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Pertuzumab

About: Pertuzumab is a research topic. Over the lifetime, 1453 publications have been published within this topic receiving 73219 citations. The topic is also known as: 2C4 Antibody & MOAB 2C4.


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Journal ArticleDOI
TL;DR: Improved pCR in HER2-positive breast cancer could lead to regulatory approval of novel agents in this disease, and dual HER2 blockade strategies could also become standard of care in other settings.
Abstract: During the last decade, the introduction of agents that target the human epidermal growth factor receptor 2 (HER2), such as the monoclonal antibody trastuzumab (Herceptin; Roche, Basel, Switzerland) or the tyrosine kinase inhibitor lapatinib (Tykerb; GlaxoSmithKline, Research Triangle Park, NC), in combination with chemotherapy, has changed the course of HER2-positive breast cancer. In the metastatic setting, the addition of trastuzumab to taxanes increases progression-free survival (PFS) and overall survival (OS), whereas the addition of lapatinib to capecitabine increases PFS after treatment with regimens that include an anthracycline, a taxane, and trastuzumab. In the adjuvant setting, trastuzumab increases diseasefree survival and OS. In addition to these impressive advances, clinical research to improve the outcome in HER2-positive breast cancer is as vibrant as it has ever been. A number of important questions are being addressed at this time, including the delineation of the role of neoadjuvant (presurgical) therapy, theconceptofdualHER2receptorblockade, theidentificationof markers of sensitivity or resistance to therapy, and, finally, the study of new agents. As reported in the article that accompanies this editorial, the timely Neoadjuvant Translational Breast Cancer Research Consortium 006 (TBCRC 006) trial by Rimawi et al has addressed three of these questionsandhas identifiedonemorepiece in thepuzzle: the importance ofaddinghormonal therapyinthesubsetofpatientswithHER2-positive/ hormone receptor (HR) –positive tumors. To place this study in context, let us look at what we know today. In the neoadjuvant setting, the addition of trastuzumab to chemotherapy and maintenance for 1 year increases pathologic complete response (pCR) rates and 3-year event-free survival (EFS). And there is increasing evidence that there is a good correlation between pCR and EFS in HER2-positive disease, which has led to the acceptance of pCR as the primary end point in a number of neoadjuvant studies. If some of these studies, such as the Neo-Adjuvant Lapatinib and/or Trastuzumab Treatment Organisation (NeoALTTO) study, further confirm that pCR is a surrogate marker of EFS, improved pCR in HER2-positive breast cancer could lead to regulatory approval of novel agents in this disease. In terms of dual HER2 blockade, laboratory studies have shown that a more complete blockage of the HER2 and/or the HER signaling pathway by combining two or three inhibitors with nonoverlapping mechanisms of action improves cell death and tumor shrinkage in HER2-positive models. These preclinical findings have now been confirmed in the clinical setting. Trastuzumab and lapatinib (or trastuzumab and pertuzumab [Perjeta; Genentech, South San Francisco, CA], a humanized monoclonal antibody binding to the HER2 dimerization domain), in combination with chemotherapy, results in pCR rates of 45.8% to 51.3% compared with pCR rates of 24.0% to 29.5% with a single anti-HER2 agent combined with the same chemotherapy schedule. Moreover, the addition of pertuzumab to trastuzumab and docetaxel increases PFS and OS in first-line metastatic HER2-positive disease. These results have led to regulatory approval of pertuzumab and have placed the dual HER2 blockade with pertuzumab and trastuzumab in combination with chemotherapy as the standard of care in first-line metastatic disease. Furthermore, dual HER2 blockade strategies could also become standard of care in other settings. For example, the ongoing Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation (ALTTO) phase III trial is evaluating the adjuvant dual HER2 blockade with trastuzumab and lapatinib afterchemotherapy,andAStudyofPertuzumabinAdditiontoChemotherapy and Herceptin (Trastuzumab) As Adjuvant Therapy in Patients With HER2-Positive Primary Breast Cancer (APHINITY), a phase III trial, is also currently evaluating adjuvant trastuzumab and pertuzumab with chemotherapy. Given that the dual HER2 blockade is more efficacious that single-agent HER2 therapy, a question that arises is whether the dual blockade may eliminate the need for chemotherapy in a subset of patients. In support of this proposal, the dual HER2 blockade without chemotherapy has shown high activity in a group of patients with metastatic and primary HER2-positive breast cancer. In HER2-positive metastatic breast cancer that was previously treated with trastuzumab, the addition of pertuzumab or lapatinib to trastuzumab showed higher clinical benefit than either pertuzumab or lapatinib alone. In treatment-naive JOURNAL OF CLINICAL ONCOLOGY E D I T O R I A L VOLUME 31 NUMBER 14 MAY 1

26 citations

Journal ArticleDOI
14 Jul 2021
TL;DR: Pertuzumab increases the risk of clinical HF, but not asymptomatic/minimally symptomatic left ventricular systolic dysfunction, in HER2-positive cancer patients, in a systematic review and meta-analysis of phase 2 and 3 randomized controlled trials.
Abstract: Background: HER2 over-expressing malignancies, including breast and gastro-esophageal, are associated with a poor prognosis. The cardiotoxicity of trastuzumab, a HER2-targeting monoclonal antibody, is well established. However, the cardiotoxic effect of pertuzumab, another HER2-directed therapy, is less well documented. The objective of this systematic review and meta-analysis was to determine the risk of cardiac events in patients with HER2 positive cancer receiving pertuzumab. Methods: We performed a systematic review of phase 2 and 3 randomized controlled trials (RCTs) in which the addition of pertuzumab to other standard therapies in patients with stage I-IV HER2 positive cancer was evaluated and cardiac adverse effects reported. We searched Medline (1946-2020), Embase (1974-2020), and CENTRAL. Two independent reviewers assessed the risk of bias and extracted the data. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated from the pooled data using the inverse variance method and random-effects models. Results: Eight RCTs (8420 patients) were included: 1 gastro-esophageal; and 7 breast cancer trials. Participants’ median age ranged from 49 to 61.5 years. All participants received trastuzumab and chemotherapy in addition to pertuzumab or placebo. Compared with placebo, pertuzumab increased the risk of clinical heart failure (HF) [RR (95% CI): 1.97 (1.05-3.70); I2 = 0%]. However, pertuzumab had no demonstrable effect on asymptomatic/ minimally symptomatic left ventricular systolic dysfunction (LVSD) [RR (95% CI): 1.19 (0.89 to 1.61); I2 =19%]. Conclusions: Pertuzumab increases the risk of clinical HF, but not asymptomatic/ minimally symptomatic LVSD, in HER2 positive cancer patients. Further research into the mechanisms underlying pertuzumab-related HF is needed to understand its clinical spectrum of cardiotoxicity.

26 citations

Journal ArticleDOI
TL;DR: The cocktail of the three anti-HER2 scFv-I, scF v-II, and scFV-III, which induces high growth inhibition in breast cancer cells and downregulates HER2 gene and protein expression, can be considered as a new alternative for targeting of HER2-positive breast cancers.
Abstract: Dual therapy targeting human epidermal growth factor receptor 2 (HER2) by pertuzumab and trastuzumab (Herceptin) resulted in the significant survival of patients with HER2-positive breast cancers. However, a number of HER2-overexpressing breast cancers escape from this combination therapy. Due to several advantages of human single-chain antibodies (single chain variable fragments (scFvs)), these molecules were approved as valuable alternatives to entire IgGs for molecular targeting. In this study, our aim was to evaluate the growth inhibitory effects of three novel human anti-HER2 scFvs on breast cancer cells either alone or in combination and to assess their influence on HER2 expression in these cells. Flow cytometry was performed to show the cell binding ability of the scFvs to HER2-overexpressing cell lines, BT-474 and SKBR-3 cells, and HER2 low-expressing cell line, HeLa cells. The antiproliferative effects of the antibodies on the cancer cells were assessed by MTT assay. The amounts of HER2 gene and protein expression after antibody treatments were determined by quantitative real-time PCR and western blotting, respectively. FACS analysis showed that the anti-HER2 scFvs bound to BT-474 and SKBR-3 cells significantly higher than HeLa cells. Growth inhibitory assessment demonstrated that the triple blockade of HER2 by a cocktail of the three anti-HER2 scFvs significantly inhibited the proliferation of the both cancer cells to a greater extent than scFvs individually, in dual combination (scFv-I and scFv-III), and Herceptin. The percentages of growth inhibition of BT-474 and SKBR-3 cells after treatment with the cocktail were up to 77.4 and 76.5 %, respectively. The three scFv antibodies also reduced HER2 expression at both the gene and protein levels individually and in combination. Our results suggest that the cocktail of the three anti-HER2 scFv-I, scFv-II, and scFv-III, which induces high growth inhibition in breast cancer cells and downregulates HER2 gene and protein expression, can be considered as a new alternative for targeting of HER2-positive breast cancers.

26 citations

Journal ArticleDOI
TL;DR: Clinical assessment of radiolabeled trastuzumab and anti-HER2 affibody molecule demonstrated potential to identify new lesions but both agents lacked sensitivity and highlighted the need for improved pharmacokinetics.
Abstract: Molecular imagings of hEGF receptor 2 (HER2) using radiolabeled tracers has the potential to determine the extent of HER2-positive disease and could be of great clinical value. HER2 overexpression affects 20-25% of breast cancer patients, conferring a worse prognosis. HER2 status determines choice and response to therapy but can change in response to treatment and during disease progression. Anti-HER2 agents in development for molecular imaging include immunoglobulins (trastuzumab and pertuzumab), immunoglobulin fragments, F(ab´)2, diabodies, nanobodies and nonimmunoglobulin scaffolds, affibody and designed ankyrin-repeat proteins. Clinical assessment of radiolabeled trastuzumab and anti-HER2 affibody molecule demonstrated potential to identify new lesions but both agents lacked sensitivity and highlighted the need for improved pharmacokinetics. New tracers in the pipeline showed preclinical promise and could potentially improve sensitivity.

26 citations

01 Jan 2015
TL;DR: In this article, pertuzumab was shown to have potent antitumor activity in biliary tract carcinoma (BTC) cells co-overexpressing HER2 and HER3.
Abstract: Background Pertuzumab is a humanized monoclonal antibody that binds to HER2 at an epitope that prevents HER2 from dimerizing with ligand-activated HER-family receptors. To assess the potential of pertuzumab as a new therapy, the expression status of HER family members was determined in biliary tract carcinoma (BTC), and the antitumor activity of pertuzumab was investigated by assessing the inhibition of BTC cell growth. Methods The expression status of HER family members in 113 archival specimens of BTC was analyzed by using immunohistochemistry and fluorescence in situ hybridization. Using ten BTC cell lines, heregulin-alpha (HRG-a) stimulated cell proliferation and its inhibition by pertuzumab was tested in vitro. The phosphorylated HER family proteins and their respective downstream molecules were analyzed. In vivo antitumor activity of pertuzumab was evaluated in a xenograft model. Results Protein overexpression of HER2 and/or HER3 was observed in 23–34 % of the specimens and gene amplification in 17–27 %. Seven of the ten cell lines showed HER2 and/or HER3 protein overexpression and gene amplification, and HRG-a stimulated cell proliferation was observed in four of the ten cell lines. In a BTC cell line co-overexpressing HER2 and HER3, pertuzumab potently inhibited the HRG-a stimulated cell proliferation in a dose-dependent manner, and completely blocked the phosphorylation of HER3. Suppression of downstream pathway molecules including p-AKT was also observed. Pertuzumab inhibited the in vivo growth of subcutaneous tumors, and increased the number of apoptotic cancer cells. Conclusions Pertuzumab exerts potent antitumor activity in BTC cells co-overexpressing HER2 and HER3. Pertuzumab provides a new therapeutic option against BTC.

26 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
2023372
2022307
2021158
2020144
2019143
2018130