Dr. Burris Discusses Promise of T-DM1 in HER2+ Breast Cancer

Howard “Skip” A. Burris, III, MD, chief medical officer, Sarah Cannon Research Institute, and a 2014 Giant of Cancer Care® in Drug Development, discusses the promise of ado-trastuzumab emtansine (T-DM1; Kadcyla) in the treatment of patients with HER2-positive breast cancer.

For many years, investigators have liked the concept of T-DM1, Burris says. Traditionally, the antibody-drug conjugate (ADC) was used palliatively while data in the adjuvant and neoadjuvant setting continued to accrue. Now, based on data from the phase III KATHERINE trial presented at the 2018 San Antonio Breast Cancer Symposium, the role of T-DM1 has become practice-changing, he says.

Burris says that it makes sense to give additional chemotherapy in the neoadjuvant setting and it makes sense to give trastuzumab-based therapy. Results showed that substituting T-DM1 for adjuvant trastuzumab (Herceptin) in patients who had residual disease after receiving neoadjuvant chemotherapy reduced the risk of invasive disease recurrence or death by 50% compared with standard trastuzumab in patients with early-stage HER2-positive breast cancer. Three-year invasive-disease survival rate was 88.3% with the ADC versus 77.0% with the HER2-targeted agent. Burris feels that this therapy will be quickly adopted and yield greater patient outcomes.