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Adding the brain-penetrant HER2 pill tucatinib to trastuzumab and capecitabine lengthened survival in heavily pretreated HER2-positive metastatic breast cancer, and uniquely the trial included patients with active brain metastases, who also benefited.
Phase 3 placebo-controlled trial of 612 patients with HER2-positive metastatic breast cancer previously treated with trastuzumab, pertuzumab and T-DM1, randomised 2:1 to tucatinib or placebo with trastuzumab and capecitabine; nearly half had brain metastases, including untreated or progressing lesions.
Overall survival at two years was 44.9 percent with tucatinib against 26.6 percent with placebo (hazard ratio 0.66); progression-free survival among patients with brain metastases at one year was 24.9 versus 0 percent.
Tucatinib-based therapy is the standard for HER2-positive disease with active brain metastases and a standard later-line option overall; it was the first trial to enrol progressing brain metastases and show a systemic drug helps them.
Shares HER2CLIMB, HER2-positive breast cancer with brain metastases, Tucatinib, Trastuzumab.
Shares HER2CLIMB, HER2-positive breast cancer with brain metastases, Tucatinib, Trastuzumab.
Shares Tucatinib, Trastuzumab, Capecitabine.
Shares HER2-positive breast cancer with brain metastases, Tucatinib, Trastuzumab.
Shares HER2CLIMB, HER2-positive breast cancer with brain metastases, Tucatinib.
Shares Tucatinib, Trastuzumab, Capecitabine.
Shares Tucatinib, Trastuzumab.
Shares HER2-positive breast cancer with brain metastases, Tucatinib.