TDM1 – 2012 update
Herceptin and laptinib are two currently available drugs that work in HER+ breast cancer. A way to make anti-HER2 therapy more effective is to combine the antibody that affects the HER2 receptor with a molecule that kills cancer cells. The antibody attaches to the cancer cell HER2 receptor and bring the chemo molecule in proximity to it, which then kills the cell. Trastuzumab emtansine (INN), variousely calledL trastuzumab-DM1 or trastuzumab-MCC-DM1, or T-DM1 is such an antibody-drug conjugate consisting of the antibody trastuzumab (Herceptin) linked to a cytotoxic agent that is a derivative of maytansine (DM1). Is is promising drug and is in several studies. EMILIA, a phase III trial of 991 people with HER2-positive unresectable locally advanced or metastatic breast cancer, comparing T-DM1 versus capecitabine plus lapatanib in patients previously treated with trastuzumab and a taxane chemotherapy, showed improved progression free survival in patients treated with T-DM1 (median 9.6 vs. 6.4 months) with an improved safety profile. The study sponsor reported in August 2012 that T-DM1 significantly improved survival.
There is also the MARIANNE study, which compares taxane (docetaxel or paclitaxel) plus trastuzumab vs T-DM1 vs T-DM1 plus pertuzumab as first-line treatment for people with HER2 positive unresectable locally advanced or metastatic breast cancer and the TH3RESA stud, which is comparing T-DM1 vs treatment of physician’s choice for people with HER2 positive metastatic breast cancer previously treated with trastuzumab and lapatinib.
For Professional version see here