Dr. Chang on Combining HER2 Targeted Therapies

Jenny C. Chang, MD, director, Methodist Cancer Center, The Methodist Hospital, Professor of Medicine, Weill Cornell Medical College of Cornell University, discusses the efficacy of combining multiple targeted agents to fully block the HER2 signaling pathway in patients with breast cancer.

Chang alludes to research presented at the 2011 ASCO meeting that clarified the advantages of fully blocking the HER2 receptor. These studies explored the combination of trastuzumab, a monoclonal antibody targeting HER2, and lapatinib, a dual inhibitor of HER2 and EGFR, in HER2-positive breast cancer. These agents were provided to patients without chemotherapy with pathologic complete response (pCR) as a primary endpoint. Patients that were both HER2-positive and estrogen receptor (ER)-positive were given the estrogen deprivation therapy letrozole, plus goserelin if premenopausal.

The overall pCR rate for all groups was approximately 30%. Participants that were HER2-positive and ER-negative demonstrated nearly a 40% increase in pCR. The high rates of response without chemotherapy suggest that some tumors can be controlled using a combination of targeted therapies alone.

Omitting chemotherapy from the treatment process would avoid many of the adverse events associated with the treatment.