Personalizing therapy for metastatic breast cancer

Abstract

Treatments for metastatic breast cancer are increasingly tailored towards individual tumor biology. For tumors that overexpress HER2, progressing on trastuzumab and lapatinib, a range of active agents including pertuzumab, neratinib and trastuzumab-MCC-DM1, have demonstrated activity when combined with trastuzumab. In HER2-normal metastatic breast cancer, recent studies suggest that the addition of bevacizumab to first-line chemotherapy improves progression-free survival irrespective of choice of cytotoxic agent. Another interesting area of investigation is the inhibition of poly-ADP-ribose polymerase, an enzyme important for DNA repair. This strategy may be particularly effective in patients with inherited defects in DNA repair or by the co-administration of DNA damaging cytotoxic chemotherapy. This article covers key new areas of systemic therapy for MBC from the American Society of Clinical Oncology 2009 annual meeting.

Keywords::

• bevacizumab
• metastatic breast cancer
• neratinib
• PARP-inhibitor
• pertuzumab
• poly-ADP ribose polymerase
• trastuzumab–MCC–DM1

Financial & competing interests disclosure

Clifford A Hudis is a consultant for Genentech and is on the data safety monitoring committee for the CLEOPATRA, RIBBON-1 and RIBBON-2 studies. Patrick G Morris has received honoraria from Eisai, Genomic Health, Pfizer, Haymarket Media, Bristol-Myers Squibb, Genentech, Novartis and OrthoBiotech. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.