7/31/2023 0 Comments T dm1 breast cancer![]() There were mechanisms of resistance due to transporters and the efflux of the emtansine out of the cell causing a decrease in the HER2 expression. Sarah Donahue, MPH, NP, AOCNP: Do you have any thoughts on why T-DM1 did not show efficacy in gastric cancer as it did with breast cancer?Įlizabeth Prechtel Dunphy, DNP, CRNP, AOCN: There’s some potential thought that was seen in some preclinical models. The most common for trastuzumab emtansine were anemia at around 26% and thrombocytopenia at around 11% ,compared to the taxane-treated arm, where the incidence of neutropenia was 39% and anemia was 18%. In the trastuzumab emtansine group, the patients had lower incidence of grade 3 or more adverse events. In this study, trastuzumab emtansine was not superior to taxane therapy in patients previously treated with HER2-positive advanced gastric cancer, with the median overall survival being 7.9 months in trastuzumab emtansine for the 2 to 4 mg/kg group, and 8.6 months with the taxane-treated patients. With this stage, 153 patients were added in that arm of the study, and in the taxane-treated arm, there were an additional 80 patients. In the second stage of the study, the dose levels were 2 to 4 mg of the trastuzumab emtansine given weekly. In the initial stage, there were 2 dosing levels for the trastuzumab emtansine, with 70 patients assigned to receive 3 to 6 mg/kg every 3 weeks, 75 patients to receive trastuzumab emtansine 2 to 4 mg/kg weekly, and 37 patients to receive taxane therapy. Liz, can you briefly discuss the results of the GATSBY trial, which evaluated T-DM1 in gastric cancer?Įlizabeth Prechtel Dunphy, DNP, CRNP, AOCN: In the GATSBY trial, trastuzumab emtansine was compared with taxane therapy. ![]() It is something that I will continue to use with patients who are HER2-positive. Patients can live their lives normally while they’re on it, so it’s a great treatment to offer patients and it has great control over their disease. ![]() It’s really well tolerated generally, it has very little nausea, little fatigue. I would definitely consider using it after trastuzumab deruxtecan for our newer patients who are going into their second lines of therapy. Sarah Donahue, MPH, NP, AOCNP: Considering other therapies for use in later lines, where do you find the clinical utility of T-DM1 ? For which patients would you consider continuing to use T-DM1 in the potential second- or specifically third-line settings? In my group, we use T-DM1, we have many patients still on it in their second-line setting because trastuzumab deruxtecan was just approved. ![]()
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