Professor Chen Wenyan Interview: T-DM1 Brings Treatment Innovation stort for Breast Cancer, Patient Assistance Project Helps Early Treatment of Breast Cancer

T-DM1 is officially available in China, which is great news for HER2-positive breast cancer patients, especially HER2-positive patients who have not achieved full pathological remission after new complementary treatmentThe application of T-DM1 in HER2-positive breast cancerin domestic and foreign guidelines, the application of T-DM1 also involves the treatment of early-late-stage breast cancerFor early stage breast cancer, T-DM1 has been approved in China, is the first chinese approved for HER2-positive early breast cancer after the new auxiliary treatment of non-pathological complete remission (non-pCR) treatment drugsBased on the results of the KATHERINE study, the program should become the standard treatment for patients who do not reach pCR after new complementary treatmentTHE KATHERINE STUDY SCREENED PATIENTS WITH NON-PCR BASED ON THE POST-POST-POST-TREATMENT CONDITION OF HER2-POSITIVE EARLY BREAST CANCER PATIENTS, ONE GROUP WITH COCTHERIUM-MONO-COMBINED CHEMOTHERAPY AND THE OTHER WITH T-DM1The results showed that the risk of recurrence and death decreased by about 50 percent in patients treated with T-DM1, and that the survival rate of non-leachate disease (IDFS) in the T-DM1 group increased by 11.3% compared to the absolute value of the tattoritus monoantigen groupIn addition, the benefit trends in the T-DM1 group were consistent regardless of receptor status, lymph node status, and anti-HER2 options selected for new complementary therapyIt can therefore be noted that, during the complementary treatment phase, T-DM1 can bring significant benefits to HER2-positive breast cancer patients with non-pCR after the new complementary treatmentthe application of T-DM1 has been explored internationally in her2-positive advanced breast cancerEMILIA trial participants were HER2-positive advanced breast cancer patients with advances in the treatment of the Yew United Quto-Beadi, compared after treatment with the Rapatinib union carpetine or T-DM1 protocolThe results showed that the median PFS in the Rapatini group and the T-DM1 group was 6.4 months and 9.6 months, the median OS was 25.1 months and 30.9 months, respectively, and the T-DM1 group was significantly better than the Rapatini union capetabineBased on the EMILIA study, T-DM1 has leapt to international standard sehractative seilife, and is also used as a second-line recommendation for anti-HER2 treatment in the domestic CSCO BC guidelinesIn addition, in foreign reports, we can see that T-DM1 is used in the post-hertology of Her-2-positive advanced breast cancer, for example: TH3RESA Phase III clinical study, including the previous acceptance of 2 anti-HER2 treatment regimens of HER2-positive MBC patients, such patients in any guide there is no standard treatment plan, the test group is T-DM1, the treatment group for the doctor's choice of treatmentThe study found that T-DM1 could significantly improve PFS and OS in PATIENTS WITH HER2-POSITIVE ADVANCED BREAST CANCER WHO HAD PREVIOUSLY USED THE METTTHANE, RAPATINIB, AND YEW DRUGSTherefore, T-DM1 can be used for the backline rescue treatment of HER2-positive advanced breast cancer In addition to the single-drug use, T-DM1 is now also a joint drug study THE KATE2 STUDY WAS THE FIRST CLINICAL STUDY USING ADC-TYPE DRUGS AND IMMUNOTHERAPY COMBINATION THERAPY, INCLUDING ABOUT 200 PATIENTS WITH HER2-POSITIVE ADVANCED BREAST CANCER WHO FAILED FIRST-LINE TREATMENT, COMPARED WITH APLACEBO USING T-DM1 COMBINED ATTRIEZUMAB AND T-DM1, AND IN THE PD-L1-POSITIVE PATIENT POPULATION, THE T-DM1 COMBINED IMMUNOTHERAPY GROUP HAD 8.6 MONTHS, COMPARED WITH THE T-DM1 COMBINED IMMUNOTHERAPY GROUP FOR 4 MONTHS THE MARIANNE STUDY IS A PHASE III RANDOMIZED CONTROLLED STUDY, FOR HER2-POSITIVE PATIENTS WITH ADVANCED BREAST CANCER, ON THE BASIS OF T-DM1 TO ADD AND SUBTRACT PATOZUMAB, AND QUTOBEU MONO-COMBINED YEW DRUGS FOR FIRST-LINE TREATMENT COMPARISON, THE RESULTS SHOW THAT THE FIRST-LINE TREATMENT PLAN CONTAINING T-DM1, MEDIAN PFS AND OS IS NOT INFERIOR TO TH PROGRAM, AND SIDE EFFECTS THAN THE TH PROGRAM IS LOWER, THE QUALITY OF LIFE IS ALSO MORE ADVANTAGEOUS charitable assistance and insurance claims, greatly reducing the burden on patients
the efficacy of T-DM1 has been clearly confirmed through a series of clinical studies For HER2-positive early breast cancer patients, if the new auxiliary treatment is non-pCR, the risk of recurrence, metastasis is relatively high, from the doctor's point of view, should choose a better drug, to achieve more chance of cure Because early breast cancer cannot be cured once it progresses to late On April 30, 2020, the China Cancer Foundation announced its assistance plan for early stage breast cancer, and if patients purchase and use seven courses of T-DM1 at their own expense, no progression of the disease has been developed, and after review by the Foundation's T-DM1 Assistance Program Office, patients will receive t-DM1 assistance of up to 7 courses, or "7 plus 7" program At the same time, if the patient uses T-DM1 and purchases "rest assured Lai" commercial insurance, to meet the claims conditions, the maximum can get the total price of more than 10,000 yuan of insurance compensation The T-DM1 Patient Assistance program, as well as the Rest assured-lay commercial insurance, can be used in combination After the overlay, the patient's 14-cycle treatment plan is expected to reduce the cost by 18 to 300,000, greatly reducing the burden on patients Common adverse reactions of T-DM1 and prevention and control T-DM1 is a new drug for China, and the safety data are mainly derived from clinical research Overall, T-DM1 is well tolerated and adverse reactions can be controlled and manageable At the same time, toxicology studies from multiple administrations can also be observed that T-DM1 does not present cumulative toxicity, so the vast majority of patients use T-DM1 is relatively safe However, in the clinical practice of T-DM1, the reduction of platelets caused by T-DM1 should be given high priority by doctors In patients with reduced platelets caused by mild thrombocytial disease caused by T-DM1 use, they can recover on their own during the drug interval, but for patients with severe illness, especially those with combined bleeding, the focus should be on If the pursuit of drugs in the treatment of patients to achieve the greatest efficacy, then the management of adverse reactions is particularly important Without good management of adverse reactions, patients may be adverse reactions leading to drug reduction, or even discontinuation of drugs, patients will be difficult to benefit from treatment For patients using T-DM1, a physical examination is required before initial treatment to observe the skin, mucous membranes and organs for bleeding, and for women, changes in menstrual volume may also be observed If the patient does not have bleeding, the doctor needs to decide whether to improve platelet treatment based on the reduction of platelets, or to adjust the dose of the drug at the same time If bleeding occurs, you can choose to infusion platelets or use a blood platelet-boosting drug In addition, patients using T-DM1 should also be educated, should be informed of the importance of monitoring platelets and advised not to do dangerous actions that may cause bleeding, such as brushing too hard, eating too hard or stinging bones For patients who are taking anticoagulant drugs, adjustments and monitoring should also be made Since infection can also lead to a reduction in platelets, patients should also be reminded to prevent infection In short, doctors and patients should have good communication to ensure that patients have sufficient compliance, so as to complete the routine blood monitoring and drug dose adjustment author: Chen Wenyan Source: oncology information