Breast Cancer Clinical Case Review

Mridula George, MD, assistant professor of medicine at Rutgers Robert Wood Johnson Medical School, and associate program director for breast medical oncology program in the division of medical oncology at Rutgers Cancer Institute of New Jersey, reveals the chosen therapy for this patient.

Editor’s note: The following is an automatically generated transcript of the above video.

"So the key trial that led to the approval of trastuzumab and pertuzumab in the metastatic setting was the CLEOPATRA study. The study was a randomized phase III, a double blinded study that randomized patients to docetaxel, trastuzumab, pertuzumab or placebo. Median progression-free survival with the addition of pertuzumab was 18.7 months compared to 12.4 months using the placebo, and the hazard ratio was 0.68. And there was an overall survival benefit as well with the addition of pertuzumab, and the median overall survival was 56.5 months with the addition of pertuzumab, the hazard ratio of 0.68.

So patients are treated with taxane-based chemotherapy. They can either be treated with docetaxel given every three weeks or paclitaxel given weekly. After patients are treated for at least six cycles with chemotherapy, patients can continue on maintenance trastuzumab and pertuzumab. In patients with ER-positive metastatic breast cancer, we add endocrine therapy as well to the dual HER2 therapy backbone."