October 3, 2022

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Can ADC drug effectively treat brain metastases from breast cancer?

Can ADC drug effectively treat brain metastases from breast cancer?



 

Can ADC drug effectively treat brain metastases from breast cancer? 

Breast cancer , whose incidence rate ranks first among female malignant tumors for many years, is called “pink killer”.

According tothe 2020 global cancer burden data released by the World Health Organization’s International Agency for Research on Cancer (IARC) , breast cancer has replaced lung cancer as the number one cancer in the world. In some countries, the incidence of breast cancer is also increasing year by year.

 

What’s more, breast cancer is prone to metastases . Not only that, many breast cancer patients are insensitive to chemotherapy, targeted therapy and immunotherapy, which greatly affects the patient’s treatment prognosis.

 

On August 8, 2022, researchers from the Medical University of Vienna published a research paper entitled: Trastuzumab deruxtecan in HER2-positive breast cancer with brain metastases: a single-arm, phase 2 trial in the top international medical journal Nature Medicine.

 

This phase 2 clinical trial confirmed that the HER2-targeting antibody-drug conjugate (ADC) drug Trastuzumab deruxtecan can effectively treat and even clear brain metastases in patients with HER2-positive breast cancer.

 

This study opens up a new avenue for oncology research and targeted therapy, and is a pioneering study in the treatment of cancer brain metastases.

 

Can ADC drug effectively treat brain metastases from breast cancer?

 

 

Trastuzumab deruxtecan , trade name Enhertu®, or T-DXd for short. It is an antibody-drug conjugate (ADC)jointly developed by AstraZeneca and Daiichi Sankyo , which was approved by the FDA in 2019 for the treatment of patients with unresectable or metastatic HER2-positive breast cancer .

This ADC drug is to link the HER2 monoclonal antibody Trastuzumab(trastuzumab) with the topoisomerase 1 inhibitor exatecan derivative(DXd), thereby blocking the HER2 protein while playing a chemical toxin for anti-cancer effect.

 

Can ADC drug effectively treat brain metastases from breast cancer?Enhertu costs around $14,000/month

 

The Phase 2 clinical trial involved 15 patients (14 women, 1 man) with HER2-positive breast cancer with brain metastases. The research team used this ADC drug for treatment.

 

Breast cancer is the most common cancer in women, but men also suffer from breast cancer (male breast cancer accounts for less than 1% of breast cancers) , and 15% of breast cancers are HER2-positive breast cancers, which are prone to metastases, And 50% of it goes to the brain.

 

The clinical trial results showed that after treatment, brain metastases shrank in 11 of 15 patients (73.3%) , and brain metastases disappeared completely in 2 patients (13.3%) .

 

Can ADC drug effectively treat brain metastases from breast cancer?

 

 

In addition to this extremely positive treatment outcome, the team found that the drug was well tolerated, with no deterioration in participants’ brain function or quality of life during treatment.

 

The research team said that this latest study opens up a new avenue for clinical research and treatment of breast cancer brain metastases, and further research will be conducted to explore its effect in the treatment of other types of cancer metastases.

 

It is worth mentioning that on June 5, 2022, the New England Journal of Medicine (NEJM) published a study of Trastuzumab Deruxtecan in the treatment of HER2-low expression ( HER2-Low) phase 3 clinical trial in patients with advanced breast cancer.

 

This phase 3 clinical trial showed that compared with patients receiving standard chemotherapy,Trastuzumab Deruxtecan extended progression-free survival by approximately 50% and overall survival by 40% in patients with HER2-low-expressing advanced breast cancer .

 

Can ADC drug effectively treat brain metastases from breast cancer?

 

 

This is the first time it has been demonstrated that drugs can target the low-expressed HER2 protein and exert a cancer treatment effect .

About half of patients with breast cancers previously thought to be HER2-negative are actually HER2 -low (HER2-low) breast cancers, meaning they could benefit from this ADC drug.

This opens up new treatment possibilities for thousands of patients with advanced breast cancer.

 

 

 

Reference:
https://www.nature.com/articles/s41591-022-01935-8
https://www.nejm.org/doi/full/10.1056/NEJMoa2203690?query=featured_home

Can ADC drug effectively treat brain metastases from breast cancer?

(source:internet, reference only)


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