According to recent findings, the combination of targeted agents Herceptin® (trastuzumab) and Perjeta® (perjeta) significantly improves survival for patients with HER2-positive metastatic breast cancer when added to chemotherapy. This data was presented at the 2014 European Society for Medical Oncology (ESMO) Congress in Madrid, Spain, September 26–30.
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.
To evaluate the combination of Herceptin and Perjeta plus chemotherapy (with Taxotere® [docetaxel]) as first-line therapy for patients with HER2-postive metastatic breast cancer, researchers have conducted a Phase III clinical study called the CLEOPATRA trial. This trial included 808 patients, who were assigned to receive Herceptin and Perjeta plus chemotherapy or Herceptin-only plus chemotherapy.
In early follow-up, the combination of Herceptin and Perjeta plus chemotherapy appeared promising: patients in this group experienced improved progression-free and overall survival, and overall survival continued to improved at the next follow-up.
Now that final overall survival results are available, the combination of Herceptin and Perjeta plus chemotherapy still appears more effective than Herceptin-only plus chemotherapy. At last follow-up, median overall survival was over 15 months longer in the Perjeta group: over 56 months versus just over 40 months for the Herpceptin-only group. In addition, the researchers found no previously unknown safety concerns for this treatment combination.
“The results of the study are really outstanding,” said Giuseppe Curigliano, DM, Director of the Division of Experimental Therapeutics in Milan, Italy. He called the more than 56-month median overall survival for Herceptin and Perjeta plus chemotherapy “unprecedented” in the treatment of HER2-positive metastatic breast cancer and added, “The CLEOPATRA trial changes clinical practice. We now have a new standard of care for patients with metastatic HER2-positive breast cancer.”
 Swain S, Kim S,Cortes J, et al. 350O_PR – Final overall survival (OS) analysis from the CLEOPATRA study of first-line (1L) pertuzumab (Ptz), trastuzumab (T), and docetaxel (D) in patients (pts) with HER2-positive metastatic breast cancer (MBC). European Society for Medical Oncology (ESMO) Congress 2014: Abstract 350O_PR. Presented September 28, 2014.
CLEOPATRA Trial Changes Standard Therapy for Metastatic HER2 Positive Breast Cancer [press release]. European Society for Medical Oncology (ESMO) Congress 2014. Available at: https://www.esmo.org/Conferences/ESMO-2014-Congress/Press-Media/CLEOPATRA-Trial-Changes-Standard-Therapy-for-Metastatic-HER2-Positive-Breast-Cancer. Accessed October 4, 2014.
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