Novel approaches to target HER2-positive breast cancer: trastuzumab emtansine.
The human epidermal growth factor receptor 2 (HER2) is overexpressed in 20% of breast carcinomas. Prior to the development of targeted therapies, HER2-positive breast cancer was associated with more aggressive disease and poor prognosis. Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate that results from the combination of trastuzumab and DM1, a derivative of the antimicrotubule agent maytansine. This molecule has the ability to enhance cytotoxic drug delivery to specifically targeted cells that overexpress HER2, therefore, maximizing efficacy while sparing toxicity. In recent years, T-DM1 has shown to improve outcomes in metastatic HER2-positive breast cancer that is resistant to trastuzumab. In addition, T-DM1 is currently being tested in the neoadjuvant and adjuvant settings to identify patients who may benefit from this therapy. This review focuses on the mechanism of action, early and late-phase clinical trials, and ongoing studies of T-DM1 in HER2-positive breast cancer.
Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina.
Gonzalo
G
Recondo
Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina.
Maximo
M
de la Vega
Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina.
Fernando
F
Galanternik
Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina.
Enrique
E
Díaz-Cantón
Grupo Oncológico Cooperativo del Sur, Neuquén, Argentina.
Bernardo Amadeo
BA
Leone
Division of Hematology-Oncology and Blood & Marrow Transplantation, Holden Comprehensive Cancer Center, University of Iowa Hospitals & Clinics, Iowa City, IA, USA.
José Pablo
JP
Leone
HER2-positive breast cancer; T-DM1; metastatic breast cancer; targeted therapies; trastuzumab emtansine