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Role of trastuzumab emtansine in the treatment of HER2-positive breast cancer

Authors Oostra D, Macrae E

Received 6 May 2014

Accepted for publication 21 May 2014

Published 23 July 2014 Volume 2014:6 Pages 103—113


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Drew R Oostra,1 Erin R Macrae2

1Division of Hematology, Oncology, and Transplant. University of Minnesota, Minneapolis, MN, USA; 2Division of Medical Oncology, The James Cancer Hospital, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA

Abstract: Trastuzumab is a monoclonal antibody that is used in the treatment of breast cancer. Trastuzumab targets the human epidermal growth factor receptor 2 (HER2) receptor on breast cancer cells that express this tyrosine kinase receptor. These cancers are referred to as HER2-positive breast cancer. The original studies of trastuzumab showed improved survival in metastatic breast cancer; however, resistance often develops. In the adjuvant setting, women often progress despite therapy that includes trastuzumab. Antibody–drug conjugates are a new class of powerful drugs designed to target high-dose chemotherapy directly to the cancer cells. Trastuzumab emtansine is one of these antibody–drug conjugates and was the first Food and Drug Administration approved drug for a solid tumor. Emtansine is a potent antimicrotubule agent. Trastuzumab is used to target this potent chemotherapy agent directly to the HER2-expressing cancer cells. This review article will summarize the evidence from the preclinical studies, summarize evidence from the clinical trials, discuss current clinical trials, discuss current approval of trastuzumab emtansine, and discuss future directions of research.

Keywords: T-DM1, trastuzumab emtansine, Kadcyla®, breast cancer, HER2

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