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One
Heavy news yesterday, Pertuzumab (brand name: Pajet) was approved for use in China First-line treatment for patients with HER2-positive advanced breast cancer!
HER2-positive (HER2 +) Breast cancer is a subtype of breast cancer because tumor cells highly express a type called “HER2” Named after the protein. According to genetic characteristics, breast cancer can be divided into three categories: HER2 positive, hormone receptor positive and triple negative. (Further reading: How should breast cancer be classified?)
In the past, HER2-positive breast cancer progressed rapidly due to lack of drugs and was once the worst subtype of treatment. Fewer than 30% of patients survive more than 5 years. But in the past 20 years, several new targeted drugs targeting HER2 have been launched, which has completely changed this situation. Especially with the advent of trastuzumab (brand name: Herceptin) , this type of breast cancer has completely turned over and turned into treatment The one that works best.
Trastuzumab and Pertuzumab are targeted drugs against HER2. Their mechanism of action, in short, is to inhibit the cell’s HER2 signaling pathway. This signal is extremely important for the growth of HER2-positive breast cancer cells. When blocked, cancer cells stop growing and even die.
Second
The current standard therapy for patients with HER2-positive advanced breast cancer in China is “trastuzumab + chemotherapy.” Now that Pertuzumab is approved, it is not intended to replace trastuzumab and chemotherapy, but to add standard therapies, to form a better “pertuzumab + trastuzumab + chemotherapy “Three-drug joint program.
Research shows that compared with the current two-drug regimen, the three-drug regimen can better control tumors and prolong patient survival. In an international large-scale clinical trial code-named CLEOPATRA, the median survival of advanced patients treated with the three-drug regimen has been improved by a full 16 months compared to the previous, and it is almost five years!
Let the advanced patients live for more than a year, which is a great achievement. This result has also been published twice in the top New England Journal of Medicine.
As a result of this study, as early as 2012, the United States has approved Pertuzumab for the treatment of patients with HER2-positive advanced breast cancer.
After 7 years, Chinese patients have finally waited for the good news. They no longer need to use this drug in other countries and regions.
People will definitely ask, why is China so late?
The main reason is that Chinese data have been lacking in previous clinical trials, and almost all are European and American patients. The successful launch of the drug is mainly due to the clinical trials of the Chinese population led by Professor Xu Binghe of the Cancer Hospital of the Chinese Academy of Medical Sciences.
In the trial of PUFFIN in Chinese breast cancer patients, the three-drug regimen of “Pertuzumab + Trastuzumab + Chemotherapy” has once again proven to be superior to traditional therapies.
There is no doubt that with the introduction of Pertuzumab in China, treatment options for some patients with advanced breast cancer in China will change.
Quoting Professor Xu Binghe’s comment: “(This study) provides strong evidence-based medical evidence for the Chinese patient’s more secure use of Pertuzumab combined with Trastuzumab, which will further promote our country. The change in the diagnosis and treatment pattern of HER2-positive advanced breast cancer brings hope for patients. “
Three
Are there any chances of clinical cure for HER2-positive advanced breast cancer?
Although no one dares to vouch for an individual, turning HER2-positive breast cancer into a chronic disease as a whole is no longer a dream.
The treatment of HER2-positive breast cancer has changed dramatically in the past 20 years, and several targeted drugs have been introduced. In addition to the aforementioned trastuzumab and pertuzumab, as well as lapatinib, pirlotinib, T-DM1, etc., they have shown varying degrees of efficacy in their clinical trials, bringing patients Here comes more options and hope.
Everyone has reason to be confident.
For example, in the 8-year survival study published this year, up to 37% of patients with advanced drugs using the three-drug combination regimen of “pertuzumab + trastuzumab + chemotherapy” are still alive!
Experts do n’t use the word “heal” at will, but let itMore advanced patients have lived for 8 years, which is a very remarkable achievement.
Not only is there a breakthrough in HER2-positive breast cancer, in fact, the overall treatment of breast cancer is getting better and better.
For example, patients with hormone receptor-positive subtypes also welcome CDK4 / 6 targeted drugs, while triple-negative patients welcome PARP-targeted drugs and PD-1 / PD-L1 immune drugs.
Everyone may not know that the goals in the guidelines for breast cancer treatment developed by experts have quietly changed.
In the 2014 ABC International Consensus Guidelines, it is stated that “advanced breast cancer as a whole remains incurable, and the goal of treatment is to improve quality of life and prolong life.”
But in 2018, the new guide speech has changed a little bit. The goal now is: “Improve the quality of life and prolong life, and strive for cure.” The emergence of the word “heal” proves academic The world is more confident than before.
In the recent medical insurance negotiations, Herceptin in the dual-target treatment plan was successfully renewed through the national health insurance negotiations, and new adjuvant therapy indications were added; and Pateit was used for locally advanced, inflammatory patients with HER2 positive New adjuvant therapy for patients with early or early breast cancer and adjuvant therapy for patients with HER2-positive early breast cancer with a high risk of recurrence are also included for the first time in the Medicare Drug List.
It is foreseeable that more and more breast cancer patients will have the opportunity to receive standardized two-target therapy and benefit from it. Let us believe in science together, in ourselves.
To pay tribute to life!
* This article aims at the science behind new cancer medicines for popular science. It is not a drug promotion material, nor is it a treatment plan recommendation. For guidance on disease treatment options, visit a regular hospital.
References:
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3. Marty M, et al. J Clin Oncol. 2005 Jul 1; 23 (19): 4265-74.
4. Baselga J, et al. N Engl J Med. 2012; 366: 109-119.
5. Swain SM, et al.N Engl J Med 2015; 372: 724–734
6. Swain SM, et al. ASCO.2019. abstr 1020.
7. Binghe Xu ,, etal. 2019 ASCO. Abstract 1026.
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