Trastuzumab Emtansine: A Review of Its Adjuvant Use in Residual Invasive HER2-Positive Early Breast Cancer
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Funding The preparation of this review was not supported by any external funding.
Authorship and Conflict of interest Katherine A. Lyseng-Williamson is a salaried employee of Adis International Ltd/Springer Nature and declares no relevant conflicts of interest. All authors to the review are responsible for the article content.
Ethics approval, Consent to participate, Consent for publication, Availability of data and material, Code availability Not applicable.
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Trastuzumab emtansine (Kadcyla®), an
antibody-drug conjugate of trastuzumab (Herceptin®) connected by a
thioether linker to the microtubule inhibitor DM1 (a cytotoxic derivative of maytansine), provides direct intracellular delivery of the
potent cytotoxin DM1 to HER2-overexpressing cells, while retaining trastuzumab
activity. Its approval in metastatic/advanced breast cancer (BC) has been
extended to include single-agent adjuvant treatment of HER2-positive early BC
in patients with residual invasive disease in the breast and/or lymph nodes after
neoadjuvant taxane-based and HER2-targeted treatment. In the pivotal KATHERINE trial in this population, significantly more
trastuzumab emtansine than trastuzumab recipients were estimated to be free of invasive
disease recurrence at 3 years, with a 50% reduction in the risk of invasive
disease recurrence or death. The tolerability of
trastuzumab emtansine in early BC was consistent with its known safety profile;
as expected, adverse events were more common with trastuzumab emtansine than
with trastuzumab. Recently updated international and national treatment guidelines
recommend trastuzumab emtansine as a preferred option in this high-risk BC
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