T-DM1 for Her2 positive breast cancer

FDA approval of antibody drug conjugate T- DM1 (trastuzumab emtansine, Kadcyla), deliverers cytotoxic to its target Her2+ receptor. Phase II studies show from 137 patients, randomly assigned to receive first line trastuzumab + docetaxel (TD), vs TDM1, after median 23month F/U, PFS was signigicany improved compared to TD, 14.2 vs 9.2 months. Together with higher objective response to TDM1 vs TD. TDM1 also associated to lower serious adverse risks. Thus, one may expect the future that TDM1 will replace current treatment for Her2+ metastatic BC who experience disease progression after receiving Trasustmab. Has a favorable safety profile. Clinical trials of using TDM1 in ealier treatment and adjuvant settings with metastatic BC are under way. Ref- Hurvitz et al. Phase II randomized study of trastuzumab Emtansine versus trastuzumab plus docetaxel in patients with Her2+ metastatic Breast cancer. J Clinincal Oncology. 2013. 31, 1157