Is the improved efficacy of trastuzumab and lapatinib combination worth the added toxicity? a discussion of current evidence, recommendations, and ethical issues regarding dual HER2-targeted therapy

Eugene R. Ahn, Emilie Wang, Stefan Glück

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Following FDA approval of trastuzumab in 1998 and lapatinib in 2007, several clinical studies have addressed the question of whether trastuzumab and lapatinib combination therapy is better than trastuzumab alone in the metastatic breast cancer and neoadjuvant setting. In this review, updated to September 2012, we focus on the relevant clinical trials that address this question and, based on the available data, reach conclusions regarding a rational and reasonably individualized approach to the management of HER2+ breast cancer. With the FDA approval of pertuzumab in June 2012 and the likely approval of T-DM1 approaching, several ethical issues overshadow the excitement oncologists have for these new treatment options. We discuss the potential evolution of highly active anti- HER2 therapy (HAAHT) as an optimal treatment paradigm for HER2+ breast cancer. Additionally, we review lessons learned from the evolution of HAART for HIV treatment.

Original languageEnglish
Pages (from-to)191-207
Number of pages17
JournalBreast Cancer: Basic and Clinical Research
Volume6
Issue number1
DOIs
StatePublished - Dec 4 2012
Externally publishedYes

Fingerprint

Ethics
Breast Neoplasms
Therapeutics
Highly Active Antiretroviral Therapy
lapatinib
Trastuzumab
Clinical Trials
HIV

Keywords

  • Breast cancer
  • Dual
  • HER2
  • Lapatinib
  • Pertuzumab
  • T-DM1
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

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