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Park MH, Seo JH, Park JH, Seong MK, Park KU, Kim MK, Chang M, Koh SJ, Lee MH, Lim ST, Yoo YB, Oh SY, Kim SH, Ahn KY, Park TH, Ju H, Baek EH, Kim S, Kim N, Lee E, Kim TH. Efficacy and safety of biosimilar trastuzumab (CT-P6) in routine clinical practice in the Republic of Korea: a real-world post-marketing surveillance study. Expert Opin Biol Ther 2024; 24:305-312. [PMID: 38664937 DOI: 10.1080/14712598.2024.2334386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/20/2024] [Indexed: 04/30/2024]
Abstract
BACKGROUND The trastuzumab biosimilar CT-P6 is approved for human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (EBC), metastatic breast cancer (MBC), and metastatic gastric cancer (MGC). The objective of this post-marketing surveillance (PMS) study was to evaluate the real-world safety and effectiveness of CT-P6 in patients with HER2-positive cancers. RESEARCH DESIGN AND METHODS This open-label, observational, prospective, PMS study collected data via investigator surveys from 35 centers in the Republic of Korea (5 October 2018-4 October 2022). Eligible patients with HER2-positive EBC, MBC, or MGC started CT-P6 treatment during routine clinical practice, followed by 1-year observation. Evaluations included adverse events (AEs), adverse drug reactions (ADRs), and effectiveness. RESULTS Safety was analyzed in 642 patients (494 EBC, 94 MBC, 54 MGC). Overall, 325 (50.6%) patients experienced 1316 AEs, and 550 ADRs occurred in 199 (31.0%) patients. Unexpected ADRs occurred in 62 (9.7%) patients. Unexpected ADRs and ADRs of special interest did not raise any new safety signals. Among trastuzumab-naïve patients, 34/106 (32.1%) with EBC achieved pathological complete response; 30/74 (40.5%) MBC and 24/49 (49.0%) MGC patients achieved complete or partial response. CONCLUSIONS In a real-world setting, CT-P6 demonstrated safety and efficacy findings consistent with previous CT-P6 studies.
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Affiliation(s)
- Min Ho Park
- Chonnam National University Medical School and Hwasun Hospital, Hwasun, Republic of Korea
| | - Jae Hong Seo
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jung Ho Park
- Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Min-Ki Seong
- Korea Cancer Center Hospital, Seoul, Republic of Korea
| | - Keon Uk Park
- Keimyung University Dongsan Medical Hospital, Daegu, Republic of Korea
| | - Min Kyoon Kim
- Chung-Ang University Hospital, Seoul, Republic of Korea
| | | | - Su-Jin Koh
- Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Moon Hee Lee
- Inha University Hospital, Incheon, Republic of Korea
| | - Seung Taek Lim
- Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Young Bum Yoo
- Konkuk University Medical Center, Seoul, Republic of Korea
| | - So Yeon Oh
- Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | | | | | | | - Hana Ju
- Celltrion, Inc., Incheon, Republic of Korea
| | | | - Sinhye Kim
- Celltrion, Inc., Incheon, Republic of Korea
| | - Nahyun Kim
- Celltrion, Inc., Incheon, Republic of Korea
| | | | - Tae Hyun Kim
- Inje University, Busan Paik Hospital, Busan, Republic of Korea
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2
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Peliçário Vargas B, Sari MHM, Ferreira LM. Trastuzumab in breast cancer treatment: the Era of biosimilars. Anticancer Agents Med Chem 2022; 22:2507-2516. [PMID: 35236272 DOI: 10.2174/1871520622666220302114313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/24/2021] [Accepted: 12/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The discovery of trastuzumab as anti-HER2 therapy markedly improved disease control and the survival rates of patients with HER2+ breast cancer. However, as trastuzumab is considered a complex molecule, the cost of production is usually elevated, which significantly affects health budgets and limits the treatment access for patients who live in underdeveloped countries. Recently, trastuzumab production became more accessible and sustainable due to the patents' expiration, allowing biosimilar versions of trastuzumab to be developed. OBJECTIVE Our main goal was to shed more light on the uses of biosimilars in breast cancer treatment, emphasizing trastuzumab. METHOD An integrative review was carried out in the PubMed, Scielo, Web of Science, and SCOPUS databases using the terms "biosimilar," "breast cancer," "monoclonal antibody," and "trastuzumab." The time range included scientific articles published from 2015 to 2021. RESULTS AND DISCUSSION The bibliographic survey showed the complexities in biological medicine manufacturing and how the monoclonal antibody's therapy with trastuzumab improved the patients' life expectancy, revolutionizing HER2+ breast cancer treatment. Nonetheless, despite its benefits, trastuzumab generates certain restrictions, especially from the economic perspective. Trastuzumab biosimilars have high selectivity and rarely cause adverse effects compared to conventional chemotherapy. CONCLUSION This study shows that trastuzumab biosimilars improve patients' accessibility to breast cancer treatment through a safe and effective therapy compared to the drug reference.
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Affiliation(s)
- Bárbara Peliçário Vargas
- Departamento de Farmácia Industrial, Curso de Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | | | - Luana Mota Ferreira
- Departamento de Farmácia Industrial, Curso de Farmácia, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil;
- Programa de Pós-graduação em Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, Brazil
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3
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Minot-This MS, Bellesoeur A. [New approval: Trastuzumab-deruxtecan for metastatic breast cancer HER2]. Bull Cancer 2021; 108:783-784. [PMID: 34144792 DOI: 10.1016/j.bulcan.2021.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Marie-Sophie Minot-This
- Institut Gustave-Roussy, département d'oncologie digestive, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
| | - Audrey Bellesoeur
- Institut Curie, département d'oncologie médicale, 26, rue Ulm, 75005 Paris, France; Institut Curie, département de radio-pharmacologie, 35, rue Dailly, 92210 Saint-Cloud, France
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4
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Yokoe T, Kurozumi S, Nozawa K, Ozaki Y, Maeda T, Yazaki S, Onishi M, Fujimoto A, Nakayama S, Tsuboguchi Y, Iwasa T, Sakai H, Ogata M, Terada M, Nishimura M, Onoe T, Masuda J, Kurikawa M, Isaka H, Hagio K, Shimomura A, Okumura Y, Futamura M, Shimokawa M, Takano T. Clinical benefit of treatment after trastuzumab emtansine for HER2-positive metastatic breast cancer: a real-world multi-centre cohort study in Japan (WJOG12519B). Breast Cancer 2021; 28:581-91. [PMID: 33389616 DOI: 10.1007/s12282-020-01192-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/19/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Trastuzumab emtansine (T-DM1) treatment for human epidermal growth factor receptor-2 (HER2)-positive metastatic breast cancer after taxane with trastuzumab and pertuzumab is standard therapy. However, treatment strategies beyond T-DM1 are still in development with insufficient evidence of their effectiveness. Here, we aimed to evaluate real-world treatment choice and efficacy of treatments after T-DM1 for HER2-positive metastatic breast cancer. METHODS In this multi-centre retrospective cohort study involving 17 hospitals, 325 female HER2-positive metastatic breast cancer patients whose post-T-DM1 treatment began between April 15, 2014 and December 31, 2018 were enrolled. The primary end point was the objective response rate (ORR) of post-T-DM1 treatments. Secondary end points included disease control rate (DCR), progression-free survival (PFS), time to treatment failure (TTF), and overall survival (OS). RESULTS The median number of prior treatments of post-T-DM1 treatment was four. The types of post-T-DM1 treatments included (1) chemotherapy in combination with trastuzumab and pertuzumab (n = 102; 31.4%), (2) chemotherapy concomitant with trastuzumab (n = 78; 24.0%), (3), lapatinib with capecitabine (n = 63; 19.4%), and (4) others (n = 82; 25.2%). ORR was 22.8% [95% confidence interval (CI): 18.1-28.0], DCR = 66.6% (95% CI 60.8-72.0), median PFS = 6.1 months (95% CI 5.3-6.7), median TTF = 5.1 months (95% CI 4.4-5.6), and median OS = 23.7 months (95% CI 20.7-27.4). CONCLUSION The benefits of treatments after T-DM1 are limited. Further investigation of new treatment strategies beyond T-DM1 is awaited for HER2-positive metastatic breast cancer patients.
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5
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Pondé N, Agbor-Tarh D, Dal Lago L, Korde LA, Hilbers F, Jackisch C, Werner O, Gelber RD, Jatoi A, Dueck AC, Moreno-Aspitia A, Sotiriou C, de Azambuja E, Piccart M. Tolerability and toxicity of trastuzumab or trastuzumab + lapatinib in older patients: a sub-analysis of the ALTTO trial (BIG 2-06; NCCTG (Alliance) N063D). Breast Cancer Res Treat 2020; 185:107-116. [PMID: 32951084 DOI: 10.1007/s10549-020-05915-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/01/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE Little is known about the use of trastuzumab or trastuzumab + lapatinib in older patients. We have performed a sub-analysis of the Adjuvant Lapatinib And/Or Trastuzumab Treatment Optimisation (ALTTO) trial focused on toxicity and treatment completion of both regimens in older patients (≥ 65 years old) METHODS: The ALTTO trial randomised 8381 patients with early HER2-positive BC in 4 arms. Eligible patients for this study were those having received at least one dose of assigned treatment in either the trastuzumab or trastuzumab + lapatinib arms. Treatment completion was evaluated through the rate of temporary treatment interruptions, permanent treatment discontinuations and lapatinib dose reductions. Toxicity was evaluated via a selected subset of adverse events of interest (AEI). Risk factors for both treatment completion outcomes and toxicity were investigated, including comorbidities and use of 5 or more co-medications at randomization. RESULTS A total of 430 patients ≥ 65 year were eligible. Median age was 68 (range 65-80). In comparison with the younger cohort, older patients had a significantly higher number of comorbidities at randomization (p < 0.001). Treatment completion outcomes were worse, particularly in the trastuzumab + lapatinib arm. Adverse events of interest were likewise more common in the trastuzumab + lapatinib arm with higher AEI rates (63.4% in younger vs 78.0% in older, p < 0.001). Concomitant chemotherapy was associated with worse treatment completion outcomes among older patients. CONCLUSION Trastuzumab plus lapatinib was significantly more toxic among older patients and had worse treatment completion. Trastuzumab was generally well tolerated.
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Affiliation(s)
- Noam Pondé
- AC Camargo Cancer Center, Rua Pires da Mota, 1167, São Paulo, 01529-001, Brazil. .,Institut Jules Bordet, Brussels, Belgium.
| | | | | | | | | | | | | | - Richard D Gelber
- Dana-Farber Cancer Institute, Boston, USA.,Frontier Science and Technology Research Foundation, Boston, MA, USA
| | | | | | | | | | | | - Martine Piccart
- Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
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6
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Farràs M, Román R, Camps M, Miret J, Martínez Ó, Pujol X, Casablancas A, Cairó JJ. Heavy chain dimers stabilized by disulfide bonds are required to promote in vitro assembly of trastuzumab. BMC Mol Cell Biol 2020; 21:2. [PMID: 31964343 PMCID: PMC6975058 DOI: 10.1186/s12860-019-0244-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Monoclonal antibodies (mAbs) and their derivatives have become one of the most important classes of therapeutic drugs. Their multiple applications increased the interest for understanding their complex structure. In vivo, animal cells are able to fold mAbs correctly (Song et al, J Biosci Bioeng 110:135-40, 2010), whereas previous in vitro approaches were scarce and mostly unsuccessful. RESULTS In this work, we compared in vitro assembly characteristics of trastuzumab, produced either by A) physical separation and refolding of its sub-units or B) direct joining of individually produced heavy and light chains. Native and denatured structures of trastuzumab were determined by SEC-HPLC, HIC-HPLC and SDS-PAGE. CONCLUSIONS Our results demonstrate the requirement of correctly folded HC, forming disulfide-bonded dimers, in order to form a fully functional mAb. Otherwise, the unfolded HC tend to precipitate. We were able to assemble trastuzumab in this fashion by only mixing them to LC in pH-buffered conditions, while monomeric HC structure was too unstable to render a functional mAb. This approach has been used in the generation of homogeneous ADC, with results pending to be published.
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Affiliation(s)
- Mercè Farràs
- Department of Biotechnology, Farmhispania SA, Montmeló, Spain.
| | - Ramón Román
- Department of Chemical, Biological and Environmental Engineering, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Marc Camps
- Department of Biotechnology, Farmhispania SA, Montmeló, Spain
| | - Joan Miret
- Department of Chemical, Biological and Environmental Engineering, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Óscar Martínez
- Department of Biotechnology, Farmhispania SA, Montmeló, Spain
| | - Xavier Pujol
- Department of Biotechnology, Farmhispania SA, Montmeló, Spain
| | - Antoni Casablancas
- Department of Chemical, Biological and Environmental Engineering, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Jordi Joan Cairó
- Department of Chemical, Biological and Environmental Engineering, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
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7
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Abstract
Available data on systemic treatments in pregnancy-associated breast cancer (PABC) is reviewed in this section. These treatments include chemotherapy, endocrine therapy (ET), small molecule inhibitors, monoclonal antibodies against human epidermal growth factor receptor 2 (EGFR-2) also known as HER2; and human epidermal growth factor receptor 3 (EGFR-3), also known as HER3.In local disease, systemic treatment can be delivered as neoadjuvant (before surgery) or adjuvant (after surgery) treatment. In metastatic disease, systemic therapy is the main modality of treatment.Approach to PABC is based on available data in the general population, limited only by safety issues for use of medications during gestation and lactation. Therefore, treatments are similar to non-PABC patients while trying to minimize the risk to the fetus. Available data on different chemotherapies, anti-HER2 monoclonal antibodies, ET and small molecule inhibitors are discussed in detail.
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Affiliation(s)
- Omid S Tehrani
- Department of Hematology and Medical Oncology, Stanford University, Stanford, CA, USA.
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8
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Xu C, Ravva P, Dang JS, Laurent J, Adessi C, McIntyre C, Meneses-Lorente G, Mercier F. A continuous-time multistate Markov model to describe the occurrence and severity of diarrhea events in metastatic breast cancer patients treated with lumretuzumab in combination with pertuzumab and paclitaxel. Cancer Chemother Pharmacol 2018; 82:395-406. [PMID: 29915982 DOI: 10.1007/s00280-018-3621-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/06/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE To inform lumretuzumab and pertuzumab dose modifications in order to decrease the incidence, severity, and duration of the diarrhea events in metastatic breast cancer patients treated with a combination therapy of lumretuzumab (anti-HER3) in combination with pertuzumab (anti-HER2) and paclitaxel using quantitative clinical pharmacology modeling approaches. METHODS The safety and pharmacokinetic (PK) data from three clinical trials (lumretuzumab monotherapy n = 47, pertuzumab monotherapy n = 78, and the combination therapy of lumretuzumab, pertuzumab and paclitaxel n = 35) were pooled together to develop a continuous-time discrete states Markov model describing the dynamics of the diarrhea events. RESULTS The model was able to capture the time course of different severities of diarrhea reasonably well. The effect of lumretuzumab and pertuzumab was well described by an Emax function indicating an increased rate of transition from moderate to mild or more severe diarrhea with higher doses. The concentration needed to trigger or worsen diarrhea episodes was estimated to be 120-fold lower in combination therapy compared to monotherapy, suggesting strong synergy between the two monoclonal antibodies. The prophylactic effect of loperamide in a subset of patients was also well captured by the model with a clear tendency to reduce the occurrence of diarrhea events. CONCLUSIONS This work shows that PK-toxicity modeling provides insight into how the severity of key adverse events evolves over time and highlights the potential use to support decision making in drug development.
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Affiliation(s)
- Chao Xu
- Clinical Pharmacology, Pharmaceutical Sciences, Roche Innovation Center New York, New York, USA
- Quantitative Pharmacology and Pharmacometrics, Merck & Co., Inc, Rahway, USA
| | - Patanjali Ravva
- Clinical Pharmacology, Pharmaceutical Sciences, Roche Innovation Center New York, New York, USA
| | - Jun Steve Dang
- Clinical Pharmacology, Pharmaceutical Sciences, Roche Innovation Center New York, New York, USA
| | - Johann Laurent
- Clinical Pharmacology, Pharmaceutical Sciences, Roche Innovation Center Basel, Basel, Switzerland
| | - Céline Adessi
- Pharma Drug Safety Licensing, Roche Innovation Center Basel, Basel, Switzerland
| | - Christine McIntyre
- Clinical Pharmacology, Pharmaceutical Sciences, Roche Innovation Center Welwyn, Welwyn, UK
| | | | - François Mercier
- Clinical Pharmacology, Pharmaceutical Sciences, Roche Innovation Center Basel, Basel, Switzerland.
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9
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Hamdan D, Darrouzain F, Bejan-Angoulvant T, Isorni C, Zelek L, Paintaud G, Janin A, Bousquet G. A novel way to manage trastuzumab cardiotoxicity. Cancer Chemother Pharmacol 2018; 81:791-6. [PMID: 29497813 DOI: 10.1007/s00280-018-3555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Trastuzumab is the most widely prescribed anti-HER2 humanized monoclonal antibody. Cardiac toxicity is the only limiting toxicity of trastuzumab and it is of particular concern in patients with complete response, since the drug needs to be stopped, with a risk of disease relapse. To date, no pharmacological data on trastuzumab cardiotoxicity in patients have been made available. Here, we provide proof of concept, demonstrating that it was possible to prevent trastuzumab-induced cardiotoxicity by modifying the drug administration schedule. METHODS In this paper, we report the case of a patient with metastatic breast cancer responding to trastuzumab, who developed severe cardiac toxicity twice using a 3-weekly regimen. Considering preclinical pharmacological data on trastuzumab cardiotoxicity, we hypothesized that a weekly schedule of trastuzumab with lower peaks of serum concentration could be safe while remaining efficient. With the patient's consent, we started a weekly combination of carboplatin (AUC2) and trastuzumab (2 mg/kg) with close monitoring of trastuzumab concentrations. RESULTS We successfully controlled the disease for an additional 6 months with relevant trough concentrations of trastuzumab of around 50 mg/L. Another important aspect is that, with this weekly schedule, we observed no cardiac toxicity, and the left ventricular ejection fraction remained stabilized, at over 50%. CONCLUSIONS Trastuzumab is the most widely prescribed anti-HER2 monoclonal antibody for the treatment of HER2 metastatic breast cancer, and it is the only drug that has been approved for the treatment of localized HER2 breast cancer, 1-year treatment being required after surgery. In case of cardiac toxicity, particularly in women over 60 years of age, a weekly regimen with lower peaks of concentration could be an alternative to the standard 3-weekly regimen.
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10
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Kowalczyk L, Bartsch R, Singer CF, Farr A. Adverse Events of Trastuzumab Emtansine (T-DM1) in the Treatment of HER2-Positive Breast Cancer Patients. Breast Care (Basel) 2017; 12:401-408. [PMID: 29456473 PMCID: PMC5803744 DOI: 10.1159/000480492] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The human epidermal growth factor receptor 2 (HER2) is commonly associated with poor prognosis and is overexpressed in approximately 15-20% of all breast cancers. The introduction of HER2-targeted therapies led to significant improvement in the prognosis of patients with HER2-positive breast cancer, for both early and advanced disease. These targeted therapies include the antibodies trastzumab and pertuzumab, the tyrosine kinase inhibitor lapatinib, and the antibody-drug conjugate trastuzumab emtansine (T-DM1). T-DM1 combines the anti-tumor activity of trastuzumab with that of DM1, a highly potent derivative of the anti-microtubule agent maytansine, resulting in increased anti-tumor activity. Notably, this agent has been demonstrated to be safe and is associated with low toxicity rates. However, maytansinoid, the cytotoxic component of T-DM1, does have the potential to induce various adverse events, particularly radiation necrosis, when used in combination with stereotactic radiosurgery. In this review, we aimed to summarize the current literature regarding T-DM1 safety and toxicity, with special emphasis on the existing landmark studies.
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Affiliation(s)
- Lidia Kowalczyk
- Clinical Unit of Anesthesiology and Perioperative Intensive-Care Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Rupert Bartsch
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Christian F. Singer
- Department of Obstetrics and Gynecology, Division of Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Department of Obstetrics and Gynecology, Division of Gynecology and Gynecologic Oncology, Medical University of Vienna, Vienna, Austria
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11
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Avazzadeh R, Vasheghani-Farahani E, Soleimani M, Amanpour S, Sadeghi M. Synthesis and application of magnetite dextran-spermine nanoparticles in breast cancer hyperthermia. Prog Biomater 2017; 6:75-84. [PMID: 28624871 DOI: 10.1007/s40204-017-0068-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Cancer treatment has been very challenging in recent decades. One of the most promising cancer treatment methods is hyperthermia, which increases the tumor temperature (41-45 °C). Magnetic nanoparticles have been widely used for selective targeting of cancer cells. In the present study, magnetic dextran-spermine nanoparticles, conjugated with Anti-HER2 antibody to target breast cancer cells were developed. The magnetic dextran-spermine nanoparticles (DMNPs) were prepared by ionic gelation, followed by conjugation of antibody to them using EDC-NHS method. Then the Prussian blue method was used to estimate the targeting ability and cellular uptake. Cytotoxicity assay by MTT showed that antibody-conjugated MNPs (ADMNPs) have no toxic effect on SKBR3 and human fibroblast cells. Finally, the hyperthermia was applied to show that synthesized ADMNPs, could increase the cancer cells temperature up to 45 °C and kill most of them without affecting normal cells. These observations proved that Anti-HER2 conjugated magnetic dextran-spermine nanoparticles can target and destroy cancer cells and are potentially suitable for cancer treatment.
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Abstract
This review article delineates novel approaches for the pharmaceutical treatment of gastric cancer. A newly developed molecular classification of gastric cancer based on histology, genetic, epigenetic and proteomic characteristics has evolved. It provides a road map for development of new drugs and combinations as well as for patient stratification in clinical research and it is expected to be introduced into clinical practice in the near future. Anti-HER2 targeted treatment is a validated strategy for treatment of metastatic gastric cancer and is now also being studied in the perioperative setting to increase response rates and ultimately survival in patients undergoing curative surgery; however, the resistance mechanisms of HER2-targeted treatment are poorly understood and optimal patient selection remains challenging. Targeting angiogenesis is a novel concept in the management of advanced gastric cancer. Ramucirumab is an antibody against vascular endothelial growth factor receptor 2 (VEGFR2) and prolongs survival in second-line treatment as a monotherapy and also in combination with paclitaxel; however, biomarkers for selection of patients who particularly benefit from antiangiogenic treatment are still lacking. Immune checkpoint blockade and inhibition of cancer stem cell targets are two emerging principles for the medicinal treatment of gastric cancer. Large-scale international studies for evaluation of these treatment approaches are ongoing. In summary, promising biology-based treatment strategies are evolving; however, tumor heterogeneity, which is an inherent feature of gastric cancer is a particular challenge for the development of targeted medications and a personalized treatment.
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Affiliation(s)
- F Lordick
- Universitäres Krebszentrum Leipzig, Universitätsmedizin Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
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13
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Martínez-Jañez N, Chacón I, de Juan A, Cruz-Merino L, Del Barco S, Fernández I, García-Teijido P, Gómez-Bernal A, Plazaola A, Ponce J, Servitja S, Zamora P. Anti-HER2 Therapy Beyond Second-Line for HER2-Positive Metastatic Breast Cancer: A Short Review and Recommendations for Several Clinical Scenarios from a Spanish Expert Panel. Breast Care (Basel) 2016; 11:133-8. [PMID: 27239176 DOI: 10.1159/000443601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of this project was to provide an expert opinion regarding anti-human epidermal growth factor receptor 2 (HER2) therapy beyond second-line treatment of metastatic breast cancer (mBC). METHODS A group of experts discussed specific issues concerning anti-HER2 therapy in late-line settings in mBC. RESULTS Trastuzumab emtansine (T-DM1) or dual HER2 blockade appeared to be good options for HER2-positive mBC after ≥ 2 HER2-targeted therapies. Once an objective response has been achieved with anti-HER2-containing therapy, the anti-HER2 agent can be continued until progression of the disease, unacceptable toxicity or patient decision. mBC treated with ≥ 3 consecutive lines of anti-HER therapy, ≥ 1 being a dual HER2 blockade and with early progression of disease during a fourth or later-line treatment, are clinically resistant to anti-HER therapy. For progression of metastasis in the brain after anti-HER2 therapy, lapatinib and chemotherapy appear to be a good alternative after best local treatment. CONCLUSIONS Further clinical trials are needed to provide valuable knowledge about the best treatment options in the later settings of mBC.
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Affiliation(s)
| | - Ignacio Chacón
- Medical Oncology Department, Hospital Virgen de la Salud, Toledo, Spain
| | - Ana de Juan
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Luis Cruz-Merino
- Medical Oncology Department, Hospital Virgen de la Macarena, Sevilla, Spain
| | - Sònia Del Barco
- Instituto Catalán de Oncología, Hospital Universitario Doctor Josep Trueta, Gerona, Spain
| | | | | | | | | | - José Ponce
- Hospital General Universitario de Alicante, Alicante, Spain
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Nakada T, Masuda T, Naito H, Yoshida M, Ashida S, Morita K, Miyazaki H, Kasuya Y, Ogitani Y, Yamaguchi J, Abe Y, Honda T. Novel antibody drug conjugates containing exatecan derivative-based cytotoxic payloads. Bioorg Med Chem Lett 2016; 26:1542-1545. [PMID: 26898815 DOI: 10.1016/j.bmcl.2016.02.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/04/2016] [Accepted: 02/08/2016] [Indexed: 11/28/2022]
Abstract
Trastuzumab conjugates consisting of exatecan derivatives were prepared and their biological activities and physicochemical properties were evaluated. The ADCs showed strong efficacy and a low aggregation rate. The exatecan derivatives were covalently connected via a peptidyl spacer (Gly-Gly-Phe-Gly), which is assumed to be stable in circulation, and were cleaved by lysosomal enzymes following ADC internalization into tumor tissue. These anti-HER2 ADCs exhibited a high potency, specifically against HER2-positive cancer cell lines in vitro. The ADCs, bearing exatecan derivatives which have more than two methylene chains, exhibited superior cytotoxicity. It was speculated that steric hindrance of the cleavable amide moiety could be involved in the drug release. The adequate alkyl lengths of exatecan derivatives (13, 14, 15) were from two to four in terms of aggregation rate. The ADC having a hydrophilic moiety showed good efficacy in a HER2-positive and Trastuzumab-resistant breast carcinoma cell model in mice.
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Affiliation(s)
- Takashi Nakada
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan.
| | - Takeshi Masuda
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Hiroyuki Naito
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Masao Yoshida
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Shinji Ashida
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Koji Morita
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Hideki Miyazaki
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Yuji Kasuya
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Yusuke Ogitani
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Junko Yamaguchi
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Yuki Abe
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Takeshi Honda
- Daiichi Sankyo Co., Ltd., 1-2-58, Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
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Ag D, Bongartz R, Dogan LE, Seleci M, Walter JG, Demirkol DO, Stahl F, Ozcelik S, Timur S, Scheper T. Biofunctional quantum dots as fluorescence probe for cell-specific targeting. Colloids Surf B Biointerfaces 2013; 114:96-103. [PMID: 24176888 DOI: 10.1016/j.colsurfb.2013.09.033] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 09/14/2013] [Accepted: 09/16/2013] [Indexed: 11/30/2022]
Abstract
We describe here the synthesis, characterization, bioconjugation, and application of water-soluble thioglycolic acid TGA-capped CdTe/CdS quantum dots (TGA-QDs) for targeted cellular imaging. Anti-human epidermal growth factor receptor 2 (HER2) antibodies were conjugated to TGA-QDs to target HER2-overexpressing cancer cells. TGA-QDs and TGA-QDs/anti-HER2 bioconjugates were characterized by fluorescence and UV-Vis spectroscopy, X-ray diffraction (XRD), hydrodynamic sizing, electron microscopy, and gel electrophoresis. TGA-QDs and TGA-QDs/anti-HER2 were incubated with cells to examine cytotoxicity, targeting efficiency, and cellular localization. The cytotoxicity of particles was measured using an MTT assay and the no observable adverse effect concentration (NOAEC), 50% inhibitory concentration (IC50), and total lethal concentration (TLC) were calculated. To evaluate localization and targeting efficiency of TGA-QDs with or without antibodies, fluorescence microscopy and flow cytometry were performed. Our results indicate that antibody-conjugated TGA-QDs are well-suited for targeted cellular imaging studies.
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Affiliation(s)
- Didem Ag
- Ege University, Faculty of Science, Department of Biochemistry, 35100 Bornova-Izmir, Turkiye
| | - Rebecca Bongartz
- Leibniz University of Hannover, Institute for Technical Chemistry, Callinstr. 5, 30167 Hannover, Germany
| | - Leyla Eral Dogan
- Izmir Institute of Technology, Department of Chemistry, Faculty of Science, 35430 Urla-Izmir, Turkiye
| | - Muharrem Seleci
- Ege University, Faculty of Science, Department of Biochemistry, 35100 Bornova-Izmir, Turkiye
| | - Johanna-G Walter
- Leibniz University of Hannover, Institute for Technical Chemistry, Callinstr. 5, 30167 Hannover, Germany
| | - Dilek Odaci Demirkol
- Ege University, Faculty of Science, Department of Biochemistry, 35100 Bornova-Izmir, Turkiye
| | - Frank Stahl
- Leibniz University of Hannover, Institute for Technical Chemistry, Callinstr. 5, 30167 Hannover, Germany
| | - Serdar Ozcelik
- Izmir Institute of Technology, Department of Chemistry, Faculty of Science, 35430 Urla-Izmir, Turkiye
| | - Suna Timur
- Ege University, Faculty of Science, Department of Biochemistry, 35100 Bornova-Izmir, Turkiye.
| | - Thomas Scheper
- Leibniz University of Hannover, Institute for Technical Chemistry, Callinstr. 5, 30167 Hannover, Germany
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