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Cancer Summaries and Commentaries Vol. 1, No. 1

Release Date: August 20, 2008
Expiration Date: August 20, 2009

Publication Overview

Authors

Commentary by: Hope S. Rugo, MD; Medical writer: Paul Card, PhD
Reviewed: Susan Peck, PhD, Debu Tripathy, MD; Reviewed by: Susan Peck, PhD, and Debu Tripathy, MD; Reviewed by: Susan Peck, PhD, Debu Tripathy, MD

Overview and Purpose

Metastatic breast cancer (MBC) has served as a useful paradigm in the development of targeted agents. The inhibition of growth factor and hormone response pathways through a variety of strategies has improved clinical outcomes. The success of anti-HER2 therapies in particular has prompted researchers to investigate additional HER-directed approaches. These include anti-HER2 antibodies, pan-HER small-molecule tyrosine kinase inhibitors (TKIs), and epidermal growth factor receptor (EGFR)–specific agents used in combination with endocrine therapy or chemotherapy. Angiogenesis inhibitors combined with HER-targeted agents or chemotherapy are also being assessed in the treatment of MBC, and novel strategies, such as the incorporation of heat shock protein (HSP)90 inhibitors, are being investigated for their ability to improve the effectiveness of targeted therapy.

Breast cancer is a heterogeneous malignancy and requires a careful analysis of available data to optimize treatment, including the use of regimens that contain one of the growing number of targeted agents. A thorough review of this information will help clinicians stay up-to-date on targeted approaches currently being evaluated for the treatment of MBC.

The purpose of this activity is to educate physicians regarding current data on the use of targeted therapies for MBC and to highlight new developments regarding the use of these agents in a variety of combination regimens.

Target Audience

This activity is intended for medical oncologists involved in the care of patients with breast cancer. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Learning Objectives

Upon completion of this educational activity, you should be able to:

  • Evaluate the efficacy and safety of adding antiangiogenic agents to taxanes in the treatment of advanced breast cancer
  • Evaluate the activity and safety of simultaneous inhibition of HER2 and vascular endothelial growth factor signaling using 2 small-molecule TKIs as first-line therapy for advanced breast cancer
  • Appraise the activity and safety of a dual HER2 blockade strategy using 2 humanized monoclonal antibodies in MBC that had progressed on prior HER2-targeted therapy
  • Assess the clinical benefit and safety of adding an HSP90 inhibitor to an anti-HER2 agent in the treatment of HER2+ MBC that had progressed on prior HER2-targeted therapy
  • Evaluate the clinical benefit and safety of adding an EGFR-targeted small-molecule TKI to an aromatase inhibitor in the treatment of hormone receptor–positive MBC
  • Assess response with and clinical benefit from the addition of a platinum agent to an EGFR-targeted antibody in the treatment of hormone receptor–negative/HER2–MBC

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    3. Complete the CME test.
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    5. After successful completion of the CME test and evaluation, you will receive your certificate of credit online.
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    Hope S. Rugo, MD
    Research Funding – Bristol-Myers Squibb Company, Genentech, Inc., GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Pfizer Inc., Roche Pharmaceuticals
    Speaker’s Bureau – AstraZeneca, Genomic Health, Inc.

    PER Editorial Staff
    No relevant relationships to disclose

    This CME activity might include discussion of investigational and/or unlabeled uses of drugs. If the activity includes discussion of investigational and/or unlabeled uses of a drug, specific information is located on the title page. Please refer to the full prescribing information for each drug discussed in this newsletter for FDA–approved dosing, indications, and warnings.

    Commercial Support
    An educational grant for this activity was provided by Genentech BioOncology.

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    Illustration

    In recent years, the design of targeted therapies for breast cancer has been dominated by agents that inhibit pathologic signaling from cell-surface growth factor receptors, such as vascular endothelial growth factor receptor, epidermal growth factor receptor, and HER2. Interactions between these receptors and their ligands can initiate signaling cascades, such as the Ras/Raf/mitogen–activated protein kinase and phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin pathways, that control the expression of key genes, which regulate a variety of physiologic processes, including cell growth and proliferation, recruitment of new vasculature, and cell death. Research continues to clarify molecular interactions involved in these signaling systems, revealing an elaborate degree of cross-talk occurring between receptor complexes. In addition to developing rational combinations of agents targeting individual receptors, the simultaneous inhibition of signaling from multiple receptors is being evaluated in order to improve the overall clinical benefit yielded by these targeted approaches.

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    Editor, Cancer Summaries and Commentaries
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