Latest news with #HER2positive
Medscape
19 hours ago
- Health
- Medscape
ASCO 2025: Key Updates in Early Breast Cancer Care
Mariana Chavez MacGregor, MD, MSc, comments on how the ASCO 2025 meeting delivered a wealth of impactful data, particularly in the early-stage breast cancer setting. Trials like neoCARHP and CompassHER2 raised important questions about de-escalating therapy for HER2-positive patients, challenging the role of carboplatin and demonstrating strong pathologic complete response rates with shorter regimens. Long-term data from SOFT and TEXT reinforced the survival benefits of ovarian suppression plus an aromatase inhibitor in high-risk premenopausal patients, and the OASIS 4 study showed promise with elinzanetant in managing vasomotor symptoms. Across subtypes, including triple-negative disease, and with the growing role of AI and circulating tumor DNA, the meeting emphasized more personalized, less toxic approaches to care.
Daily Mail
3 days ago
- Health
- Daily Mail
Dakota, 28, was fit, happy and had no reason to think anything was wrong with her health. Then she received heartbreaking news
Just three weeks before her 29th birthday, Dakota Middleby 's life changed in an instant. It was March 26 when she received the call that confirmed her worst fears. What began as seemingly innocuous swelling under her right arm turned out to be something far more serious: stage 3, grade 3 HER2-positive breast cancer - a rare and aggressive form of the disease most often associated with older women. 'I initially went to the doctors seven years ago for a lump I found in my breast, but I was told it was a fatty lump and not harmful,' Dakota told FEMAIL. 'The only thing I noticed this time was some swollen lymph nodes under my arm. My doctor initially thought it was viral, and that I'd start to get sick because of it. But weeks went by and they weren't going down.' Eventually, she was sent for an ultrasound. 'I put it off for a week because I couldn't get an appointment and I didn't think it was serious. I mean, I was 28 and extremely healthy - what could it actually have been? 'But then I saw the ultrasound technician's face change and I knew something was wrong,' she recalled. Dakota's doctor told her it was suspected breast cancer. 'I was in shock,' she recalled. 'There's no cancer in my family. I felt completely healthy. I didn't know people in their twenties could get breast cancer.' What followed was a blur of medical tests: two biopsies, a PET scan, a CT scan, and a flurry of bloodwork. Then came the official diagnosis - stage 3 HER2-positive breast cancer, known for how quickly it spreads. 'I literally thought I was going to die. My whole life flashed before my eyes,' she said. She had just moved from the Gold Coast to Melbourne for a new job, but within six months, she was forced to resign to focus on treatment. 'I resigned when I was diagnosed, just because mentally it was too much to try and manage both,' she said. Dakota quickly discovered how aggressive her treatment would need to be. HER2-positive cancers require a combination of chemotherapy, targeted therapy, and often surgery. There wasn't time to do traditional egg freezing to preserve her fertility. Instead, she underwent emergency ovarian tissue freezing - a relatively uncommon procedure - and began monthly Zoladex injections to shut down her ovaries and protect them from the harsh effects of chemo. 'I had to go into early menopause almost overnight,' she said, suffering menopause-like symptoms such as hot flushes, mood swings, and more changes and puts your body through a physical toll. Dakota's chemotherapy began shortly after. Every three weeks, she receives a round of powerful drugs designed to kill the cancer cells. 'I get mouth ulcers, nausea, heartburn, memory fog, and even temporary vision issues,' she said. 'It takes about a week to even feel semi-human again. By the second week, I start feeling slightly better. The third week is my only good week - then it all starts again.' Two weeks after her first treatment, her hair started to fall out. 'My skin changed overnight. I've gone from having clear skin to acne on my face, chest and back,' she said. 'It's not something I can hide, and that's been one of the hardest parts.' In September, Dakota is scheduled to undergo surgery to remove the lymph nodes from her right side. If chemotherapy hasn't shrunk the tumour enough by then, doctors will perform a mastectomy. Determined to keep her mind active, she recently began an internship with a marketing agency. 'I just wanted to keep my brain moving and keep learning as much as I can,' she explained. Still, daily life looks dramatically different now. Even something as simple as leaving the house has become a challenge. 'It's whether you're brave enough to go to the grocery store with no hair and have everyone look,' she said. 'Otherwise it's, "Where's my wig? I've got to put my wig on". Those appearance-based things mean a lot more now. You're looked at differently.' Being 29 and living in Melbourne, she used to thrive on a busy social life. 'There was always something happening - going out for a wine during the week, seeing friends, just being out and about,' she said. 'Now it feels like everything's been put on hold.' Even the small things - those most people wouldn't think twice about - have shifted. 'I have to be so careful about what I eat, make sure all my vegetables are washed properly, make sure I'm walking, moving my body, keeping on top of everything. It's a lot. A lot of things have changed,' she said. The experience has made her re-evaluate everything - including how long the cancer may have been growing. 'I was told I had a fatty lump in my breast when I was 21. I didn't get it checked again until now,' she said. 'Looking back, I wonder if that was the start of it.' Despite everything, Dakota has found strength in unexpected places. She's continued doing Pilates and is completing her internship to stay mentally stimulated between treatments. 'There were a couple of weeks where I was in a 'poor me' headspace,' she said. 'But I've had to shift my mindset. I don't want cancer to take more from me than it already has.' She's also been buoyed by support from her loved ones. Her mum has flown to Melbourne twice to help care for her, and her partner has remained by her side. 'He's been incredible. His workplace has been so understanding, and not everyone is that lucky,' she said. But Dakota knows many other women don't have the same support - or access to early screenings. Since sharing her story, she's been contacted by other women in their twenties who are also battling breast cancer. 'I've heard from girls as young as 20 who have it. We're not anomalies - it's happening more and more,' she said. 'But there's still a massive age bias. We're told we're "too young" for breast cancer. We're not taught to check our breasts. Screenings aren't offered to us. And when we do speak up, we're often dismissed.' That's why she's launching a donation fund to help women under 40 access early breast cancer screenings - even if they don't have symptoms or family history. 'There's just no help for us,' she said. 'You shouldn't have to find a lump or wait until it's stage 3 to get answers.' Her goal is to have the fund up and running by the end of the year. 'I don't want to just survive this. I want to do something with it,' she said.
Medscape
4 days ago
- Health
- Medscape
Which Tx Combo Is Best for HER2+ Breast Cancer?
The combination of trastuzumab deruxtecan (Enhertu) with pertuzumab (Perjeta) as a first-line treatment for HER2-positive advanced metastatic breast cancer has been shown to reduce the risk for disease progression or death by more than the current standard-of-care treatment. Sara Tolaney, MD, MPH Sara Tolaney, MD, MPH, of the Dana-Farber Cancer Institute in Boston, presented this finding and other interim results of the phase 3 DESTINY-Breast09 study, at the American Society of Clinical Oncology (ASCO) 2025 annual meeting in Chicago. 'Trastuzumab deruxtecan, or T-DXd, in combination with pertuzumab demonstrated a statistically significant and clinically meaningful improvement in progression-free survival, with a 44% reduction in the risk of disease progression or death when compared to a taxane, trastuzumab, and pertuzumab (THP),' said Tolaney, during her presentation. New First-line Standard? Similar results were observed across all patient subgroups, with no new safety signals, Tolaney said. 'These data suggest that T-DXd and pertuzumab may represent a new first-line standard of care for patients with metastatic HER2-positive breast cancer,' she said. The study randomized 1157 patients to three treatment groups: T-DXd 5.4 mg/kg every three weeks plus placebo, T-DXd-pertuzumab, or a taxane plus trastuzumab with pertuzumab (THP). The interim study readout includes only data from the T-DXd-pertuzumab and the taxane plus trastuzumab with pertuzumab groups. Pertuzumab + T-Dxd or Standard of Care? Median progression-free survival (PFS) was 40.7 months in the T-DXd-pertuzumab patients and 26.9 months in the taxane plus trastuzumab with pertuzumab patients ( P < .00001). Tolaney explained that the study was designed to have an interim analysis for PFS after approximately 399 events across the three arms with at least 277 events for comparison. At the time of the interim analysis, she said, only the TDX-pertuzumab and THP groups met the criteria for superiority, a P -value < .00043, which was not met for the comparison of T-DXd plus placebo to THP. The T-DXd-placebo arm remains blinded until the final progression-free survival analysis, Tolaney said. Twenty-one percent of the patients in the T-DXd-pertuzumab arm had discontinued T-DXd due to adverse events, Tolaney said; 9% of patients elected to continue with trastuzumab and pertuzumab after they discontinued T-DXd. Among hormone receptor-positive patients, 13.5% in the T-DXd-pertuzumab group and 38% in the THP group elected to add endocrine treatment. At the data cutoff, 46% of the T-DXd-pertuzumab patients and 33% of those in the THP group remained on study treatment. Median follow-up duration was 29 months. The treatment effect of T-DXd-pertuzumab became evident early in the study, Tolaney said. Six months after starting treatment, 7% of the T-DXd-pertuzumab group vs 12% of the THP group had progressed. The gap continued to widen over time, she said. 'With 26% of patients still on steady treatment with T-DXd and pertuzumab, it suggests that this median is likely to evolve with further follow-up,' she said. Objective response rates were also higher with T-DXd–pertuzumab, 86% vs 79% with THP, Tolaney said. 'The complete response rate for T-DXd and pertuzumab was 15%, which was almost double what was seen with THP (8.5%),' she said. Response duration was also longer with T-DXd-pertuzumab, with 73% remaining in response at 24 months vs 55% in the THP arm. 'Overall survival data are very immature at this timepoint with just 16% of survival events seen, but you can see that there is an early trend favoring T-DXd plus pertuzumab with a hazard ratio of 0.84,' she said. A similar number of patients in both groups had serious treatment-emergent adverse events: 27% for T-DXd-pertuzumab and 25.1% for THP, which Tolaney said, was consistent with the known toxicity profiles of both agents, with no new toxicities identified. The median duration of treatment in the DESTINY-Breast09 study was 21 months. 'A Pivotal Advancement?' Rebecca Dent, MD, deputy CEO at the National Cancer Center Singapore, called the DESTINY-Breast09 results 'a pivotal advancement in the treatment of HER2-positive metastatic breast cancer that is both clinically and statistically significant.' Rebecca Dent, MD HER2-positive metastatic breast cancer was once considered a 'death sentence,' Dent said at a press conference, but now patients can survive on therapy for years, which presents its own challenges. Regarding the T-DXd-plus-pertuzumab regimen, Dent said, 'Is this for all patients at the beginning of their treatment for metastatic disease?' The truth of the matter is we don't know.' Having better biomarkers would provide answers, she said, but for patients with extensive disease with central nervous system metastasis, pertuzumab in combination with other agents 'is clearly your first-line choice.' How to best sequence therapies is another challenge emerging with these evolving treatment regimens, Dent added. 'And then I think finally we do have to appreciate that there are toxicities: One in terms of quality of life but also cost toxicity,' she said. Which Therapeutic Regimen Costs More? Tolaney acknowledged the cost implications of adding pertuzumab to T-DXd, in an interview with Medscape Medical News . 'But I would also note,' Tolaney said, 'that the standard-of-care arm does involve getting continued trastuzumab and pertuzumab therapy.' In the PATINA study, which added palbociclib (Ibrance) to standard maintenance therapy in patients with HER2-positive metastatic breast cancer, the cost profile was similar to those of the treatments used in the newer trial, Tolaney said. 'You are looking at substantial continued cost because we're continuing to suppress the HER2 pathway for years in these patients,' she said. AstraZeneca and Daiichi Sankyo funded the study. Tolaney reported financial relationships with ADi, Ambrx, Artios Biopharmaceuticals, Arvinas, AstraZeneca, Bayer, BeiGene, Bicycle Therapeutics, BioNTech, Blueprint Medicines, Bristol Myers Squibb, Circle Pharma, Cullinan Oncology, Daiichi Sankyo, eFFECTOR Therapeutics, Eisai, Exelixis, Genentech, Gilead Sciences, Hengrui Pharmaceutical (USA), Immunomedics/Gilead, Incyte, Jazz Pharmaceuticals, Johnson & Johnson, Launch Therapeutics, Lilly, Menarini Group, Merck, Mersana, NanoString Technologies, Natera, Novartis, OncoPep, Pfizer, Reveal Genomics, Sanofi, Seagen, Sumitovant Biopharma, Summit Therapeutics, Systimmune, Tango Therapeutics, Zentalis, Zuellig Pharma, and Zymeworks. Dent reported having financial relationships with AstraZeneca, Daiichi Sankyo/Astra Zeneca, DKSH, Eisai, Gilead Sciences, Merck Sharpe and Dohme, Novartis, Pfizer, and Roche.
Free Malaysia Today
03-06-2025
- Business
- Free Malaysia Today
New hope for patients with less common breast cancer
Results from a new study could soon establish a new first-line therapy for people with HER2-positive metastatic breast cancer. (Envato Elements pic) WASHINGTON : A new treatment nearly halves the risk of disease progression or death from a less common form of breast cancer that hasn't seen major drug advances in over a decade, researchers reported Monday. Results from the study, presented at the annual meeting of the American Society for Clinical Oncology, are expected to be submitted to regulators and could soon establish a new first-line therapy for people with HER2-positive metastatic breast cancer – the advanced stage of a form that comprises 15–20% of all breast cancer cases. HER2-positive cancers are fuelled by an overactive HER2 gene, which makes too much of a protein called human epidermal growth factor receptor 2 that helps cancer cells grow and spread. Patients with HER2-positive breast cancer that has spread to other parts of the body live around five years. 'Seeing such a striking improvement was really impressive to us – we were taking a standard and almost doubling how long patients could have their cancer controlled for,' oncologist Sara Tolaney, chief of the breast oncology division at Dana-Farber Cancer Institute, told AFP. The current standard of care, known as THP, combines chemotherapy with two antibodies that block growth signals from the HER2 protein. The new approach uses a drug called trastuzumab deruxtecan (T-DXd), an antibody attached to a chemotherapy drug. 'Smart bomb' This 'smart bomb' strategy allows the drug to target cancer cells directly. 'You can bind to the cancer cell and dump all that chemo right into the cancer cells,' explained Tolaney. 'Some people call them smart bombs because they're delivering chemo in a targeted fashion – which is how I think we're able to really increase efficacy so much.' Common side effects included nausea, diarrhea and a low white blood cell count, with a less common effect involving lung scarring. T-DXd is already approved as a 'second-line' option – used when first-line treatments stop working. But in the new trial, it was given earlier, paired with another antibody, pertuzumab. In a global trial led by Tolaney, just under 400 patients were randomly assigned to receive T-DXd in combination with pertuzumab, thought to enhance its effects. A similar number received the standard THP regimen. A third group, who received T-DXd without pertuzumab, was also enrolled — but those results haven't yet been reported. 44% risk reduction At a follow-up of 2.5 years, the T-DXd and pertuzumab combination reduced the risk of disease progression or death by 44% compared to standard care. Meanwhile, 15% of patients in the T-DXd group saw their cancer disappear entirely, compared to 8.5% in the THP group. Because this was an interim analysis, the median progression-free survival – meaning the point at which half the patients had seen their cancer return or worsen – was 40.7 months with the new treatment, compared to 26.9 months with the standard, and could rise further as more data come in. Tolaney said the results would be submitted to regulators around the world, including the US Food and Drug Administration, and that future work would focus on optimizing how long patients remain on the treatment, particularly those showing complete remission. 'This represents a new first-line standard treatment option for HER2-positive metastatic breast cancer,' said Dr. Rebecca Dent, a breast cancer specialist at the National Cancer Center Singapore who was not involved in the study
CTV News
02-06-2025
- Business
- CTV News
New hope for patients with less common breast cancer
A new treatment nearly halves the risk of disease progression or death from a less common form of breast cancer, researchers reported. (Voyagerix/ Washington, United States — A new treatment nearly halves the risk of disease progression or death from a less common form of breast cancer that hasn't seen major drug advances in over a decade, researchers reported Monday. Results from the study, presented at the annual meeting of the American Society for Clinical Oncology, are expected to be submitted to regulators and could soon establish a new first-line therapy for people with HER2-positive metastatic breast cancer -- the advanced stage of a form that comprises 15–20 percent of all breast cancer cases. HER2-positive cancers are fueled by an overactive HER2 gene, which makes too much of a protein called human epidermal growth factor receptor 2 that helps cancer cells grow and spread. Patients with HER2-positive breast cancer that has spread to other parts of the body live around five years. 'Seeing such a striking improvement was really impressive to us -- we were taking a standard and almost doubling how long patients could have their cancer controlled for,' oncologist Sara Tolaney, chief of the breast oncology division at Dana-Farber Cancer Institute, told AFP. The current standard of care, known as THP, combines chemotherapy with two antibodies that block growth signals from the HER2 protein. The new approach uses a drug called trastuzumab deruxtecan (T-DXd), an antibody attached to a chemotherapy drug. 'Smart bomb' This 'smart bomb' strategy allows the drug to target cancer cells directly. 'You can bind to the cancer cell and dump all that chemo right into the cancer cells,' explained Tolaney. 'Some people call them smart bombs because they're delivering chemo in a targeted fashion -- which is how I think we're able to really increase efficacy so much.' Common side effects included nausea, diarrhea and a low white blood cell count, with a less common effect involving lung scarring. T-DXd is already approved as a 'second-line' option -- used when first-line treatments stop working. But in the new trial, it was given earlier, paired with another antibody, pertuzumab. In a global trial led by Tolaney, just under 400 patients were randomly assigned to receive T-DXd in combination with pertuzumab, thought to enhance its effects. A similar number received the standard THP regimen. A third group, who received T-DXd without pertuzumab, was also enrolled -- but those results haven't yet been reported. 44 percent risk reduction At a follow-up of 2.5 years, the T-DXd and pertuzumab combination reduced the risk of disease progression or death by 44 percent compared to standard care. Fifteen percent of patients in the T-DXd group saw their cancer disappear entirely, compared to 8.5 percent in the THP group. Because this was an interim analysis, the median progression-free survival -- meaning the point at which half the patients had seen their cancer return or worsen -- was 40.7 months with the new treatment, compared to 26.9 months with the standard, and could rise further as more data come in. Tolaney said the results would be submitted to regulators around the world, including the US Food and Drug Administration, and that future work would focus on optimizing how long patients remain on the treatment, particularly those showing complete remission. 'This represents a new first-line standard treatment option for HER2-positive metastatic breast cancer,' said Dr. Rebecca Dent, a breast cancer specialist at the National Cancer Center Singapore who was not involved in the study
