 The importance of combined HER2 inhibition CLEOPATRA n=406 Placebo + trastuzumab PD Patients with HER2-positive MBC centrally confirmed (N=808) 1:1 Docetaxel 6 cycles recommended Pertuzumab + trastuzumab PD n=402 Docetaxel 6 cycles recommended Randomization was stratified by geographic region and prior treatment status (neo/adjuvant chemotherapy received or not) HER2, human epidermal growth factor receptor 2; MBC, metastatic breast cancer; PD, progressive disease 11
12 Cleopatra: Docetaxel & herceptin ± pertuzumab. Independently reviewed objective response Placebo + Herceptin + docetaxel (n=336) Perjeta + Herceptin + docetaxel (n=343) Objective response rate, n (%) 233 (69.3) 275 (80.2) Difference in response rates (95% CI) 10.8 % points ( ) P=0.001* Complete response rate, n (%) Partial response rate, n (%) 14 (4.2) 219 (65.2) 19 (5.5) 256 (74.6) Stable disease, n (%) 70 (20.8) 50 (14.6) Progressive disease, n (%) 28 (8.3) 13 (3.8) Unable to assess or no assessment, n (%) 5 (1.5) 5 (1.5) J Baselga et al N Engl J Med 2012;366:109-19
13 Cleopatra: Docetaxel & herceptin ± pertuzumab. Updated investigator assessed PFS Progression-free survival (%) n at risk Pjt + H + D Time (months) Pla + H + D Analysis was exploratory only D, docetaxel; PFS, progression-free survival; Pla, placebo; Pjt, Perjeta; H, Herceptin 218 Pjt + H + D: median 18.7 months Pla + H + D: median 12.4 months Pjt + H + D Pla + H + D Independently assessed PFS, data cut-off: May HR= % CI =6.3 months Swain et al. San Antonio Breast Cancer Symposium 2012, Poster P
14 Cleopatra: Docetaxel & herceptin ± pertuzumab. Updated overall survival Overall survival (%) year 94% 89% 2 years 81% 69% Time (months) 3 years 66% 50% Ptz + T + D: 113 events; median not reached Pla + T + D: 154 events; median 37.6 months HR= % CI p= Swain et al. San Antonio Breast Cancer Symposium 2012, Poster P
15 Cleopatra: Docetaxel & herceptin ± pertuzumab. Adverse events Adverse event, n (%) Placebo + Herceptin + docetaxel (n=397) Perjeta + Herceptin + docetaxel (n=407) Diarrhea 184 (46.3) 272 (66.8) Constipation 99 (24.9) 61 (15.0) Alopecia 240 (60.5) 248 (60.9) Neutropenia 197 (49.6) 215 (52.8) Nausea 165 (41.6) 172 (42.3) Decreased appetite 105 (26.4) 119 (29.2) Fatigue 146 (36.8) 153 (37.6) Asthenia 120 (30.2) 106 (26.0) Rash 96 (24.2) 137 (33.7) Mucosal inflammation 79 (19.9) 113 (27.8) Peripheral edema 119 (30.0) 94 (23.1) Febrile neutropenia 30 (7.6) 56 (13.8) Dry skin 17 (4.3) 43 (10.6) Green: higher in Perjeta arm Blue: higher in placebo arm J Baselga et al N Engl J Med 2012;366:109-19
16 Cleopatra: Docetaxel & herceptin ± pertuzumab. PFS by prior therapy Placebo + Herceptin + docetaxel Median PFS, months Perjeta + Herceptin + docetaxel Median PFS, months Hazard ratio (CI) Prior (neo)adjuvant Herceptin treatment (n = 88) ( ) No prior (neo)adjuvant Herceptin treatment (n = 288) ( ) PFS, progression-free survival J Baselga et al N Engl J Med 2012;366:109-19
17 Can we avoid all this mucking about with signal transduction? armed Herceptin for HER2+ BC DM1 = microtubule targeting agent Average number DM1 molecules/ monoclonal antibody = 3.5
18 Phase II study of T-DM1 vs trastuzumab + docetaxel in 1st-line HER2-positive MBC HER2-positive MBC No prior chemotherapy for metastatic disease (n=120) T-DM1 Trastuzumab + docetaxel Hurvitz S A et al. JCO 2013;31:
19 T-DM1 vs trastuzumab + docetaxel: response rates Trastuzumab + docetaxel (n=69) a T-DM1 (n=67) Patients with an objective response, b n (%) 40 (58.0) 43 (64.2) 95% CI Objective responses, n (%) Complete response 3 (4.3) 7 (10.4) Partial response 37 (53.6) 36 (53.7) Stable disease 23 (33.3) 13 (19.4) Progressive disease 4 (5.8) 8 (11.9) Unable to evaluate or missing 2 (2.9) 3 (4.5) Patients with clinical benefit, c n (%) 56 (81.2) 50 (74.6) 95% CI Hurvitz S A et al. JCO 2013;31:
20 T-DM1 vs trastuzumab + docetaxel: progression-free survival Hurvitz S A et al. JCO 2013;31:
21 T-DM1 vs trastuzumab + docetaxel: overall survival (interim analysis). Hurvitz S A et al. JCO 2013;31:
22 T-DM1 vs trastuzumab + docetaxel: quality of life (A) Mean change in Functional Assessment of Cancer Therapy- Breast (FACT-B) Trial Outcome Index (TOI) scores from baseline. (B) Kaplan-Meier estimates of time to symptom progression (TOI-PFB [Trial Outcome Index-Physical/Functional/ Breast]). Hurvitz S A et al. JCO 2013;31:
23 EMILIA Study Design HER2-positive LABC or MBC (N=991) Prior taxane and trastuzumab Progression on metastatic treatment or within 6 months of adjuvant treatment 1:1 T-DM1 3.6 mg/kg q3w IV Capecitabine 1000 mg/m 2 PO bid, days 1 14, q3w + Lapatinib 1250 mg/day PO qd PD PD Line of therapy 1 st line 12% 2 nd line 38% 3 rd line 50% Verma et al NEJM :
24 T-DM1 vs Cap+Lap ORR and Duration of Response Objective response rate (ORR) Duration of response (DOR) Patients, % Difference: 12.7% (95% CI, 6.0, 19.4) P= % 120/389 Cap + Lap 43.6% 173/397 T-DM1 Proportion progression-free Median, months (95% CI) Cap + Lap 6.5 (5.5, 7.2) T-DM (8.4, 20.8) Time (months) Verma et al NEJM :
25 Proportion progression-free T-DM1 vs Cap+Lap progression-free survival Median (months) No. of events Cap + Lap T-DM Stratified HR=0.650 (95% CI, 0.55, 0.77) P< Time (months) Unstratified HR=0.66 (P<0.0001). Verma et al NEJM :
26 T-DM1 vs Cap+Lap updated overall survival Median (months) No. of events Cap + Lap Proportion surviving % 85.2% T-DM Stratified HR=0.682 (95% CI, 0.55, 0.85); P= Efficacy stopping boundary P= or HR= % 51.8% Time (months) Data cut-off July 31, 2012; Unstratified HR=0.70 (P=0.0012). Verma et al NEJM :
27 T-DM1 vs capecitabine and lapatinib (EMILIA): patient-reported outcomes The FACT-Breast Trial Outcome Index 1 evaluates Physical Well-Being Functional Well-Being Breast Cancer-Specific Symptoms Symptom progression defined as 5-point decrease from baseline Time to symptom progression Cap + Lap (n=445) T-DM1 (n=450) Median, mos HR (95% CI) P value 0.80 (0.67, 0.95) Brady MJ, et al. J Clin Oncol Blackwell, ASCO
28 TH3RESA Study Schema HER2-positive (central) advanced BC (N=602) 2 T-DM1 3.6 mg/kg q3w IV (n=400) PD 2 prior HER2-directed therapies for advanced BC Prior treatment with trastuzumab, lapatinib, and a taxane 1 Treatment of physician s choice (TPC)* (n=200) PD T-DM1 (optional crossover) Median number of prior regimens for MBC =4 (range 1-19) Stable brain metastases in 12% patients TPC:- 83% included HER2-directed therapies 17% single-agent chemotherapy Wildiers ESMO
29 TH3RESA: Overall response rates in patients ORRTH3RESATH3RESA By Investigator Assessment in Patients With Measurable Disease with measurable disease Difference: 22.7% (95% CI, 16.2, 29.2) P< % 30 Patients, % % /163 TPC 108/345 T-DM1 Wildiers ESMO 2013
30 TH3RESA: PFS for Patients Treated With Trastuzumab-Containing Regimens Proportion progression-free TPC (T-containing) (n=149) T-DM1 (n=404) Median (months) No. of events Stratified HR=0.558 (95% CI, 0.437, 0.711) P< Unstratified HR=0.54 (P<0.0001) Time (months) Wildiers ESMO 2013
31 TH3RESA: interim overall survival analysis 1.0 Observed 21% of targeted events Proportion surviving TPC (n=198) Time (months) T-DM1 (n=404) Median (months) 14.9 NE No. of events Stratified HR=0.552 (95% CI, 0.369, 0.826); P= Efficacy stopping boundary HR<0.363 or P< patients in the TPC arm received crossover T-DM1 treatment after documented progression. Unstratified HR=0.57 (P=0.004). Wildiers ESMO 2013
32 Clinical trials in HER2-postitive metastatic breast cancer with gains in PFS ± OS CLEOPATRA (n=808) 1 st -line setting 1 st, 2 nd + 3 rd 3 rd + 4 th TDM4450g (n=137) EMILIA (n=991) EGF (n=291) H+P+T vs H+T T-DM1 vs H+T T-DM1 vs L+C H+L vs L prior herceptin 10% 20% 100% (16%< 6m adj H) CNS disease excluded allowed? n absent or controlled (11%) 100% ( 3 regimens) absent or controlled (12%) 32
33 Clinical trials in HER2-postitive metastatic breast cancer with gains in PFS ± OS CLEOPATRA (n=808) 1 st -line setting 1 st, 2 nd + 3 rd 3 rd + 4 th TDM4450g (n=137) EMILIA (n=991) EGF (n=291) H+P+T vs H+T T-DM1 vs H+T T-DM1 vs L+C H+L vs L prior herceptin 10% 20% 100% (16%< 6m adj H) CNS disease excluded allowed? n absent or controlled (11%) 100% ( 3 regimens) absent or controlled (12%) ORR n/a n/a PFS (months)
34 Clinical trials in HER2-postitive metastatic breast cancer with gains in PFS ± OS CLEOPATRA (n=808) 1 st -line setting 1 st, 2 nd + 3 rd 3 rd + 4 th TDM4450g (n=137) EMILIA (n=991) EGF (n=291) H+P+T vs H+T T-DM1 vs H+T T-DM1 vs L+C H+L vs L prior herceptin 10% 20% 100% (16%< 6m adj H) CNS disease excluded allowed? n absent or controlled (11%) 100% ( 3 regimens) absent or controlled (12%) ORR n/a n/a PFS (months) OS (months) 37.6 NR NR NR ER+ve ER-ve 12 v v 9 OS gain? 12 months NSD 5.8 months 4.5 months toxicity slight increase T-DM1 better T-DM1 better slight increase 34
35 Suggestion for the optimal sequence of anti-her2 therapy in HER2-positive metastatic breast cancer. Trastuzumab naïve or sensitive population (T-free interval>1 year) 1 st line Docetaxel*,trastuzumab & pertuzumab Trastuzumab pre-treated and doubt about sensitivity (T-free interval < 1 year) T-DM1 * data from PERUSE should provide information on the utility of other taxoids 35
36 Suggestion for the optimal sequence of anti-her2 therapy in HER2-positive metastatic breast cancer. Trastuzumab naïve or sensitive population (T-free interval>1 year) 1 st line Docetaxel*,trastuzumab & pertuzumab Trastuzumab pre-treated and doubt about sensitivity (T-free interval < 1 year) T-DM1 2 nd line T-DM1 Lapatinib and Capecitabine * data from PERUSE should provide information on the utility of other taxoids 36
37 Suggestion for the optimal sequence of anti-her2 therapy in HER2-positive metastatic breast cancer. Trastuzumab naïve or sensitive population (T-free interval>1 year) 1 st line Docetaxel*,trastuzumab & pertuzumab Trastuzumab pre-treated and doubt about sensitivity (T-free interval < 1 year) T-DM1 2 nd line T-DM1 Lapatinib and Capecitabine 3 rd line Lapatinib and Capecitabine Lapatinib and Trastuzumab esp ER-ve * data from PERUSE should provide information on the utility of other taxoids 37
38 Suggestion for the optimal sequence of anti-her2 therapy in HER2-positive metastatic breast cancer. Trastuzumab naïve or sensitive population (T-free interval>1 year) 1 st line Docetaxel*,trastuzumab & pertuzumab Trastuzumab pre-treated and doubt about sensitivity (T-free interval < 1 year) T-DM1 2 nd line T-DM1 Lapatinib and Capecitabine 3 rd line Lapatinib and Capecitabine Lapatinib and Trastuzumab esp ER-ve 4 th line Lapatinib and Trastuzumab esp ER-ve Trastuzumab and chemo * data from PERUSE should provide information on the utility of other taxoids 38
39 Questions Does the presence of brain metastases influence this sequence? if symptomatic, treat and use above schedule if asymptomatic,?lap +Cap,?T-DM1 or usual schedule Will results of BOLERO 3 influence this algorithm? improved PFS with the addition of Everolimus to navelbine-trastuzumab (ER ve cohort) 39
40 Conclusions The availability of HER2 directed therapies has had a huge impact on the prognosis of patients with this disease control arm of CLEOPATRA (median OS 37.6m) experimental arm OS not reached? 4 years is a chemotherapy-free strategy feasible (MARIANNE)? The importance of combined and continued HER2 suppression has been confirmed in randomised studies with negligible additional physical toxicity with significant financial toxicity We clearly need to derive biomarkers to identify, those who do NOT need intensive anti-her2 approaches those who are resistant and thereby need novel strategies 40
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 informationMiquel 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 informationNew 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 informationThe NCPE has issued a recommendation regarding the use of pertuzumab for this indication. The NCPE does not recommend reimbursement of pertuzumab.
Cost Effectiveness of Pertuzumab (Perjeta ) in Combination with Trastuzumab and Docetaxel in Adults with HER2-Positive Metastatic or Locally Recurrent Unresectable Breast Cancer Who Have Not Received Previous
More informationCorporate 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 informationAvastin 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 informationQu 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 informationVan 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 informationThe benefit of HER2-targeted therapies on overall survival of patients with metastatic HER2-positive breast cancer a systematic review
Mendes et al. Breast Cancer Research (2015) 17:140 DOI 10.1186/s13058-015-0648-2 RESEARCH ARTICLE The benefit of HER2-targeted therapies on overall survival of patients with metastatic HER2-positive breast
More informationBREAST 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 informationHER2-positive Metastatic Breast Cancer: New Agents on the Horizon
Hong Kong J Radiol. 2012;15(Suppl):S51-6 REVIEW ARTICLE HER2-positive Metastatic Breast Cancer: New Agents on the Horizon W Yeo Department of Clinical Oncology, The Chinese University of Hong Kong, Prince
More informationEverolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer
LONDON CANCER NEWS DRUGS GROUP RAPID REVIEW Everolimus plus exemestane for second-line endocrine treatment of oestrogen receptor positive metastatic breast cancer Everolimus plus exemestane for second-line
More informationWhat 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 informationA Phase 1 Study of MM-302, a HER2- targeted PEGylated liposomal doxorubicin, in Patients with HER2-positive Metastatic Breast Cancer (MBC)
A Phase 1 Study of MM-32, a HER2- targeted PEGylated liposomal doxorubicin, in Patients with HER2-positive Metastatic Breast Cancer (MBC) P LoRusso 1, I Krop 2, K Miller 3, C Ma 4, BA Siegel 4, AF Shields
More informationOptimizing 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 informationNew 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 informationTreatment of Metastatic Breast Cancer: Endocrine Therapies. Robert W. Carlson, M.D. Professor of Medicine Stanford University
Treatment of Metastatic Breast Cancer: Endocrine Therapies Robert W. Carlson, M.D. Professor of Medicine Stanford University MDACC Experience with FAC in Chemotherapy-Naive MBC Greenberg et al, J Clin
More informationWhat is the Optimal Front-Line Treatment for mrcc? Michael B. Atkins, MD Deputy Director, Georgetown-Lombardi Comprehensive Cancer Center
What is the Optimal Front-Line Treatment for mrcc? Michael B. Atkins, MD Deputy Director, Georgetown-Lombardi Comprehensive Cancer Center The Case for Immunotherapy in mrcc 1. Achieves patient s goal 2.
More informationJanuary 2013 LONDON CANCER NEW DRUGS GROUP RAPID REVIEW. Summary. Contents
LONDON CANCER NEW DRUGS GROUP RAPID REVIEW Paclitaxel albumin (Abraxane ) as a substitute for docetaxel/paclitaxel for cancer Paclitaxel albumin (Abraxane ) as a substitute for docetaxel/ paclitaxel for
More informationAdvances In Chemotherapy For Hormone Refractory Prostate Cancer. TAX 327 study results & SWOG 99-16 study results presented at ASCO 2004
Ronald de Wit Rotterdam Cancer Institute The Netherlands Advances In Chemotherapy For Hormone Refractory Prostate Cancer TAX 327 study results & SWOG 99-16 study results presented at Slide 1 Prostate Cancer
More informationBreast 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 informationMaintenance 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 informationAvastin 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 informationNew Agents as Options in the Treatment of Breast Cancer in 2012 2013. Realities and Possibilities
New Agents as Options in the Treatment of Breast Cancer in 2012 2013. Realities and Possibilities Peter M. Ravdin, MD, PhD UT Health Science Center San Antonio San Antonio, TX 2012 2013 New Options for
More informationHOW 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 informationGilberto de Lima Lopes, MD, MBA, FAMS Chief Medical and Scientific Officer, Oncoclinicas Group Asst. Prof. of Oncology, Johns Hopkins University
Gilberto de Lima Lopes, MD, MBA, FAMS Chief Medical and Scientific Officer, Oncoclinicas Group Asst. Prof. of Oncology, Johns Hopkins University Assoc. Editor ASCO University and JGO Progress Against
More informationLa 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 informationOI 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 informationNew Treatment Paradigms in the Management of Metastatic Breast Cancer. Objectives
New Treatment Paradigms in the Management of Metastatic Breast Cancer Sara A. Hurvitz, MD, FACP Assistant Professor of Medicine Director, Breast Oncology Program, UCLA Co-Director, Outpatient Oncology
More informationONCOLOGIA: esperienze cliniche a confronto. Il carcinoma mammario metastatico
ONCOLOGIA: esperienze cliniche a confronto. Il carcinoma mammario metastatico Sequenza ottimale del trattamento Maria Teresa Scognamiglio U.O.C. Clinica Oncologica Chieti-Ortona Chieti 12 novembre 213
More informationCLINICAL POLICY Department: Medical Management Document Name: HER2 Breast Cancer Treatments
Page: 1 of 11 Specialist Review: Revised: 06/13 IMPORTANT REMINDER This Clinical Policy has been developed by appropriately experienced and licensed health care professionals based on a thorough review
More informationLondon Cancer New Drugs Group APC/DTC Briefing
London Cancer New Drugs Group APC/DTC Briefing Continued use of trastuzumab following disease progression in metastatic breast cancer Contents Summary 1 Background 2 Adverse events/safety issues Health
More informationBackground. t 1/2 of 3.7 4.7 days allows once-daily dosing (1.5 mg) with consistent serum concentration 2,3 No interaction with CYP3A4 inhibitors 4
Abstract No. 4501 Tivozanib versus sorafenib as initial targeted therapy for patients with advanced renal cell carcinoma: Results from a Phase III randomized, open-label, multicenter trial R. Motzer, D.
More informationHorizon Scanning in Oncology
Horizon Scanning in Oncology Pertuzumab (Omnitarg/Perjeta ) for the first-line therapy of metastatic HER2 positive breast cancer DSD: Horizon Scanning in Oncology Nr. 31 ISSN online 2076-5940 Horizon
More informationMetastatic 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 informationUpdate on neoadjuvant treatment of breast cancer
Update on neoadjuvant treatment of breast cancer «IS PATHOLOGIC COMPLETE RESPONSE STILL A GOOD SURROGATE OF SURVIVAL?» Complete histological response varies according to tumoral type pcr (%) 40 35 30 25
More informationOvarian Cancer and Modern Immunotherapy: Regulatory Strategies for Drug Development
Ovarian Cancer and Modern Immunotherapy: Regulatory Strategies for Drug Development Sanjeeve Bala, MD, MPH Ovarian Cancer Endpoints Workshop FDA White Oak September 3, 2015 Overview Immune agents from
More informationCancer Treatments Subcommittee of PTAC Meeting held 18 September 2015. (minutes for web publishing)
Cancer Treatments Subcommittee of PTAC Meeting held 18 September 2015 (minutes for web publishing) Cancer Treatments Subcommittee minutes are published in accordance with the Terms of Reference for the
More informationDECISION AND SUMMARY OF RATIONALE
DECISION AND SUMMARY OF RATIONALE Indication under consideration Clinical evidence Everolimus in combination with exemestane hormone therapy for oestrogen receptor positive locally advanced or metastatic
More informationESMO 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 informationManagement of Locally Advanced and Metastatic HER2-Positive Breast Cancer
Management of Locally Advanced and Metastatic HER2-Positive Breast Cancer Pretest Question #1 Which of the following is an antibody-drug conjugate indicated for use in HER2-positive metastatic breast cancer?
More informationTrials in Elderly Melanoma Patients (with a focus on immunotherapy)
Trials in Elderly Melanoma Patients (with a focus on immunotherapy) Where we were Immunotherapy Trials: past and present Relevance for real world practice Where we are SIOG October 2012 James Larkin FRCP
More informationGemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer
Gemcitabine, Paclitaxel, and Trastuzumab in Metastatic Breast Cancer Review Article [1] December 01, 2003 By George W. Sledge, Jr, MD [2] Gemcitabine (Gemzar) and paclitaxel show good activity as single
More informationLOOKING 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 informationChemotherapy 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 informationProgress 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 informationCurr Oncol, Vol. 22, pp. S19-28; doi: http://dx.doi.org/10.3747/co.22.2363 TARGETED THERAPY IN HER2-POSITIVE METASTATIC BREAST CANCER REVIEW ARTICLE
Curr Oncol, Vol. 22, pp. S19-28; doi: http://dx.doi.org/10.3747/co.22.2363 TARGETED THERAPY IN HER2-POSITIVE METASTATIC BREAST CANCER REVIEW ARTICLE Targeted therapy in her2-positive metastatic breast
More informationNOUVEAUTES THERAPEUTIQUES DANS LES TUMEURS NEUROENDOCRINES DIGESTIVES (Radiothérapie vectorisée et loco-régionale exclue) Philippe RUSZNIEWSKI
NOUVEAUTES THERAPEUTIQUES DANS LES TUMEURS NEUROENDOCRINES DIGESTIVES (Radiothérapie vectorisée et loco-régionale exclue) Réunion APRAMEN, Paris, 2 février 2013 Philippe RUSZNIEWSKI Pôle des Maladies de
More informationPertuzumab, Trastuzumab, and Docetaxel in HER2-Positive Metastatic Breast Cancer
The new england journal of medicine original article Pertuzumab, Trastuzumab, and Docetaxel in HER2-Positive Metastatic Breast Cancer Sandra M. Swain, M.D., José Baselga, M.D., Sung-Bae Kim, M.D., Jungsil
More informationSAMO 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 informationTreatments for HER2 Positive Metastatic Breast Cancer: Past, Present, and Future
Treatments for HER2 Positive Metastatic Breast Cancer: Past, Present, and Future Maria Theodoulou, MD Attending, Breast Cancer Service,MSKCC Professor of Medicine Weill Cornell Medical School Outline 1.
More informationDrug/Drug Combination: Bevacizumab in combination with chemotherapy
AHFS Final Determination of Medical Acceptance: Off-label Use of Bevacizumab in Combination with Chemotherapy for the Treatment of Metastatic Breast Cancer Previously Treated with Cytotoxic Chemotherapy
More informationAdjuvant 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 informationLa 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 informationTreatment results with Bortezomib in multiple myeloma
Treatment results with Bortezomib in multiple myeloma Prof. Dr. Orhan Sezer Hamburg University Medical Center Circulating proteasome levels are an independent prognostic factor in MM 1.0 Probability of
More informationInflammatory 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 informationClinical Study Report
An Open, Multi-Center, Phase II Clinical Trial to Evaluate Efficacy and Safety of Taxol (), UFT, and Leucovorin in Patients with Advanced Gastric Cancer Clinical Study Report 4F, No. 156, Jiankang Rd.,
More informationBiomarker 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 informationCytotoxic 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 informationBreast 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 informationIMMUNOMEDICS, INC. February 2016. Advanced Antibody-Based Therapeutics. Oncology Autoimmune Diseases
IMMUNOMEDICS, INC. Advanced Antibody-Based Therapeutics Oncology Autoimmune Diseases February 2016 Forward-Looking Statements This presentation, in addition to historical information, contains certain
More informationMETASTATIC BREAST CANCER
METASTATIC BREAST CANCER Executive Summary Metastatic breast cancer is defined as disease beyond the breast and regional lymph nodes. Although metastatic breast cancer is generally incurable, patients
More informationClinical Spotlight in Breast Cancer
2015 European Oncology Congress in Vienna Clinical Spotlight in Breast Cancer Reference Slide Deck Abstract #1815 Impact of Palbociclib Plus Fulvestrant on Global QOL, Functioning, and Symptoms Compared
More informationNew developments and controversies in breast cancer treatment: PARP Inhibitors: a breakthrough?
New developments and controversies in breast cancer treatment: PARP Inhibitors: a breakthrough? F. Cardoso, MD Champalimaud Cancer Center Lisbon, Portugal BBM 2010 Thank you to A Tutt & PRIME Oncology
More informationPast, Present and Future HER2 targeted therapy in breast cancer
Past, Present and Future HER2 targeted therapy in breast cancer Joseph Gligorov MD, PhD Tenon Hospital, University Cancer Institute, Paris VI, Sorbonne University Paris, France Disclosures Roche GSK What
More informationNovel 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 informationLAPATINIB-BASED THERAPY FOR WOMEN WITH ADVANCED/ METASTATIC HER2 POSITIVE BREAST CANCER
146 Experimental Oncology 37, 146 150, 2015 (June) Exp Oncol 2015 37, 2, 146 150 LAPATINIB-BASED THERAPY FOR WOMEN WITH ADVANCED/ METASTATIC HER2 POSITIVE BREAST CANCER J. Zekri 1, 2, M. Mokhtar 3, S.M.
More informationMultiple Myeloma: Novel Agents. Robert A. Kyle, M.D. Germany June 28, 2008. Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida
Multiple Myeloma: Novel Agents Robert A. Kyle, M.D. Germany June 28, 2008 Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida Multiple Myeloma Untreated Initial Therapy Transplant eligible Multiple
More informationEndpoint Selection in Phase II Oncology trials
Endpoint Selection in Phase II Oncology trials Anastasia Ivanova Department of Biostatistics UNC at Chapel Hill aivanova@bios.unc.edu Primary endpoints in Phase II trials Recently looked at journal articles
More informationShould we use Docetaxel in hormone- naïve prostate cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France
Should we use Docetaxel in hormone- naïve prostate cancer? Karim Fizazi, MD, PhD Institut Gustave Roussy Villejuif, France Disclosure Participation to advisory boards/honorarium from: Amgen, Astellas,
More information12.5 VI.2 ELEMENTS FOR A PUBLIC SUMMARY
12.5 VI.2 ELEMENTS FOR A PUBLIC SUMMARY 12.5.1 VI.2.1 Overview of disease epidemiology Breast cancer affects 10 12% of women globally, and is more common among older people. Some cancer cells have proteins
More informationClinical Trials of Lapatinib in Patients with Brain Metastases. Nancy U Lin, MD Dana Farber Cancer Institute March 1, 2009
Clinical Trials of Lapatinib in Patients with Brain Metastases from HER2+ Breast Cancer Nancy U Lin, MD Dana Farber Cancer Institute March 1, 2009 Background ~1/3 of women with HER2+ MBC develop brain
More informationHER2-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 informationLapatinib for the treatment of advanced and metastatic breast cancer: a review of the response to the ACD provided by the manufacturer of Lapatinib
Lapatinib for the treatment of advanced and metastatic breast cancer: a review of the response to the ACD provided by the manufacturer of Lapatinib 7 September 2008 Report by the NICE Decision Support
More informationStrength of Study End Point(s): Progression-free survival
AHFS Final Determination of Medical Acceptance: Off-label Use of Bevacizumab in Combination with Paclitaxel for the First-line Treatment of Metastatic Breast Cancer Drug/Drug Combination: Bevacizumab and
More informationtrastuzumab, 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 informationTreatment 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 informationMetastatic Breast Cancer: where are we and where are we going?
Metastatic Breast Cancer: where are we and where are we going? Dr. Stefania Redana Clinical Research Fellow The Royal Marsden Hospital Thursday 5 th November 2015 Outline Overview on Breast Cancer Statistics
More information18.5 Percent Overall Response Rate Observed in Pembrolizumab-Treated Patients with this Aggressive Form of Breast Cancer
News Release Media Contacts: Annick Robinson Investor Contacts: Joseph Romanelli (514) 837-2550 (908) 740-1986 Stephanie Lyttle NATIONAL Public Relations (514) 843-2365 Justin Holko (908) 740-1879 Merck
More information5.04.20. Perjeta. Perjeta (pertuzumab) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.04.20 Subject: Perjeta Page: 1 of 5 Last Review Date: June 19, 2015 Perjeta Description Perjeta (pertuzumab)
More informationI. 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 informationBioPATH: 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 informationMechanism Of Action of Palbociclib & PFS Benefit
A Phase II Randomized Controlled Trial of Palbociclib & Tamoxifen/Fulvestrant in Postmenopausal Women and Men With Hormone-Receptor Positive, HER2- Negative Metastatic Breast Cancer (MBC) Protocol Chair:
More informationTriple 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 informationAvastin in Metastatic Breast Cancer
Non-interventional study Avastin in Metastatic Breast Cancer ML 21165 / 2007 Clinical Study Report Synopsis ROCHE ML21165 / WiSP Project RH09 / V. 1.0 / 24.06.2013 ROCHE ML21165-2 - Name of Sponsor Roche
More informationAnti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma. Claire Vines, 2016 Pharm.D. Candidate
+ Anti-PD1 Agents: Immunotherapy agents in the treatment of metastatic melanoma Claire Vines, 2016 Pharm.D. Candidate + Disclosure I have no conflicts of interest to disclose. + Objectives Summarize NCCN
More informationAIDS 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 informationClinical Trial Design. Sponsored by Center for Cancer Research National Cancer Institute
Clinical Trial Design Sponsored by Center for Cancer Research National Cancer Institute Overview Clinical research is research conducted on human beings (or on material of human origin such as tissues,
More informationOptimizing chemotherapy-free survival for the ER/HER2 positive metastatic breast cancer patient
Optimizing chemotherapy-free survival for the ER/HER2 positive metastatic breast cancer patient Stefan Glück, Carlos L. Arteaga, and Kent Osborne, University of Miami s Sylvester Comprehensive Cancer Center,
More informationIs the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study
Turkish Journal of Cancer Volume 34, No.1, 2004 19 Is the third-line chemotherapy feasible for non-small cell lung cancer? A retrospective study MUSTAFA ÖZDO AN, MUSTAFA SAMUR, HAKAN BOZCUK, ERKAN ÇOBAN,
More informationName of Policy: Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 Dimers
Name of Policy: Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 Dimers Policy #: 487 Latest Review Date: January 2016 Category: Laboratory Policy Grade: B Background/Definitions:
More informationSan 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 informationWhat is the reference cytotoxic regimen in advanced gastric cancer?
What is the reference cytotoxic regimen in advanced gastric cancer? Florian Lordick Professor of Oncology Director of the University Cancer Center Leipzig (UCCL) Germany What we know from clinical research.
More informationDRUG NAME: Pertuzumab
DRUG NAME: Pertuzumab SYNONYM(S): COMMON TRADE NAME(S): PERJETA CLASSIFICATION: monoclonal antibody Special pediatric considerations are noted when applicable, otherwise adult provisions apply. MECHANISM
More informationHow valuable is a cancer therapy? It depends on who you ask.
How valuable is a cancer therapy? It depends on who you ask. Comparing and contrasting the ESMO Magnitude of Clinical Benefit Scale with the ASCO Value Framework in Cancer Ram Subramanian Kevin Schorr
More informationpan-canadian Oncology Drug Review Initial Clinical Guidance Report Ramucirumab (Cyramza) for Gastric Cancer September 3, 2015
pan-canadian Oncology Drug Review Initial Clinical Guidance Report Ramucirumab (Cyramza) for Gastric Cancer September 3, 2015 DISCLAIMER Not a Substitute for Professional Advice This report is primarily
More informationManagement of low grade glioma s: update on recent trials
Management of low grade glioma s: update on recent trials M.J. van den Bent The Brain Tumor Center at Erasmus MC Cancer Center Rotterdam, the Netherlands Low grades Female, born 1976 1 st seizure 2005,
More informationGENETIC 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 informationRecommendation Strength Strong, supported by the evidence and expert consensus. Recommendation Benefit/Harm Evidence Quality
CHEMO- AND TARGETED THERAPY FOR WOMEN WITH HER2 NEGATIVE (OR UNKNOWN) ADVANCED BREAST Benefit/Harm Evidence Quality 1: Endocrine therapy, rather than chemotherapy, should be offered as the standard firstline
More information