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Neoadjuvant T-DM1/Pertuzumab Combo Boosts pCR in HER2+ Breast Cancer

Laura Panjwani
Published: Monday, Apr 25, 2016

Dr Angela M. DeMichele

Angela M. DeMichele, MD

Neoadjuvant ado-trastuzumab emtansine (T-DM1; Kadcyla) in combination with pertuzumab (Perjeta) improved pathologic complete response (pCR) compared with standard of care in patients with advanced HER2-positive breast cancer, according to recently reported data from the adaptively randomized I-SPY 2 trial.

“The primary endpoint of the trial is pCR and this is important because, in HER2-positive breast cancer, pCR is a very good short-term surrogate for long-term outcomes,” says DeMichele, who presented the HER2-positive I-SPY 2 data at the 2016 AACR Annual Meeting. “Our ultimate goal is to prevent disease from recurring, but if a drug or drug combination can get patients to the point of pCR, then they stand a very good likelihood of never having their breast cancer come back.”

In an interview with OncLive, DeMichele explains the significance of the I-SPY 2 data, the advantages of T-DM1 versus standard of care, and what is on the horizon for the use of T-DM1 in HER2-positive disease.

OncLive: What was the design of the I-SPY 2 trial?

DeMichele: I-SPY 2 is a phase II trial that aims to identify active new agents in breast cancer to take to phase III. It is adaptively randomized, which means that we can evaluate several drugs simultaneously; it also minimizes the number of patients we need to enroll to find effective agents.
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