Trastuzumab emtansine

Meta-analysis of 12 trials (584 patients) shows ADC + ICI combination therapy has 58% ORR (95%CI 46%, 70%) with acceptable AEs. Subgroup analysis indicates better efficacy in tumors with high antigen expression. Future studies should focus on biomarker-based patient stratification and expanding ADC targets to tumor microenvironment.

T-DXd showed promising overall and intracranial activity in HER2-positive metastatic breast cancer patients, regardless of brain metastasis status, according to DESTINY-Breast12 study results presented at ESMO 2024.

Article references on antibody-drug conjugates (ADCs) in cancer therapy, including comprehensive reviews, clinical trials, and analyses of toxicity and mechanisms.

Advancements in HER2-positive breast cancer treatment emphasize personalized, less toxic regimens, with trials like APT, ATEMPT, and TRAIN-2 showing high invasive disease-free survival rates and reduced cardiotoxicity. Ongoing trials, such as ATEMPT 2.0 and CompassHER2 RD, aim to further tailor treatments based on individual patient factors and address specific challenges like central nervous system recurrences. The future of HER2-positive breast cancer treatment is focused on personalized medicine and understanding resistance mechanisms to HER2-targeting agents.

REVEAL GENOMICS released further evidence supporting HER2DX®, a genomic test for HER2+ breast cancer, in collaboration with F. Hoffmann-La Roche Ltd. The test's ability to predict long-term survival outcomes was evaluated in the CLEOPATRA trial, showing a strong association with PFS and OS. HER2DX® aims to guide treatment decisions for HER2+ breast cancer patients.

Pyrotinib plus metronomic vinorelbine showed safety and efficacy in HER2+ advanced breast cancer post-trastuzumab, with median PFS of 13.5 months and ORR of 38.9%. The study highlights the need for alternative therapies due to economic constraints on ADCs. Subgroup analysis revealed better PFS in patients with lung metastases and primary trastuzumab resistance. No new AEs were reported, and the regimen warrants further study.