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HER2CLIMB Trial Introduces Tucatinib Combination Therapy

HER2CLIMB Trial Introduces Tucatinib Combination Therapy
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Published on October 29, 2020

New Combination Therapy for HER2+ Metastatic Breast Cancer Patients

It’s estimated that there are more than 168,000 people living with metastatic breast cancer in the United States, according to the Susan G. Komen Foundation.1 While metastatic breast cancer is not curable, it is treatable. New and combined therapies are improving the quality of life and extending life spans for some patients.

Up to 50 percent of people with HER2+ metastatic breast cancer (MBC) will develop brain metastases. A recent study showed how the drug tucatinib (Tukysa) affected progression-free survival (PFS) in patients with HER2+ metastatic breast cancer with brain metastases. This oral therapy was approved by the U.S. Food & Drug Administration (FDA) in April 2020 for patients with late-stage breast cancer who have been through several lines of therapy.2 HER2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2). This protein promotes the growth of cancer cells. 

Metastatic breast cancer, also called stage IV, indicates that the cancer has spread to other parts of the body, including the brain, liver and bones. The goal of the oncology team will be to stabilize and stop the cancer from progressing any further.Treatments for HER2+ Breast Cancer

New Tucatinib Combination Therapy Proves Successful In HER2CLIMB Trial

The results of the HER2CLIMB trial showed that tucatinib (Tukysa) with trastuzumab (Herceptin) and capecitabine (Xeloda) reduced the risk of brain metastases progression and death in patients with HER2-positive metastatic breast cancer. People with all types of brain metastases (active or stable) showed improvement on this treatment.  

The HER2CLIMB trial was for patients with HER2-positive metastatic breast cancer previously treated with trastuzumab, pertuzumab, and trastuzumab emtansine. At baseline, 291 patients had brain metastases in the tucatinib arm of the trial and 93 in the control arm. Of the 117 patients who had stable brain metastases, the risk of disease progression or death was reduced by 44 percent in the tucatinib arm. PFS was 7.5 months in the tucatinib arm versus 5.0 months in the control arm.

In 174 patients with brain metastases, the risk of disease progression or death was reduced by 62 percent in the tucatinib arm. PFS was 7.6 months in the tucatinib arm versus 4.1 months in the control arm. In the 66 patients with untreated brain metastases, risk of disease progression or death was reduced by 53 percent in the tucatinib arm; median PFS was 6.9 months in the tucatinib arm versus 3.6 months in the control arm. The bottom line? Patients with active brain metastases (typically excluded from HER2+ metastatic breast cancer trials) had substantially longer progression-free survival with tucatinib treatment.3

Living with Metastatic Breast Cancer

Metastatic breast cancer is often misunderstood by those unfamiliar with the disease. Unlike some cancers, even other types of breast cancer, MBC patients will never be “done” with treatment. For some, living with an incurable disease means finding their joy.

“You just have to find what gives you joy,” said Shonte Drakeford, MSN, CRNP, AGNP-C, in a Patient Power interview. Shonte was diagnosed with metastatic breast cancer when she was 31 years old. “I can't control this disease, so I just live the best way that I can,” she added. “And I just kind of do things that I can do until I'm not able to do it anymore. I like to snowboard. I like to hike. I like to spend time with my friends.”

Questions to Ask Your Doctor

  • What type of breast cancer do I have?
  • What stage is my breast cancer?
  • What grade is my breast cancer?
  • What clinical trials are available?
  • Can I have my pathology report to get a second opinion?
  • Do you have a patient navigator available to me?
  • What is my prognosis?

Understanding the cancer type and stage can help you navigate your cancer journey and empower you to make the best decisions as a patient.

~Lauren Evoy Davis

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References:

1Metastatic breast cancer. Susan G. Komen.

2FDA approves tucatinib for patients with HER2-positive metastatic breast cancer. FDA. April 2020.

3Bachelot T, Lin NU, R.K. Murthy, et al. Impact of tucatinib on progression free survival in patients with HER2+ metastatic breast cancer and stable or active brain metastases. Annals of Oncology. 2020; 31 (suppl_4): S348-S395.


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