Patients with aggressive subtypes of locally-advanced breast cancer may have new treatment options on the horizon, according to two reports published in the New England Journal of Medicine.
Results show that use of new targeted therapies neratinib or a combination of veliparib and carboplatin improves outcomes, when used in addition to standard chemotherapy before surgery for patients with HER2-positive and triple-negative breast cancer, respectively.
The results are part of the multi-institutional I-SPY 2 study.
“Compared to standard therapies alone, the drugs tested in the trial substantially reduced the presence of residual disease in the breast tissue and lymph nodes (known as achieving pathological complete response, or “pCR”) when administered before surgery,” said Angela DeMichele, MD, MSCE, a professor of Hematology-Oncology and Epidemiology.
“pCR strongly predicts prevention of later recurrence of incurable metastatic disease. These results suggest that neratinib and veliparib-carboplatin are very promising treatment options for patients with HER2-positive and triple-negative breast cancer, respectively.”
The data presented in the two NEJM articles shows that when added to standard, neoadjuvant chemotherapy, the combination of the molecularly targeted experimental drug veliparib plus carboplatin showed sufficient improvement to meet the pre-specified threshold for “graduation” from the trial, signifying a high likelihood for success in a modest, confirmatory phase 3 neoadjuvant trial in the triple negative subset.
Likewise, the experimental drug neratinib was found to have sufficient improvement in the pCR rate for patients in the HER2-positive/HR-negative subset, that it too was “graduated” from the I-SPY 2 trial.
“Because there are so many subtypes of breast cancer, and because we always test drugs in the metastatic and then adjuvant setting, finding effective therapies is a very difficult and long process.”
The I-SPY 2 platform allows therapies to be tested and evaluated in more expeditious, cost-effective ways,” said Laura J. Esserman, MD, MBA.
“These results provide valuable information on which drugs should proceed to confirmatory trials to improve outcomes for patients with extremely aggressive cancers.”
“In particular, finding drug combinations that are effective and less toxic is extremely important. The new studies show that by using the I-SPY 2 model to match therapies with biomarker subsets, we can create trials that are more focused, smaller, and faster, thereby exposing more patients to effective treatments.”
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News source: Penn Medicine. The content is edited for length and style purposes.
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