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Review
. 2021 May 26:13:361-381.
doi: 10.2147/BCTT.S268451. eCollection 2021.

Treating Advanced Unresectable or Metastatic HER2-Positive Breast Cancer: A Spotlight on Tucatinib

Lara Ulrich  1 , Alicia F C Okines  1
Affiliations
Review

Treating Advanced Unresectable or Metastatic HER2-Positive Breast Cancer: A Spotlight on Tucatinib

Lara Ulrich et al. Breast Cancer (Dove Med Press). .

Abstract

The management of HER2 positive breast cancer has been transformed by the development of targeted therapies. Dual blockade with the monoclonal antibodies, trastuzumab and pertuzumab, added to first-line taxane chemotherapy and second-line therapy with the antibody-drug conjugate, T-DM1, are internationally agreed standards of care for advanced HER2 positive breast cancer, where available. However, until recently, options for patients for third-line therapy and beyond were of modest efficacy or limited by toxicity. In 2019, the results of trials of two exciting new agents for this space were presented. A third-generation HER2 tyrosine kinase inhibitor, tucatinib, combines the efficacy of the second-generation drug, neratinib, with a more manageable toxicity profile and has become a new standard of care after T-DM1, in combination with capecitabine and trastuzumab. The antibody-drug conjugate, trastuzumab deruxtecan, demonstrated remarkable efficacy in heavily pre-treated patients and received accelerated approval in the United States, whilst confirmatory Phase 3 trials are completed. This review will discuss the available data for the post-T-DM1 setting, focusing on tyrosine kinase inhibitors including tucatinib.

Keywords: CNS; HER2-positive; central nervous system; metastatic breast cancer; tucatinib; tyrosine kinase inhibitor.

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Conflict of interest statement

Dr Okines has participated in (compensated) advisory boards for Astra Zeneca/Daiichi Sankyo, Seagen and Roche, has received speakers fees from Pfizer, Roche and Seagen and has received research funding from Pfizer and Roche. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
The HER2 receptor and its drug targets.
See this image and copyright information in PMC

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