Substituting Kadcyla an antibody-drug conjugate for Herceptin (trastuzumab) as neoadjuvant therapy appears promising in the treatment of HER2-positive breast cancer.
Kadcyla™ (ado-trastuzumab emtansine, formerly known as T-DM1) is part of a new class of drugs called antibody-drug conjugates, which consist of an antibody attached to a toxic chemotherapy. It combines Herceptin and a chemotherapy drug (emtansine or DM1) that interferes with cancer cell growth. Kadcyla delivers Herceptin and DM1 directly to HER2-positive cells, and limits exposure of the rest of the body to the chemotherapy.
HER2 is a protein involved in normal cell growth. Approximately 20-25% of breast cancers overexpress (make too much of) the HER2 protein, and this over-expression contributes to cancer cell growth and survival. HER2-targeted therapies such as Herceptin have dramatically improved outcomes for women with HER2-positive breast cancer, but researchers continue to explore new approaches to treatment.
The clinical trial included 375 women with HER2-positive/ER-positive early stage breast cancer. Individuals were treated with Kadcyla™, Kadcyla™+ hormone therapy, or Herceptin + hormonal therapy every 3 weeks for four cycles and directly compared by evaluating the response to treatment surgery or a core needle biopsy to assess the pathologic compete response rate (pCR).
After 12 weeks of therapy, 41% of patients treated with Kadcyla™, and 41.5% of those treated with Kadcyla™ + hormone therapy achieved pCR, compared with 15% of those treated with Herceptin plus hormone therapy.
The trial “demonstrates that neoadjuvant Kadcyla™ given for only 12 weeks results in a clinically meaningful pathologic complete response rate and appears superior to Herceptin.
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