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Published in: Annals of Surgical Oncology 3/2024

21-12-2023 | Trastuzumab | ASO Perspectives

Adjuvant Trastuzumab Emtansine Versus Paclitaxel and Trastuzumab in Stage I HER2-Positive Breast Cancer: The ATEMPT Trial

Authors: Monica N. Khattak, DO, Anna M. Chichura, MD, Julie E. Lang, MD

Published in: Annals of Surgical Oncology | Issue 3/2024

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Abstract

This ASO perspective reviews the findings of a randomized, phase II clinical trial evaluating adjuvant trastuzumab emtansine (T-DM1) compared with paclitaxel and trastuzumab (TH) in stage I human epidermal growth factor receptor 2-positive breast cancer, as reported recently by the ATEMPT trial investigators. Patients treated with T-DM1 had better disease-free survival but did not have fewer treatment toxicities. The T-DM1-treated group had higher rates of treatment discontinuations, therefore long-term follow-up will be required to evaluate survival differences between T-DM1 and TH.
Literature
1.
go back to reference Slamon DJ, Godolphin W, Jones LA, Holt JA, Wong SG, Keith DE, et al. Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science. 1989;244(4905):707–12.ADSCrossRefPubMed Slamon DJ, Godolphin W, Jones LA, Holt JA, Wong SG, Keith DE, et al. Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science. 1989;244(4905):707–12.ADSCrossRefPubMed
2.
go back to reference Howlader N, Cronin KA, Kurian AW, Andridge R. Differences in breast cancer survival by molecular subtypes in the United States. Cancer Epidemiol Biomark Prev. 2018;27(6):619–26.CrossRef Howlader N, Cronin KA, Kurian AW, Andridge R. Differences in breast cancer survival by molecular subtypes in the United States. Cancer Epidemiol Biomark Prev. 2018;27(6):619–26.CrossRef
3.
go back to reference Hudis CA. Trastuzumab—mechanism of action and use in clinical practice. N Engl J Med. 2007;357(1):39–51.CrossRefPubMed Hudis CA. Trastuzumab—mechanism of action and use in clinical practice. N Engl J Med. 2007;357(1):39–51.CrossRefPubMed
4.
go back to reference Mahtani R, Hineman L. Advances in HER2-positive breast cancer: novel therapies and adverse event management. J Adv Practitioner Oncol. 2019;10(2):136. Mahtani R, Hineman L. Advances in HER2-positive breast cancer: novel therapies and adverse event management. J Adv Practitioner Oncol. 2019;10(2):136.
5.
go back to reference Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005;353(16):1673–84.CrossRefPubMed Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005;353(16):1673–84.CrossRefPubMed
7.
go back to reference Tolaney SM, Barry WT, Dang CT, Yardley DA, Moy B, Marcom PK, et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. N Engl J Med. 2015;372(2):134–41.CrossRefPubMedPubMedCentral Tolaney SM, Barry WT, Dang CT, Yardley DA, Moy B, Marcom PK, et al. Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer. N Engl J Med. 2015;372(2):134–41.CrossRefPubMedPubMedCentral
8.
go back to reference Tolaney SM, Guo H, Pernas S, Barry WT, Dillon DA, Ritterhouse L, et al. Seven-year follow-up analysis of adjuvant paclitaxel and trastuzumab trial for node-negative, human epidermal growth factor receptor 2–positive breast cancer. J Clin Oncol. 2019;37(22):1868.CrossRefPubMedPubMedCentral Tolaney SM, Guo H, Pernas S, Barry WT, Dillon DA, Ritterhouse L, et al. Seven-year follow-up analysis of adjuvant paclitaxel and trastuzumab trial for node-negative, human epidermal growth factor receptor 2–positive breast cancer. J Clin Oncol. 2019;37(22):1868.CrossRefPubMedPubMedCentral
10.
go back to reference Barok M, Joensuu H, Isola J. Trastuzumab emtansine: mechanisms of action and drug resistance. Breast Cancer Res. 2014;16(2):1–12.CrossRef Barok M, Joensuu H, Isola J. Trastuzumab emtansine: mechanisms of action and drug resistance. Breast Cancer Res. 2014;16(2):1–12.CrossRef
11.
go back to reference Verma S, Miles D, Gianni L, Krop IE, Welslau M, Baselga J, et al. Trastuzumab emtansine for HER2-positive advanced breast cancer. N Engl J Med. 2012;367(19):1783–91.CrossRefPubMedPubMedCentral Verma S, Miles D, Gianni L, Krop IE, Welslau M, Baselga J, et al. Trastuzumab emtansine for HER2-positive advanced breast cancer. N Engl J Med. 2012;367(19):1783–91.CrossRefPubMedPubMedCentral
12.
go back to reference Tolaney SM, Tayob N, Dang C, Yardley DA, Isakoff SJ, Valero V, et al. Adjuvant trastuzumab emtansine versus paclitaxel in combination with trastuzumab for stage I HER2-positive breast cancer (ATEMPT): a randomized clinical trial. J Clin Oncol. 2021;39(21):2375–85.CrossRefPubMed Tolaney SM, Tayob N, Dang C, Yardley DA, Isakoff SJ, Valero V, et al. Adjuvant trastuzumab emtansine versus paclitaxel in combination with trastuzumab for stage I HER2-positive breast cancer (ATEMPT): a randomized clinical trial. J Clin Oncol. 2021;39(21):2375–85.CrossRefPubMed
13.
go back to reference Zhao M, Chen C, Zhang C, Xu X, Tian F, Wu B, et al. Cardiotoxicity with human epidermal growth factor receptor-2 inhibitors in breast cancer: Disproportionality analysis of the FDA adverse event reporting system. Int J Cardiol. 2023;375:87–93.CrossRefPubMed Zhao M, Chen C, Zhang C, Xu X, Tian F, Wu B, et al. Cardiotoxicity with human epidermal growth factor receptor-2 inhibitors in breast cancer: Disproportionality analysis of the FDA adverse event reporting system. Int J Cardiol. 2023;375:87–93.CrossRefPubMed
14.
go back to reference Nowsheen S, Viscuse PV, O’Sullivan CC, Sandhu NP, Haddad TC, Blaes A, et al. Incidence, diagnosis, and treatment of cardiac toxicity from trastuzumab in patients with breast cancer. Curr Breast Cancer Rep. 2017;9:173–82.CrossRefPubMedPubMedCentral Nowsheen S, Viscuse PV, O’Sullivan CC, Sandhu NP, Haddad TC, Blaes A, et al. Incidence, diagnosis, and treatment of cardiac toxicity from trastuzumab in patients with breast cancer. Curr Breast Cancer Rep. 2017;9:173–82.CrossRefPubMedPubMedCentral
15.
go back to reference Sardesai S, Sukumar J, Kassem M, Palettas M, Stephens J, Morgan E, et al. Clinical impact of interruption in adjuvant Trastuzumab therapy in patients with operable HER-2 positive breast cancer. Cardio-Oncology. 2020;6(1):1–9.CrossRef Sardesai S, Sukumar J, Kassem M, Palettas M, Stephens J, Morgan E, et al. Clinical impact of interruption in adjuvant Trastuzumab therapy in patients with operable HER-2 positive breast cancer. Cardio-Oncology. 2020;6(1):1–9.CrossRef
16.
go back to reference Barroso-Sousa R, Tarantino P, Tayob N, Dang C, Yardley DA, Isakoff SJ, et al. Cardiac outcomes of subjects on adjuvant trastuzumab emtansine vs paclitaxel in combination with trastuzumab for stage I HER2-positive breast cancer (ATEMPT) study (TBCRC033): a randomized controlled trial. NPJ Breast Cancer. 2022;8(1):18.CrossRefPubMedPubMedCentral Barroso-Sousa R, Tarantino P, Tayob N, Dang C, Yardley DA, Isakoff SJ, et al. Cardiac outcomes of subjects on adjuvant trastuzumab emtansine vs paclitaxel in combination with trastuzumab for stage I HER2-positive breast cancer (ATEMPT) study (TBCRC033): a randomized controlled trial. NPJ Breast Cancer. 2022;8(1):18.CrossRefPubMedPubMedCentral
17.
go back to reference Sella T, Zheng Y, Tayob N, Ruddy KJ, Freedman RA, Dang C, et al. Treatment discontinuation, patient-reported toxicities and quality-of-life by age following trastuzumab emtansine or paclitaxel/trastuzumab (ATEMPT). NPJ Breast Cancer. 2022;8(1):127.CrossRefPubMedPubMedCentral Sella T, Zheng Y, Tayob N, Ruddy KJ, Freedman RA, Dang C, et al. Treatment discontinuation, patient-reported toxicities and quality-of-life by age following trastuzumab emtansine or paclitaxel/trastuzumab (ATEMPT). NPJ Breast Cancer. 2022;8(1):127.CrossRefPubMedPubMedCentral
18.
go back to reference Bellon JR, Tayob N, Yang DD, Tralins J, Dang CT, Isakoff SJ, et al. Local therapy outcomes and toxicity from the ATEMPT trial (TBCRC 033): a phase II randomized trial of adjuvant trastuzumab emtansine versus paclitaxel in combination with trastuzumab in women with stage I HER2-positive breast cancer. Int J Radiat Oncol Biol Phys. 2022;113(1):117–24.CrossRefPubMed Bellon JR, Tayob N, Yang DD, Tralins J, Dang CT, Isakoff SJ, et al. Local therapy outcomes and toxicity from the ATEMPT trial (TBCRC 033): a phase II randomized trial of adjuvant trastuzumab emtansine versus paclitaxel in combination with trastuzumab in women with stage I HER2-positive breast cancer. Int J Radiat Oncol Biol Phys. 2022;113(1):117–24.CrossRefPubMed
19.
go back to reference Ruddy KJ, Zheng Y, Tayob N, Hu J, Dang CT, Yardley DA, et al. Chemotherapy-related amenorrhea (CRA) after adjuvant ado-trastuzumab emtansine (T-DM1) compared to paclitaxel in combination with trastuzumab (TH)(TBCRC033: ATEMPT Trial). Breast Cancer Res Treat. 2021;189(1):103–10.CrossRefPubMed Ruddy KJ, Zheng Y, Tayob N, Hu J, Dang CT, Yardley DA, et al. Chemotherapy-related amenorrhea (CRA) after adjuvant ado-trastuzumab emtansine (T-DM1) compared to paclitaxel in combination with trastuzumab (TH)(TBCRC033: ATEMPT Trial). Breast Cancer Res Treat. 2021;189(1):103–10.CrossRefPubMed
20.
go back to reference MagalhãesFilho MA, Aguiar PN Jr, Neves MB, et al. Cost-effectiveness analysis of Ado-trastuzumab emtansine for the treatment of residual invasive HER2-positive breast cancer. Einstein (São Paulo). 2022;20:eGS6655.CrossRef MagalhãesFilho MA, Aguiar PN Jr, Neves MB, et al. Cost-effectiveness analysis of Ado-trastuzumab emtansine for the treatment of residual invasive HER2-positive breast cancer. Einstein (São Paulo). 2022;20:eGS6655.CrossRef
22.
go back to reference Von Minckwitz G, Huang CS, Mano MS, Loibl S, Mamounas EP, Untch M, et al. Trastuzumab emtansine for residual invasive HER2-positive breast cancer. N Engl J Med. 2019;380(7):617–28.CrossRef Von Minckwitz G, Huang CS, Mano MS, Loibl S, Mamounas EP, Untch M, et al. Trastuzumab emtansine for residual invasive HER2-positive breast cancer. N Engl J Med. 2019;380(7):617–28.CrossRef
23.
go back to reference US FDA. FDA approves ado-trastuzumab emtansine for early breast cancer. Silver Spring, MD: US FDA; 2019. US FDA. FDA approves ado-trastuzumab emtansine for early breast cancer. Silver Spring, MD: US FDA; 2019.
Metadata
Title
Adjuvant Trastuzumab Emtansine Versus Paclitaxel and Trastuzumab in Stage I HER2-Positive Breast Cancer: The ATEMPT Trial
Authors
Monica N. Khattak, DO
Anna M. Chichura, MD
Julie E. Lang, MD
Publication date
21-12-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-14766-9

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