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. 2022 Oct;134(19-20):683-692.
doi: 10.1007/s00508-022-02082-3. Epub 2022 Sep 23.

Austrian treatment algorithms in HER2-positive metastatic breast cancer: a 2022 update

Gabriel Rinnerthaler  1 , Christian Singer  2 , Edgar Petru  3 , Daniel Egle  4 , Andreas Petzer  5 , Ursula Pluschnig  6 , Simon Peter Gampenrieder  1 , Georg Pfeiler  2 , Michael Gnant  7 , Birgit Grünberger  8 , Peter Krippl  9 , Kathrin Strasser-Weippl  10 , Christoph Suppan  11 , Christine Brunner  4 , Renate Pusch  5 , Margit Sandholzer  12 , Marija Balic  13 , Rupert Bartsch  14
Affiliations

Austrian treatment algorithms in HER2-positive metastatic breast cancer: a 2022 update

Gabriel Rinnerthaler et al. Wien Klin Wochenschr. 2022 Oct.

Abstract

In the past 12 months a plethora of relevant novel data for the treatment of metastatic HER2 positive breast cancer were published. To bring this new evidence into a clinical perspective, a group of Austrian breast cancer specialists updated their previously published treatment algorithm for those patients. For this consensus paper a total of eight scenarios were developed in which treatment strategies appropriate for specific patient profiles were evaluated. Consensus was established by detailed discussions of each scenario and by reaching full consensus.

Keywords: Advanced breast cancer; Antibody-drug conjugates; Erbb2; Systemic therapy; Tyrosin kinase inhibitors.

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Conflict of interest statement

G. Rinnerthaler: Consulting or advisory role: Piere Fabre, Celgene, Roche, Novartis, Pfizer, Eli Lilly, Daiichi-Sankyo, MSD. Speakers’ bureau: Amgen, AstraZeneca, Novartis, Bristol-Myers Squibb, Roche, Pfizer, Eli Lilly. Research funding: Roche. Travel, accommodations, expenses: Roche, Novartis, Amgen, Pfizer, Bristol-Myers Squibb. C. Singer: Advisory role: AstraZeneca, Daiichi-Sankyo, Eli-Lilly, Novartis, Pfizer, Roche. Lecture honoraria: AstraZeneca, Roche, Amgen, Eli-Lilly, Novartis, Pfizer. Research support: Daiichi, Amgen, Novartis, Roche. E. Petru: Honoraria for lectures: AGEA, Amgen, AstraZeneca, Angelini, Eisai, Eli Lilly, GlaxoSmithKline, MSD, Novartis, Pharma Mar, Pfizer, Roche, GILEAD, Seagen. Honoraria for advisory boards: Amgen, AstraZeneca, Angelini, Eisai, Eli Lilly, GlaxoSmithKline, MSD, Novartis, Pharma Mar, Pfizer, Roche, Clovis, Daiichi-Sankyo, Seagen, GILEAD. Honoraria (Institution): Amgen, AstraZeneca, Angelini, Eli Lilly, GlaxoSmithKline, Novartis, Pharma Mar, Pfizer, Roche, TESARO. Travel expenses: AGEA, Amgen, AstraZeneca, GlaxoSmithKline, Pharma Mar, Pfizer, Roche. D. Egle: Honoraria and Travel Grants: AstraZeneca, Amgen, Daiichi-Sankyo, Eli Lilly, MSD, Novartis, Pfizer, Roche, Seagen. A. Petzer: Honoraria, Advisory Role and/or Travel Support: Roche, Novartis, AstraZeneca, BMS-Celgene, Daiichi-Sankyo, Eisai, Eli-Lilly, Pfizer, Amgen, Seagen, Sanofi. U. Pluschnig: Advisory role: Roche, Eli-Lilly, Daiichi-Sankyo, AstraZeneca. Speaking: Roche. S.P. Gampenrieder: Speakers’ honoraria: Novartis, Roche, BMS, AstraZeneca, MSD, Seagen, Lilly. Advisory boards: Roche, Novartis, Pfizer, Lilly, AstraZeneca, MSD, BMS, Astellas, Daiichi-Sankyo, Sanofi, Seagen. Travel grants: Roche, Amgen, Shire, Novartis, Pfizer, Bayer, Celgene, Daiichi-Sankyo. Research funding: Roche. G. Pfeiler: Honoraria and grants: Daiichi-Sankyo, Amgen, Pfizer, AstraZeneca, MSD, Novartis, Roche, UCB, Pierre Fabre, Seagen, Eli-Lilly, Gilead. M. Gnant: Personal fees/travel support: Amgen, Daiichi-Sankyo, AstraZeneca, EliLilly, LifeBrain, Nanostring, Novartis, Pierre Fabre, MSD. Other: an immediate family member is employed by Sandoz. B. Grünberger: Speaker’s honoraria: MSD, BMS, Eli Lilly, Servier, Merck, Roche, Seagen, Gilead, AstraZeneca, Sanofi. Advisory boards: MSD, BMS, Merck, Roche, EliLilly, Seagen. Travel grants: MSD, BMS, Roche, Merck, Servier. P. Krippl: Honoraria: MSD, BMS, Eli Lilly, Servier, Merck, Roche, Gilead, AstraZeneca, Sanofi, Novartis, Pfizer, Celgene, Amgen, Pierre Fabre, Shire, Daiichi-Sankyo, Astellas. K. Strasser-Weippl: Travel support: Roche, Pfizer, MSD. Advisory Boards: Roche, Pfizer, Novartis, Lilly, Daiichi, Myriad, Seagen, MSD, Astra Zeneca. C. Suppan: Consulting or advisory role: Novartis, Pfizer, Eli Lilly, Daiichi-Sankyo. Speakers’ bureau: AstraZeneca, Novartis, Roche, Pfizer, Eli Lilly, Gilead. Travel, accommodations, expenses: Roche, Novartis, Pfizer. C. Brunner: Honoraria: AstraZeneca, Daiichi-Sankyo, Novartis, Pfizer, Roche, Seagen. R. Pusch: Honoraria: Novartis, Roche, Pfizer, Daiichi-Sankyo. Advisory Boards: Roche, Myriad, Amgen, Astra Zeneca, Lilly, Pfizer, Novartis. Travel support: Roche, Pfizer. M. Sandholzer: Advisory boards: Myriad, Novartis, AstraZeneca, Amgen, Roche, Pfizer, Pierre Fabre, Eli Lilly. Honoraria and travel grants: Novartis, Amgen, Servier, Roche, Eli Lilly, Pfizer, Merck. M. Balic: Research funding: AstraZeneca, Eli Lilly, Novartis, Pfizer, Samsung, Seagen. Advisory role: Amgen, AstraZeneca, Celgene, Daiichi-Sankyo, Eli Lilly, Gilead, MSD, Novartis, Pierre Fabre, Pfizer, Roche, Samsung, Seagen. Speaker’s bureau: Amgen, AstraZeneca, Celgene, Daiichi-Sankyo, Eli Lilly, Gilead, Novartis, Pierre Fabre, Pfizer, Roche, Seagen. R. Bartsch: Advisory Role: AstraZeneca, Daiichi, Eisai, Eli-Lilly, Gilead, MSD, Novartis, Pfizer, Pierre Fabre, Puma, Roche, Seagen. Lecture honoraria: AstraZeneca, Daiichi, Eli-Lilly, Gilead, Novartis, Pfizer, Pierre Fabre, Roche, Seagen. Research Support: Daiichi, MSD, Novartis, Roche.

Figures

Fig. 1
Fig. 1
Treatment scenario 1. T trastuzumab, P pertuzumab, T‑DXd trastuzumab deruxtecan, T‑DM1 trastuzumab emtansine, Cap capecitabine, Tuc tucatinib, DPD dihydropyrimidine dehydrogenase, Chemo chemotherapy, L lapatinib, N neratinib, Pembro pembrolizumab, AI aromatase inhibitor, Abema abemaciclib, Ful fulvestrant. ⋆These treatment options do not have market authorization in the EU
Fig. 2
Fig. 2
Treatment scenario 2. T trastuzumab, P pertuzumab, T‑DXd trastuzumab deruxtecan, T‑DM1 trastuzumab emtansine, Cap capecitabine, Tuc tucatinib, DPD dihydropyrimidine dehydrogenase, Chemo chemotherapy, L lapatinib, N neratinib, Pembro pembrolizumab, AI aromatase inhibitor, Abema abemaciclib, Ful fulvestrant. ⋆These treatment options do not have market authorization in the EU
Fig. 3
Fig. 3
Treatment scenario 3. T trastuzumab, P pertuzumab, T‑DXd trastuzumab deruxtecan, T‑DM1 trastuzumab emtansine, Cap capecitabine, Tuc tucatinib, DPD dihydropyrimidine dehydrogenase, Chemo chemotherapy, L lapatinib, N neratinib, Pembro pembrolizumab, AI aromatase inhibitor, Abema abemaciclib, Ful fulvestrant. ⋆These treatment options do not have market authorization in the EU
Fig. 4
Fig. 4
Treatment scenario 4. T trastuzumab, P pertuzumab, AI aromatase inhibitor, Vino vinorelbine, Endo endoxan, T‑DXd trastuzumab deruxtecan, T‑DM1 trastuzumab emtansine, Cap capecitabine, Tuc tucatinib, DPD dihydropyrimidine dehydrogenase, Chemo chemotherapy, L lapatinib, N neratinib, Pembro pembrolizumab, Abema abemaciclib, Ful fulvestrant. ⋆These treatment options do not have market authorization in the EU
Fig. 5
Fig. 5
Treatment scenario 5. T trastuzumab, P pertuzumab, AI aromatase inhibitor, Vino vinorelbine, T‑DXd trastuzumab deruxtecan, T‑DM1 trastuzumab emtansine, Cap capecitabine, Tuc tucatinib, DPD dihydropyrimidine dehydrogenase, Chemo chemotherapy, L lapatinib, N neratinib, Pembro pembrolizumab, Abema abemaciclib, Ful fulvestrant. ⋆These treatment options do not have market authorization in the EU
Fig. 6
Fig. 6
Treatment scenario 6. Mets metastases, T trastuzumab, AI aromatase inhibitor, Vino vinorelbine, T‑DXd trastuzumab deruxtecan, Cap capecitabine, Tuc tucatinib, DPD dihydropyrimidine dehydrogenase, Chemo chemotherapy, L lapatinib, N neratinib, Pembro pembrolizumab, Abema abemaciclib, Ful fulvestrant. ⋆These treatment options do not have market authorization in the EU
Fig. 7
Fig. 7
Treatment scenario 7
Fig. 8
Fig. 8
Treatment scenario 8
See this image and copyright information in PMC

References

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