Dr. Carey on Everolimus in Metastatic Breast Cancer
Lisa A. Carey, MD
Published Online: Friday, April 5, 2013
Lisa A. Carey, MD, Professor of Medicine, University of North Carolina at Chapel Hill, discusses the use of everolimus in the metastatic and adjuvant settings of breast cancer.
Everolimus, an mTOR inhibitor, has demonstrated benefit to women with acquired endocrine resistance. These patients are treated with an aromatase inhibitor, respond briefly, but eventually develop resistance. It has been seen, Carey says, that adding everolimus to any aromatase inhibitor still produces beneficial results with regard to progression-free survival. Everolimus, and targeting the mTOR pathway in general, is a promising arena in metastatic acquired resistance to endocrine therapies.
Future studies will move everolimus into the adjuvant setting and analyze whether it helps to augment the effectiveness of endocrine therapy.
An updated guideline from ASCO regarding the use of sentinel lymph node (SLN) biopsy in early stage breast cancer supports the use of the procedure over axillary lymph node dissection (ALND) in a larger group of patients than previously recommended.